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Orts-Cortés MI, Cabañero-Martínez MJ, Meseguer-Liza C, Arredondo-González CP, de la Cuesta-Benjumea C, Abad-Corpa E. Effectiveness of nursing interventions in the prevention of falls in older adults in the community and in health care settings: A systematic review and meta-analysis of RCT. Enferm Clin (Engl Ed) 2024; 34:4-13. [PMID: 38185371 DOI: 10.1016/j.enfcle.2024.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Accepted: 08/09/2023] [Indexed: 01/09/2024]
Abstract
OBJECTIVE To estimate the effectiveness of fall prevention programs in people aged 65 years and older involving nursing professionals. METHODS We included available full-text randomized clinical trials on nurse-led prevention of falls in the community in people over 65 years of age and reporting the incidence of such falls. An extensive search was performed in 14 databases covering the period 2016-2018 for publications in English, French, Portuguese and Spanish. The quality of the papers was assessed independently and blindly by reviewers working in pairs using the risk of bias dominios of the Cochrane Collaboration. The hazard ratio was used as a measure of the effect size of the incidence of falls. A random-effects model was assumed for statistical analyses. The influence of moderator variables of the studies on the effect sizes was performed using ANOVAs and its 95% CI for each moderator category. RESULTS A total of 31 randomized clinical trials were selected with 25,551 participants. The most frequent type of intervention was education (57.1%), followed by multifactorial models (37.1%). The probability of falling was significantly reduced by 13% in the intervention groups compared to the control groups (RR+=0.87). Multifactorial (RR+=0.89) and education-based (RR=+0.84) interventions significantly reduced the probability of falls by 11% and 16%, respectively. CONCLUSIONS Discarding publication bias prevention programs carried out by nurses produce a significant 10% reduction in falls. Education-based and multifactorial interventions are the most effective when conducted by nurses.
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Affiliation(s)
- María Isabel Orts-Cortés
- Department of Nursing, University of Alicante, Alicante Institute for Health and Biomedical Research (ISABIAL), Alicante, Nursing and Healthcare Research Unit (Investén-ISCIII), CIBER of Frailty and Healthy Aging (CIBERFES) Instituto de Salud Carlos III, Madrid, Spain
| | - María José Cabañero-Martínez
- Department of Nursing, University of Alicante, Alicante Institute for Health and Biomedical Research (ISABIAL), Alicante, Spain
| | - Cristóbal Meseguer-Liza
- Adjunct Professor of Nursing, University of Murcia, Nurse Murcia Health Service, Murcia, Spain
| | | | | | - Eva Abad-Corpa
- University of Murcia, Nurse, Murcia Health Service, IMIB-Arrixaca. Murcia, Nursing and Healthcare Research Unit (Investén-ISCIII), CIBER of Frailty and Healthy Aging (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain.
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Abad-Corpa E, Guillén-Ríos JF, Pastor-Bravo MDM, Jiménez-Ruiz I. Assessment of high fidelity simulation with actors in palliative care in nursing students: a mixed methods study. Enferm Clin (Engl Ed) 2023; 33:401-411. [PMID: 37898170 DOI: 10.1016/j.enfcle.2023.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 09/27/2023] [Indexed: 10/30/2023]
Abstract
OBJECTIVE The most effective training methods are experiential, including those focused on experiences and emotions. Clinical simulation, especially high-fidelity simulation, is one of the most effective methodologies for the acquisition of competencies in care like palliative care. The simulation with actors can train future healthcare science professionals: in technical, intellectual, or interpersonal skills. The objective is to evaluate high-fidelity simulation with actors as a tool in palliative care training for nursing students. METHOD Over three years, the study was conducted in a Faculty of Nursing of the south of Spain with nursing students. A mixed methods study with sequential explanatory design in three moments was conducted: (1) Quasi-experimental study in a single group (n = 12) before and after attending the palliative care course with Clinical Simulation with actors to assess the communication skills (CICAA scale), (2) Qualitative study with phenomenological perspective after Clinical Simulation (174 reflective students' narratives), (3) Cross-sectional observational study, one year later, to assess the transfer of knowledge and skills to the clinical practice (71 students). RESULTS Students who interacted with actors in Clinical Simulation improved their communication skills and the ability to establish an effective helping relationship with both end-of-life patients and their families. The students perceived the Clinical Simulation as an innovative learning methodology that is useful to encourage reflection and transfer of learning during their clinical internship. CONCLUSIONS Standardization of the use of active learning methodologies is recommended for a better acquisition of transversal skills such as communication skills in palliative care.
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Affiliation(s)
- Eva Abad-Corpa
- Departamento de Enfermería, Facultad de Enfermería, Universidad de Murcia, El Palmar, Murcia, Spain; ENFERAVANZA, Instituto Murciano de Investigación Biosanitaria (IMIB-Pascual Parrilla), El Palmar, Murcia, Spain; Hospital General Universitario Reina Sofía, Servicio Murciano de Salud, Murcia, Spain; Unidad de Investigación en Cuidados de la Salud (Investén-ISCIII), Centro de Investigación Biomédica en Red Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain
| | - Juan Francisco Guillén-Ríos
- Departamento de Enfermería, Facultad de Enfermería, Universidad de Murcia, El Palmar, Murcia, Spain; Residencia de personas mayores San Basilio, Instituto Murciano de Acción Social, Murcia, Spain.
| | - María Del Mar Pastor-Bravo
- Departamento de Enfermería, Facultad de Enfermería, Universidad de Murcia, El Palmar, Murcia, Spain; ENFERAVANZA, Instituto Murciano de Investigación Biosanitaria (IMIB-Pascual Parrilla), El Palmar, Murcia, Spain
| | - Ismael Jiménez-Ruiz
- Departamento de Enfermería, Facultad de Enfermería, Universidad de Murcia, El Palmar, Murcia, Spain; ENFERAVANZA, Instituto Murciano de Investigación Biosanitaria (IMIB-Pascual Parrilla), El Palmar, Murcia, Spain
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González-Pisano AC, Company-Sancho MC, Abad-Corpa E, Solé-Agusti MC, Cidoncha-Moreno MÁ, González MMP. Relationship between Falls and the Use of Medications and Diseases in an Otago Exercise Programme in Old People Living in the Community in Spain. Healthcare (Basel) 2023; 11:healthcare11070998. [PMID: 37046925 PMCID: PMC10093805 DOI: 10.3390/healthcare11070998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 03/16/2023] [Accepted: 03/17/2023] [Indexed: 04/03/2023] Open
Abstract
(1) Background: Falls are a significant health problem among older adults, and can result in severe injuries, disability, and even death. In Spain, the prevalence of falls is lower if the person lives in the community than if they are institutionalized. Research has shown that exercise is an effective strategy for reducing the risk of falls among older adults. The objective of this study was to study the influence of a multicomponent exercise intervention on falls in people between 65 and 80 years of age despite the presence of diseases and drug use that are risk factors for falls; (2) Methods: This is a quasi-experimental study that focuses on people aged 65–80 who attended 21 primary healthcare centres. Target: Inclusion criteria were people between 65 and 80 years of age, living in the community with independent ambulation, and who were served by the healthcare centre of their region. Variables analysed: The number and characteristics of falls, sociodemographic, drug use, and previous diseases; (3) Results: The drugs associated with falls are benzodiazepines (OR 2.58), vasodilators (OR = 2.51), and psychotropics (OR = 1.61). For one of the years, a relationship was found between the consumption of antidepressants and falls (OR = 1.83). The associated diseases were mental and behavioural (OR = 2.53); (4) Discussion: The intervention has been related to the reduction in falls in people who consumed benzodiazepines, vasodilators, and psychotropics and in people with mental disorders; (5) Conclusion: This research concludes the importance of the implementation of the Otago Exercise Programme in the prevention of falls in the elderly.
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Affiliation(s)
- Ana Covadonga González-Pisano
- Research Group “Community Health and Active Aging”, Biosanitary Research Institute of the Principality of Asturias, Primary Care, Ministry of Health, Asturias, 33006 Oviedo, Spain
| | - Maria Consuelo Company-Sancho
- Health Promotion Service, Directorate General for Public Health, Canary Islands Health Service, 35003 Las Palmas de Gran Canaria, Spain
| | - Eva Abad-Corpa
- Nursing and Healthcare Research Unit (Investén-Isciii), CIBER of Frailty and Healthy Aging (CIBER-FES), 30011 Murcia, Spain
| | | | | | - Marta M Pisano González
- General Direction of Care, Humanization and Social and Health Care, Principado de Asturias, Biosanitary Research Institute of the Principality of Asturias, Ministry of Health, 33006 Oviedo, Spain
- Correspondence:
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Ros-Sanchez T, Lidon-Cerezuela MB, Lopez-Benavente Y, Abad-Corpa E. Promoting empowerment and self-care in older women through participatory action research: Analysis of the process of change. J Adv Nurs 2023; 79:2224-2235. [PMID: 36790038 DOI: 10.1111/jan.15573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 11/02/2022] [Accepted: 01/04/2023] [Indexed: 02/16/2023]
Abstract
AIM To generate and understand the process of change in the empowerment of women from 60 to 80 years old through a Participatory Action Research. SPECIFIC AIM To analyse the women participants' experiences concerning empowerment and self-care. DESIGN We use the Participatory Action Research approach (in its critical option) in the Socio-critical Paradigm and applying the Kemmis and McTaggart Model. METHODS A group of 10 women participants from 60 to 80 years old was created and developed the Participatory Action Research from June 2019 to May 2020. This group was involved in 22 group sessions, individual interviews, reflective diaries and triangulation with quantitative data. RESULTS Findings were interpreted based on the Gestalt Self Theory. Women generated changes in their empowerment based on three characteristics (self-determination, self-esteem and self-confidence) and, consequently, in their self-care. They did so according to two distinct patterns of behaviour: Leader women and follower women. The former took the lead in transforming their realities and the latter observed them and evolved in a slower and more reflective manner. These changes had an impact on the most individual level (inner world) and went beyond that barrier, modifying in turn their immediate surroundings and the social level (outer world). CONCLUSIONS The group of older women began to consider their needs and consider themselves as important once they worked on their self-determination, self-esteem and self-confidence; we show these are key aspects to work on their empowerment and promote their self-care. IMPACT The patterns of behaviour and dimensions of empowerment detected may help in future research designs and emancipatory community interventions in this population group.
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Affiliation(s)
- Tania Ros-Sanchez
- Department of Nursing, Servicio Murciano de Salud (Murcian Health Service), ENFERAVANZA IMIB-Arrixaca, International Doctoral School of the University of Murcia, Murcia, Spain
| | | | - Yolanda Lopez-Benavente
- Primary Care Nursing, Area VII Murcia-East Murcia, Servicio Murciano de Salud (Murcian Health Service), ENFERAVANZA IMIB-Arrixaca, Murcia, Spain
| | - Eva Abad-Corpa
- Department of Nursing, University of Murcia, Reina Sofía Hospital, Servicio Murciano de Salud (Murcian Health Service), ENFERAVANZA IMIB-Arrixaca, Investén-isciii, CIBERFES, Murcia, Spain
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Bellon F, Stremler R, Rubinat-Arnaldo E, Padilla-Martínez JM, Casado-Ramirez E, Sánchez-Ortuño M, Gea-Sánchez M, Martin-Vaquero Y, Moreno-Casbas T, Abad-Corpa E. Sleep quality among inpatients of Spanish public hospitals. Sci Rep 2022; 12:21989. [PMID: 36539518 PMCID: PMC9764317 DOI: 10.1038/s41598-022-26412-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Accepted: 12/14/2022] [Indexed: 12/24/2022] Open
Abstract
Sleep is a complex process and is needed both in health and illness. Deprivation of sleep is known to have multiple negative physiological effects on people's bodies and minds. Despite the awareness of these harmful effects, previous studies have shown that sleep is poor among hospitalised patients. We utilized an observational design with 343 patients recruited from medical and surgical units in 12 hospitals located in nine Spanish regions. Sociodemographic and clinical characteristics of patients were collected. Sleep quality at admission and during hospitalisation was measured by the Pittsburgh Sleep Quality Index. Sleep quantity was self-reported by patients in hours and minutes. Mean PSQI score before and during hospitalisation were respectively 8.62 ± 4.49 and 11.31 ± 4.04. Also, inpatients slept about an hour less during their hospital stay. Lower educational level, sedative medication intake, and multi-morbidity was shown to be associated with poorer sleep quality during hospitalisation. A higher level of habitual physical activity has shown to correlate positively with sleep quality in hospital. Our study showed poor sleep quality and quantity of inpatients and a drastic deterioration of sleep in hospital versus at home. These results may be helpful in drawing attention to patients' sleep in hospitals and encouraging interventions to improve sleep.
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Affiliation(s)
- Filip Bellon
- grid.15043.330000 0001 2163 1432GESEC Group, Department of Nursing and Physiotherapy, Faculty of Nursing and Physiotherapy, University of Lleida, Montserrat Roig, 25198 Lleida, Spain ,Healthcare Research Group (GRECS), Institute of Biomedical Research Lleida (IRBLleida), Av. Alcalde Rovira Roure, 80, 25198 Lleida, Spain
| | - Robyn Stremler
- grid.17063.330000 0001 2157 2938Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON Canada ,grid.42327.300000 0004 0473 9646The Hospital for Sick Children (SickKids), Toronto, ON Canada
| | - Esther Rubinat-Arnaldo
- grid.15043.330000 0001 2163 1432GESEC Group, Department of Nursing and Physiotherapy, Faculty of Nursing and Physiotherapy, University of Lleida, Montserrat Roig, 25198 Lleida, Spain ,Healthcare Research Group (GRECS), Institute of Biomedical Research Lleida (IRBLleida), Av. Alcalde Rovira Roure, 80, 25198 Lleida, Spain ,grid.413448.e0000 0000 9314 1427Center for Biomedical Research on Diabetes and Associated Metabolic Diseases (CIBERDEM), Instituto de Salud Carlos III, Barcelona, Spain
| | - Julia M. Padilla-Martínez
- grid.10586.3a0000 0001 2287 8496University of Murcia-Murcia Health Service (IMIB-Arrixaca), Campus Universitario, 1, 30100 Murcia, Spain
| | - Elvira Casado-Ramirez
- grid.512898.f0000 0004 0593 3686Nursing and Healthcare Research Unit (Investén-Isciii), Av. Monforte de Lemos, 5. Pabellón 13, 28029 Madrid, Spain ,grid.512892.5Biomedical Research Center for Fragility and Healthy Aging (CIBERFES), Av. Monforte de Lemos, 5. Pabellón 11, 28029 Madrid, Spain
| | | | - Montserrat Gea-Sánchez
- grid.15043.330000 0001 2163 1432GESEC Group, Department of Nursing and Physiotherapy, Faculty of Nursing and Physiotherapy, University of Lleida, Montserrat Roig, 25198 Lleida, Spain ,Healthcare Research Group (GRECS), Institute of Biomedical Research Lleida (IRBLleida), Av. Alcalde Rovira Roure, 80, 25198 Lleida, Spain ,grid.512892.5Biomedical Research Center for Fragility and Healthy Aging (CIBERFES), Av. Monforte de Lemos, 5. Pabellón 11, 28029 Madrid, Spain
| | - Yolanda Martin-Vaquero
- Zamora Healthcare Complex, Zamora Health Care Management, Av. de Requejo, 35, 49022 Zamora, Spain
| | - Teresa Moreno-Casbas
- grid.512898.f0000 0004 0593 3686Nursing and Healthcare Research Unit (Investén-Isciii), Av. Monforte de Lemos, 5. Pabellón 13, 28029 Madrid, Spain ,grid.512892.5Biomedical Research Center for Fragility and Healthy Aging (CIBERFES), Av. Monforte de Lemos, 5. Pabellón 11, 28029 Madrid, Spain
| | - Eva Abad-Corpa
- grid.10586.3a0000 0001 2287 8496University of Murcia-Murcia Health Service (IMIB-Arrixaca), Campus Universitario, 1, 30100 Murcia, Spain ,grid.512892.5Biomedical Research Center for Fragility and Healthy Aging (CIBERFES), Av. Monforte de Lemos, 5. Pabellón 11, 28029 Madrid, Spain
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Bellon F, Beti-Abad A, Pastells-Peiró R, Casado-Ramirez E, Moreno-Casbas T, Gea-Sánchez M, Abad-Corpa E. Effects of nursing interventions to improve inpatients' sleep in intensive and non-intensive care units: Findings from an umbrella review. J Clin Nurs 2022; 32:1963-1978. [PMID: 35170142 DOI: 10.1111/jocn.16251] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 12/24/2021] [Accepted: 01/31/2022] [Indexed: 11/29/2022]
Abstract
AIM This review aimed to synthesise the available reviews on the effects of nursing interventions on sleep quality among patients hospitalised in intensive care and non-intensive care units. BACKGROUND Poor sleep quality is a common fact in hospitalised patients. Nurses can contribute to the improvement of patients' sleep quality and duration. DESIGN A review of intervention reviews was carried out and reported following the PRISMA guidelines and checklist. METHODS We systematically searched for reviews published from January 2009 to December 2019 in PubMed, CINAHL Plus, Scopus, Institute for Scientific Information Web of Science, Joanna Briggs Database of Systematic Reviews and Cochrane Central Register of Controlled Trials databases. Searches were repeated at 24 November 2020 to include the most recent evidence. A narrative synthesis of the results was conducted. RESULTS Nine reviews (representing 109 original papers) met the selection criteria and were included for critical appraisal. Overall, nursing interventions and sleep quality were poorly defined. We grouped the interventions into 3 categories (environmental, barrier and internal interventions) to provide a more comprehensive overview and examine effects of nursing interventions on inpatients sleep quality. Inconsistent results were obtained and low quality of the original articles was reported, making it difficult to establish absolute conclusions. CONCLUSION The impact of environmental changes on patients' sleep was positive but inconclusive, while use of earplugs and eye masks, music and acupuncture generally showed positive results with moderate quality of evidence, and no harmful effects were reported.
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Affiliation(s)
- Filip Bellon
- Department of Nursing and Physiotherapy, Faculty of Nursing and Physiotherapy, GESEC Group, University of Lleida, Lleida, Spain.,Healthcare Research Group (GRECS), Institute of Biomedical Research in Lleida (IRBLleida), Lleida, Spain
| | - Aintzane Beti-Abad
- Department of Infectious Diseases, Basurto University Hospital, Bilbao, Spain
| | - Roland Pastells-Peiró
- Department of Nursing and Physiotherapy, Faculty of Nursing and Physiotherapy, GESEC Group, University of Lleida, Lleida, Spain.,Healthcare Research Group (GRECS), Institute of Biomedical Research in Lleida (IRBLleida), Lleida, Spain
| | | | - Teresa Moreno-Casbas
- Nursing and Healthcare Research Unit (Investén-isciii), Madrid, Spain.,Biomedical Research Center for Fragility and Healthy Aging (CIBERFES), Madrid, Spain
| | - Montserrat Gea-Sánchez
- Department of Nursing and Physiotherapy, Faculty of Nursing and Physiotherapy, GESEC Group, University of Lleida, Lleida, Spain.,Healthcare Research Group (GRECS), Institute of Biomedical Research in Lleida (IRBLleida), Lleida, Spain.,Biomedical Research Center for Fragility and Healthy Aging (CIBERFES), Madrid, Spain
| | - Eva Abad-Corpa
- Biomedical Research Center for Fragility and Healthy Aging (CIBERFES), Madrid, Spain.,University of Murcia-Murcia Health Service (IMIB-Arrixaca), Murcia, Spain
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Company Sancho MC, González-María E, Abad-Corpa E. [Limited Reuse and Extended Use of Filtering Facepiece Respirators]. Enferm Clin 2021; 31:S78-S83. [PMID: 34629854 PMCID: PMC7241318 DOI: 10.1016/j.enfcli.2020.05.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Accepted: 05/11/2020] [Indexed: 11/29/2022]
Abstract
Objetivo Los equipos de protección individual (EPI), y dentro de ellos las mascarillas, son fundamentales en una pandemia como la del COVID-19, que ha requerido, en muchas ocasiones, de reutilización de material debido a su escasez. El objetivo de esta revisión es sintetizar la evidencia disponible sobre la reutilización y uso extendido de las mascarillas de media y alta filtración. Método Revisión exploratoria. Búsqueda a través de lenguaje natural en PubMed y Centros, Agencias y Organizaciones para el Control de Enfermedades. Se limitó a artículos publicados entre 2010-2020 en inglés y en español. Resultados Se localizaron 83 artículos, seleccionándose 14, más cinco recomendaciones. Los temas abordados se clasifican en siete apartados: Caducidad, uso extendido y reutilización de mascarillas, técnica de manipulación, sellado, efectos físicos psicológicos y cumplimentación, contaminación y descontaminación de mascarillas. Conclusiones La reutilización de las mascarillas no está recomendada por los organismos oficiales ni los fabricantes, sólo se acepta en casos extraordinarios, como las pandemias. Los estudios se caracterizan por contar con muestras pequeñas, usan diferentes modelos de mascarillas ajustando su recomendación al modelo.
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Affiliation(s)
- María Consuelo Company Sancho
- Servicio de Promoción de la Salud, Dirección General de Salud Pública. Servicio Canario de la Salud (Investén-isciii). Las Palmas de Gran Canaria, Las Palmas, España
| | - Esther González-María
- Unidad de Investigación en Cuidados de Salud (Investén-isciii). Instituto de Salud Carlos III. CIBERFES, Madrid, España
| | - Eva Abad-Corpa
- Facultad de Enfermería, Universidad de Murcia; Hospital Reina Sofía, Servicio Murciano de Salud. Instituto Murciano de Investigación Biomédica (IMIB-Arrixaca). (Investén-isciii). CIBERFES, Murcia, España
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Abad-Corpa E, Lidón-Cerezuela B, Meseguer Liza C, Arredondo-Gónzalez CP, de la Cuesta-Benjumea C. [The care in the prevention of falls in elderly people: Meta-summary of qualitative articles]. Aten Primaria 2021; 53:102067. [PMID: 33940462 PMCID: PMC8111575 DOI: 10.1016/j.aprim.2021.102067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 09/23/2020] [Accepted: 03/01/2021] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To summarize the qualitative evidence on the role of care providers in the prevention of falls of persons over 65 years of age in centres and in the community. DESIGN Meta-summary of qualitative evidence following the aggregation method. DATA SOURCES Extensive manual search of 16 databases (CINAHL, Pubmed/Medline, Embase, PsycInfo, Cochrane Library, PeDRO, Opengrey (Reports), Cuiden, Cuidatge, Enfispo, Medes, Lilacs, Teseo, Dissertation and Thesis Global and Ibecs), in English, French, Spanish and Portuguese; no time limit. SELECTION OF STUDIES Selection and blind critical appraisal by pairs. A first relevance and relevance screening and a second critical appraisal screening were carried out. A total of 4170 articles were located; 41 qualitative articles were critically appraised and 31 were selected. DATA EXTRACTION Data regarding author, year, study design, location, participants (number, age, sex and occupation), study methods and findings were extracted. RESULTS The analysis revealed four major themes: precipitating factors, preventive models, feelings and decision-making process. It also highlights the difficult act of ethical balance, the role of the institution in prevention and the fragmentation of care, as keys to successful implementation. CONCLUSIONS The findings show the complexity of fall prevention and the need to incorporate care providers' opinions in preventive models.
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Affiliation(s)
- Eva Abad-Corpa
- Departamento de Enfermería, Facultad de Enfermería, Universidad de Murcia, Murcia, España; Hospital Reina Sofía, Servicio Murciano de Salud, Murcia, España; Instituto Murciano de Investigación Biosanitaria, IMIB-Arrixaca, El Palmar, Murcia, España; Unidad de Investigación en Cuidados y Servicios de Salud, Investén-isciii. Instituto de Salud Carlos III, Madrid, España; Centro de Investigación Biomédica en Red sobre Fragilidad y Envejecimiento Saludable, CIBERFES. Instituto de Salud Carlos III, Madrid, España
| | - Beatriz Lidón-Cerezuela
- Departamento de Enfermería, Facultad de Enfermería, Universidad de Murcia, Murcia, España; Instituto Murciano de Investigación Biosanitaria, IMIB-Arrixaca, El Palmar, Murcia, España.
| | - Cristóbal Meseguer Liza
- Departamento de Enfermería, Facultad de Enfermería, Universidad de Murcia, Murcia, España; Gerencia de Urgencias y Emergencias 061, Servicio Murciano de Salud, Murcia, España
| | | | - Carmen de la Cuesta-Benjumea
- Departamento de Psicología de la Salud, Universidad de Alicante, Alicante, España; Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Alicante, España
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De La Cuesta-Benjumea C, Lidón-Cerezuela B, Abad-Corpa E, Meseguer-Liza C, Arredondo-González CP. Managing and keeping control: A qualitative synthesis of nursing and care staff strategies to prevent older people from falling. J Adv Nurs 2021; 77:3008-3019. [PMID: 33608944 DOI: 10.1111/jan.14794] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 12/14/2020] [Accepted: 01/25/2021] [Indexed: 11/28/2022]
Abstract
AIM To better understand formal care providers' role in fall prevention. DESIGN Qualitative synthesis as part of an integrative review. DATA SOURCES Fifteen electronic databases were consulted with the time limit being December 2017. Studies included were qualitative primary studies on formal care providers and fall prevention of people over 65 years of age in health care facilities. 17 studies were included. REVIEW METHODS Qualitative researchers carried out a critical appraisal and abstraction of the studies retained. Primary studies were imported into Nvivo 12 software; grounded theory procedures of constant comparison, microanalysis, coding, development of memos and diagrams were completed concurrently in a continuous growing process of data conceptualization. Analysis was iterative; it started with open coding and ended with the development of an integrative memo. FINDINGS Primary studies were synthesized with the emerging core category of "Managing and keeping control" and described by the emerging strategies of risk management, risk control and articulation work. These three categories account for the formal care providers' role in fall prevention in health care facilities. CONCLUSION Fall prevention is not given by a series of means and instruments; it is rather built in the interactions between formal care providers and the material and social world. The interactive character of prevention implies that outcomes cannot always be anticipated. IMPACT Although falls are one of the most researched clinical problems in nursing, the role played by nursing and care staff is dispersed and scantily documented. Formal care providers alternate risk management with risk control strategies to prevent older people from falling in health care facilities, they also resort to the articulation of the health care team as a complementary strategy. This review shows the dynamic character of fall prevention, which is something that has tended to go unnoticed in the literature and in policy.
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Affiliation(s)
| | | | - Eva Abad-Corpa
- University of Murcia-Murcia Health Service (IMIB-Arrixaca), Murcia, Spain.,Nursing and Healthcare Research Unit (Investén-isciii), Biomedical Research Center for Fragility and Healthy Aging (CIBERFES), Madrid, Spain
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Bellon F, Mora-Noya V, Pastells-Peiró R, Abad-Corpa E, Gea-Sánchez M, Moreno-Casbas T. The efficacy of nursing interventions on sleep quality in hospitalized patients: A systematic review of randomized controlled trials. Int J Nurs Stud 2020; 115:103855. [PMID: 33383270 DOI: 10.1016/j.ijnurstu.2020.103855] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 11/04/2020] [Accepted: 12/04/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To determine the effect of interventions that could be performed by nurses to improve the sleep quality of hospitalized patients in acute and semi-acute units. DESIGN A systematic review of randomized controlled trials and narrative synthesis. DATA SOURCES Seven electronic databases (PubMed, CINAHL Plus, Scopus, ISI WoS, CENTRAL, PsycInfo, and Embase) were accessed on 20 May 2019 with a temporal limit of 10 years prior. REVIEW METHODS Original research studies of interventions that could be delivered by nurses to improve sleep quality during hospitalization in acute and semi-acute units were included. Study selection, data extraction, and risk of bias assessment were performed by two independent reviewers. RESULTS Seventeen studies met the inclusion criteria and were included in this review. The interventions carried out in the trials were classified into four categories of measurement: environmental, physical, behavioural, and combined. Fourteen studies obtained statistically significant improvements; two showed a blend of significant and non-significant improvements; and one reported non-significant results. However, only four trials of the seventeen were judged as having a low risk of bias. CONCLUSIONS Overall evidence about interventions that could be performed by nurses to improve perceived sleep quality in hospitalized patients was found to be positive, and no negative effects were reported. However, higher quality research using both subjective and objective measures is needed, in order to strengthen the evidence.
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Affiliation(s)
- Filip Bellon
- GESEC group, Department of Nursing and Physiotherapy, Faculty of Nursing and Physiotherapy, University of Lleida. Montserrat Roig, 25198 Lleida, Spain; Healthcare Research Group (GRECS), Institute of Biomedical Research in Lleida (IRBLleida), Av. Alcalde Rovira Roure, 80, 25198 Lleida, Spain.
| | - Veronica Mora-Noya
- Department of formation and research, Foundation "Hospital de Campdevànol", Ctra, de Gombrèn, s/n, 17530 Campdevànol, Girona, Spain
| | - Roland Pastells-Peiró
- GESEC group, Department of Nursing and Physiotherapy, Faculty of Nursing and Physiotherapy, University of Lleida. Montserrat Roig, 25198 Lleida, Spain; Healthcare Research Group (GRECS), Institute of Biomedical Research in Lleida (IRBLleida), Av. Alcalde Rovira Roure, 80, 25198 Lleida, Spain.
| | - Eva Abad-Corpa
- University of Murcia-Murcia Health Service (IMIB-Arrixaca), Campus Universitario, 1, 30100 Murcia, Spain; Biomedical Research Center for Fragility and Healthy Aging (CIBERFES), Av. Monforte de Lemos, 5. Pabellón 11, 28029 Madrid, Spain.
| | - Montserrat Gea-Sánchez
- GESEC group, Department of Nursing and Physiotherapy, Faculty of Nursing and Physiotherapy, University of Lleida. Montserrat Roig, 25198 Lleida, Spain; Healthcare Research Group (GRECS), Institute of Biomedical Research in Lleida (IRBLleida), Av. Alcalde Rovira Roure, 80, 25198 Lleida, Spain; Biomedical Research Center for Fragility and Healthy Aging (CIBERFES), Av. Monforte de Lemos, 5. Pabellón 11, 28029 Madrid, Spain.
| | - Teresa Moreno-Casbas
- Nursing and Healthcare Research Unit (Investén-isciii), Av. Monforte de Lemos, 5. Pabellón 13, 28029 Madrid, Spain; Biomedical Research Center for Fragility and Healthy Aging (CIBERFES), Av. Monforte de Lemos, 5. Pabellón 11, 28029 Madrid, Spain.
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11
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de la Cuesta-Benjumea C, Arredondo-González CP, Lidón-Cerezuela B, Abad-Corpa E. [Fall prevention in older people and their families: a qualitative synthesis]. Gac Sanit 2020; 35:186-192. [PMID: 33268110 DOI: 10.1016/j.gaceta.2019.10.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 10/28/2019] [Accepted: 10/29/2019] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To analyse and synthesize the evidence on fall prevention of people older than 65 years and their family care providers METHOD: Qualitative synthesis, which is a part of a convergent systematic integrative review. Forty-one qualitative studies were retained for full text scrutiny. Nine studies on family care providers were selected for this synthesis. RESULTS Care providing, and kinship relationships mediated family care providers' interventions to prevent falls in older people. The fall of the dependent relative constitutes a turning point in these relationships. Family care providers are vulnerable to having a fall themselves and therefore receivers of preventive interventions. CONCLUSIONS Taking into account the context of care and family relations will improve the effectiveness of preventive interventions and will facilitate adherence. Fall prevention policy and programmes must pay better attention to the health and wellbeing of family care providers.
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Affiliation(s)
- Carmen de la Cuesta-Benjumea
- Departamento de Psicología de la Salud, Universidad de Alicante, Alicante, España; Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Alicante, España
| | | | | | - Eva Abad-Corpa
- Departamento de Enfermería, Universidad de Murcia, Murcia, España; Hospital Reina Sofía, Servicio Murciano de Salud, Murcia, España; IMIB-Arrixaca; Investén-iscii, Murcia, España; CIBERFES, Murcia, España
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12
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Ros-Sánchez T, Lidón-Cerezuela B, López-Román FJ, López-Benavente Y, Meseguer-Liza C, Abad-Corpa E. [Active-Murcia program: secondary analysis, with a gender perspective, on the quality of life of participating women.]. Rev Esp Salud Publica 2020; 94:e202010132. [PMID: 33079073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Accepted: 04/02/2020] [Indexed: 06/11/2023] Open
Abstract
OBJECTIVE Nowadays sedentarism has become a public health issue, as a matter of gender and age. Older women are more sedentary, which affects their Quality of life. The aim of this study was to evaluate the Activa-Murcia Program impact over the Quality of life in women participating in it. METHODS Longitudinal retrospective descriptive study within a gender perspective was carried out, including women who had participated in the Activa-Murcia Program. A SF-36 Survey of Quality of Life has been evaluated, scoring age range in three different stages and the enviroment in which they live. An analysis of repeated measurements was carried aout using ANOVA, and the Bonferroni Test was used for the pairwise analysis. RESULTS The sample included 1,140 women. "Overall health" dimension improved up to 3 points, except in women over 60. Score highed inversely proportional to their age in the following dimensions: "Vitality" in 9.9, 6.2 and 3.9; "Mental health" in 7.7, 5.6 and 3.7; "Declared health evolution" in 11.2, 8.6. and 7.6. Women between 30-44 years old living in rural areas and those over 60 living in urban areas did not improve in "Social functions". Dealing with "Emotional Role", women between 30-44 and women between 45-59 in urban areas improved (p<0.05). There was a statistical asociation between being highly aged and improving less in "Vitality", "Emotional Role" and "Mental health". CONCLUSIONS As women were getting older improve less in the dimensions of quality of life; so that could show, among others, an empowerment deficit.
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Affiliation(s)
- Tania Ros-Sánchez
- Doctoranda del Programa de Ciencias de la Salud de la Escuela Internacional de Doctorado de la Universidad de Murcia. Departamento de Enfermería. Servicio Murciano de Salud. IMIB-Arrixaca. Murcia. España
| | | | | | - Yolanda López-Benavente
- Subdirectora de Enfermería de Atención Primaria. Área VII Murcia-Este. Servicio Murciano de Salud. IMIB-Arrixaca. Murcia. España
| | | | - Eva Abad-Corpa
- Departamento de Enfermería. Universidad de Murcia. Hospital Reina Sofía. Servicio Murciano de Salud. IMIB-Arrixaca. Investén isciii. CIBERFES. Murcia. España
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13
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de la Cuesta-Benjumea C, Abad-Corpa E, Lidón-Cerezuela B, Orts-Cortés I, Meseguer-Liza C, Arredondo-González CP. Situating Preventive Action in a Moral and Clinical Context: A Qualitative Synthesis on Fall Prevention. Qual Health Res 2020; 30:1913-1923. [PMID: 32564706 DOI: 10.1177/1049732320921144] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The prevention of falls is an integral part of the safety culture of health institutions with mandatory fall prevention programs set within health care facilities. Care providers are key in identifying the risks of falls and in implementing strategic actions to prevent them. With the aim to better understand practices of fall prevention, we conducted a synthesis of qualitative evidence on care providers' practices to prevent older people from falling in health care facilities. This synthesis is part of an integrative review of the role of care providers in fall prevention of adults aged 65 years and above. Primary studies were synthesized with the emerging core category of "a complex decision" and described by four emerging conditions that make that decision complex: (a) permanent threat of a fall, (b) continuous flow of information, (c) lack of control, and (d) ethical dilemmas and moral issues over the course of action. The present synthesis shows that before implementing preventive actions, care providers consider the conditions in which they are immersed, in this way situating their preventive actions in a clinical and a moral context.
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Padilla-Martínez JM, Abad-Corpa E, Gea-Sánchez M, Casado-Ramírez E, Rol-de Lama MA, Madrid-Pérez JA, Moreno-Casbas MT. Detection of factors influencing circadian rhythms on Intensive Care inpatients and hospitalization: Protocol for an observational study. J Adv Nurs 2020; 77:411-416. [PMID: 32996642 DOI: 10.1111/jan.14569] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Accepted: 08/21/2020] [Indexed: 01/21/2023]
Abstract
AIMS Identify the prevalence of circadian health disorders in ICU and hospitalized patients. Stablish the relationship of the circadian system with light, temperature, noise and nursing activities. BACKGROUND Commonly, self-assessment through subjective questionnaires is used for research about sleep quality. However, more reliable and valid measures should be applied objectively to find out the real prevalence of the problem. There is a negative relationship between circadian rhythms and hospitalization. In this study, we will analyse sleep patterns and hospital environments to implement measures to improve the quality of care related to sleep. DESIGN Descriptive observational study. It is estimated that 975 patients from 13 hospitals need to be recruited from ICU and hospitalization units. The sample should meet the following criteria: Patients over 18 admitted to ICU and medical units, length of stay between 96-148 hr, with no visual, hearing or moderate-severe cognitive impairment. Variables: Sleep variables are collected with an electronic device (named Kronowise® and Kronobed®), circadian and infrared light exposure, environmental noise, temperature, unit structural characteristics, nursing care (from 0 to 6 a.m.) and, characteristics of hospitalization period. The study, registered on Clinical Trials, initiated in December 2019 and it will continue up to December 2022. DISCUSSION Using objective and subjective measures of sleep and circadian rhythms, this study will shed light on the factors that negatively affect the hospitalized patients' sleep quality and circadian health. The ultimate goal is to design hospital guidelines to minimize the adverse effects on the dependent variables studied. Arguably, these guidelines will contribute to reducing the risk of these alterations and it will also serve to improve the nursing activities. CONCLUSION We expect to obtain adequate results for the creation of a protocol to improve the circadian health, quality of care and health outcomes related to sleep in patients.
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Affiliation(s)
- Julia M Padilla-Martínez
- Nursing School, University of Murcia, Murcia, Spain.,Murcia Health Service (Emergencies), Murcia, Spain
| | - Eva Abad-Corpa
- University of Murcia-Murcia Health Service (IMIB-Arrixaca), Murcia, Spain.,Nursing and Healthcare Research Unit (Investén-isciii), Madrid, Spain.,Biomedical Research Center for Fragility and Healthy Aging (CIBERFES), Madrid, Spain
| | - Montserrat Gea-Sánchez
- Biomedical Research Center for Fragility and Healthy Aging (CIBERFES), Madrid, Spain.,Grup d'Estudis Societat, Salut, GESEC, Deparment of Nursing and Physiotherapy, University of Lleida, Lleida, Spain.,Grup de Recerca de Cures en Salut, GRECS, Institut de Recerca Biomèdica, Lleida, Spain
| | | | - María A Rol-de Lama
- Biomedical Research Center for Fragility and Healthy Aging (CIBERFES), Madrid, Spain.,Chronobiology Lab, Department of Physiology, College of Biology, University of Murcia, Mare Nostrum Campus.IUIE. IMIB - Arrixaca, Murcia, Spain
| | - Juan A Madrid-Pérez
- Biomedical Research Center for Fragility and Healthy Aging (CIBERFES), Madrid, Spain.,Chronobiology Lab, Department of Physiology, College of Biology, University of Murcia, Mare Nostrum Campus.IUIE. IMIB - Arrixaca, Murcia, Spain
| | - María T Moreno-Casbas
- Nursing and Healthcare Research Unit (Investén-isciii), Madrid, Spain.,Biomedical Research Center for Fragility and Healthy Aging (CIBERFES), Madrid, Spain
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Abstract
OBJECTIVE To synthesize the available evidence on the use of antiseptics and disinfectants in the face of VIDOC-19 infection METHOD: Bibliographic search in the main databases (WOS, CCC, DIIDW, KJD, MEDLINE, RSCI, SCIELO, PubMed, BMJ Best Practice, Cochrane Library, UptoDate) and on the web of official bodies in March 2020, using descriptors and truncations. The search was limited to reviews published between 2016-2020. RESULTS Thirty-six papers were identified (no duplicates) of which 17 were selected for relevance and specificity and one paper was added from the literature review. In the documents finally used, no evidence was located, but experiences and recommendations of interest were found, highlighting the importance of material, environmental and, very significantly, hand disinfection. CONCLUSION There is no clear evidence, nor are there clear recommendations for the use of one or another antiseptic, although the action of sodium hypochlorite, ethanol and hydrogen peroxide is highlighted in comparison to others such as benzalkonium chloride, chlorhexidine digluconate, povidoeyodine and diluted ethyl alcohol. Particular importance is attached to their use in hand hygiene, the use of protective equipment and environmental disinfection.
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Affiliation(s)
- Joaquín León Molina
- Hospital Virgen de la Arrixaca. Servicio Murciano de Salud, ENFERAVANZA, Instituto Murciano de Investigación Biosanitaria (IMIB-Arrixaca), Murcia, España
| | - Eva Abad-Corpa
- Facultad de Enfermería, Universidad de Murcia, Hospital Reina Sofía, Servicio Murciano de Salud, ENFERAVANZA, IMIB-Arrixaca. Investén-isciii, CIBERFES, Murcia, España
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16
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Abad-Corpa E, Sánchez-López D, Moreno-Casbas MT. [Scoping review about the recommendations for home isolation in the COVID-19 pandemic]. Enferm Clin (Engl Ed) 2020; 31:S94-S99. [PMID: 32425484 PMCID: PMC7229925 DOI: 10.1016/j.enfcli.2020.05.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Accepted: 05/11/2020] [Indexed: 10/25/2022]
Abstract
Aim The COVID-19 pandemic has affected countries on all continents where containment and isolation measures have been systematically applied. This review aims to synthesize the available evidence on the management of home isolation due to COVID-19 infection. Method A scoping review has been carried out using the Trip Database, PUBMED, CINAHL, COCHRANE and Scopus controlled language without any limits. From all the documents located, information was extracted on the date of publication, country of publication, type of study, assessment of the level of evidence and degree of recommendation, and results of interest to answer the research question. Critical reading of the selected documents has been carried out, but without using it as an exclusion criterion but rather informative. Results 163 records were located and 14 were selected. The recommendations have been grouped into 10 topics around all the daily management of home care. Conclusions The scarcity of robust evidence on isolation from COVID-19 infection is objective. Most of the documents are reviews carried out after the consensus of experts at the international level.
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Affiliation(s)
- Eva Abad-Corpa
- Facultad de Enfermería, Universidad de Murcia, Hospital Reina Sofía, Servicio Murciano de Salud, Instituto Murciano de Investigación Biomédica (IMIB-Arrixaca), Investén-isciii, CIBERFES, Murcia, España
| | - Dolores Sánchez-López
- Centro de Salud Las Huelgas, Sanidad Castilla y León, Investén-isciii, Burgos, España.
| | - María Teresa Moreno-Casbas
- Unidad de Investigación en cuidados y servicios de salud (Investén-isciii), Instituto de Salud Carlos III, CIBERFES, Madrid, España
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de la Cuesta-Benjumea C, Henriques MA, Abad-Corpa E, Roe B, Orts-Cortés MI, Lidón-Cerezuela B, Avendaño-Céspedes A, Oliver-Carbonell JL, Sánchez-Ardila C. “Falls prevention among older people and care providers: protocol for an integrative review”. J Adv Nurs 2017; 73:1722-1734. [DOI: 10.1111/jan.13245] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/21/2016] [Indexed: 11/27/2022]
Affiliation(s)
| | | | - Eva Abad-Corpa
- University of Murcia; Murcia España
- Institute for Bio-health Research of Murcia (IMIB); Murcia España
- Nursing and Healthcare Research Unit (Investen-isciii); Carlos III Health Institute; Madrid España
| | - Brenda Roe
- University of Edge Hill; Ormskirk Lancashire UK
| | - María Isabel Orts-Cortés
- University of Alicante; Alicante España
- Nursing and Healthcare Research Unit (Investen-isciii); Carlos III Health Institute; Madrid España
| | - Beatriz Lidón-Cerezuela
- University of Murcia; Murcia España
- Institute for Bio-health Research of Murcia (IMIB); Murcia España
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Abad-Corpa E. Elevación óptima del cabecero para disminuir la presión intracraneal. Revisión sistemática. Enfermería Intensiva 2016. [DOI: 10.1016/j.enfi.2016.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Sánchez-Nieto JM, Andújar-Espinosa R, Bernabeu-Mora R, Hu C, Gálvez-Martínez B, Carrillo-Alcaraz A, Álvarez-Miranda CF, Meca-Birlanga O, Abad-Corpa E. Efficacy of a self-management plan in exacerbations for patients with advanced COPD. Int J Chron Obstruct Pulmon Dis 2016; 11:1939-47. [PMID: 27574418 PMCID: PMC4994798 DOI: 10.2147/copd.s104728] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Background Self-management interventions improve different outcome variables in various chronic diseases. Their role in COPD has not been clearly established. We assessed the efficacy of an intervention called the self-management program on the need for hospital care due to disease exacerbation in patients with advanced COPD. Methods Multicenter, randomized study in two hospitals with follow-up of 1 year. All the patients had severe or very severe COPD, and had gone to either an accident and emergency (A&E) department or had been admitted to a hospital at least once in the previous year due to exacerbation of COPD. The intervention consisted of a group education session on the main characteristics of the disease, an individual training session on inhalation techniques, at the start and during the 3rd month, and a written action plan containing instructions for physical activity and treatment for stable phases and exacerbations. We determined the combined number of COPD-related hospitalizations and emergency visits per patient per year. Secondary endpoints were number of patients with visits to A&E and the number of patients hospitalized because of exacerbations, use of antibiotics and corticosteroids, length of hospital stay, and all-cause mortality. Results After 1 year, the rate of COPD exacerbations with visits to A&E or hospitalization had decreased from 1.37 to 0.89 (P=0.04) and the number of exacerbations dropped from 52 to 42 in the group of patients who received the intervention. The numbers of patients hospitalized, at 19 (40.4%) versus 20 (52.6%) (P=0.26), and those who went to A&E, at 9 (19.1%) versus 14 (36.8%) (P=0.06), due to exacerbation of COPD were also lower in this group. Intake of antibiotics was higher in the intervention group, whereas use of glucocorticoids was slightly lower, though there were no significant differences (P=0.30). There were also no differences between groups in the length of hospital stay (P=0.154) or overall mortality (P=0.191). Conclusion The implementation of a self-management program for patients with advanced COPD reduced exacerbations that required hospital care.
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Affiliation(s)
| | | | | | - Chunshao Hu
- Division of Pneumology, Hospital Morales Meseguer
| | | | | | | | | | - Eva Abad-Corpa
- Department of Professional Development Unit, Murcia, Spain
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Abad-Corpa E, Delgado-Hito P, Cabrero-García J, Meseguer-Liza C, Zárate-Riscal CL, Carrillo-Alcaraz A, Martínez-Corbalán JT, Caravaca-Hernández A. Implementing evidence in an onco-haematology nursing unit: a process of change using participatory action research. INT J EVID-BASED HEA 2013; 11:46-55. [PMID: 23448330 DOI: 10.1111/1744-1609.12006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIM To implement evidence in a nursing unit and to gain a better understanding of the experience of change within a participatory action research. METHODS Study design of a participatory action research type was use from the constructivist paradigm. The analytical-methodological decisions were inspired by Checkland Flexible Systems for evidence implementation in the nursing unit. The study was carried out between March and November 2007 in the isolation unit section for onco-haematological patients in a tertiary level general university hospital in Spain. Accidental sampling was carried out with the participation of six nurses. Data were collected using five group meetings and individual reflections in participants' dairies. The participant observation technique was also carried out by researchers. Data analysis was carried out by content analysis. The rigorous criteria were used: credibility, confirmability, dependence, transferability and reflexivity. RESULTS A lack of use of evidence in clinical practice is the main problem. The factors involved were identified (training, values, beliefs, resources and professional autonomy). Their daily practice (complexity in taking decisions, variability, lack of professional autonomy and safety) was compared with an ideal situation (using evidence it will be possible to normalise practice and to work more effectively in teams by increasing safety and professional recognition). It was decided to create five working areas about several clinical topics (mucositis, pain, anxiety, satisfaction, nutritional assessment, nauseas and vomiting, pressure ulcers and catheter-related problems) and seven changes in clinical practice were agreed upon together with 11 implementation strategies. Some reflections were made about the features of the study: the changes produced; the strategies used and how to improve them; the nursing 'subculture'; attitudes towards innovation; and the commitment as participants in the study and as healthcare professionals. CONCLUSIONS The findings throw light on the process of change in the healthcare sector. The results are useful to modify nursing practice based on evidence.
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Affiliation(s)
- Eva Abad-Corpa
- Murcia Health Service, Carlos III Health Institute, Murcia, Spain.
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21
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Abad-Corpa E, Gonzalez-Gil T, Martínez-Hernández A, Barderas-Manchado AM, De la Cuesta-Benjumea C, Monistrol-Ruano O, Mahtani-Chugani V. Caring to achieve the maximum independence possible: a synthesis of qualitative evidence on older adults' adaptation to dependency. J Clin Nurs 2013; 21:3153-69. [PMID: 23083390 DOI: 10.1111/j.1365-2702.2012.04207.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
AIMS AND OBJECTIVES To understand the process of adaptation to dependency in older adults and their families. BACKGROUND Dependency and family care giving are attracting the attention of policymakers, service providers and researchers. DESIGN An interpretative synthesis of qualitative studies has been conducted. METHODS An extensive search without time and idiom limitations was conducted using the main databases (MEDLINE, CINAHL, EMBASE, PsycINFO, SSCI, LILACS, CUIDEN, Cochrane Library and JBI): personal communication from expert panel was used to detect filters strategies to find qualitative studies; these strategies were combined with search terms for dependence in older adults. The studies (2164 potentially relevant papers) were judged by two reviewers based on reading title, abstract, keywords and/or full text (English, Spanish, French and Portuguese) to determine their inclusion. After, 203 papers were critically appraised by two reviewers (disagreements were resolved by discussions). Finally, the synthesis of the 20 studies with best interpretative character was carried out based on the principles and procedures of Grounded Theory. RESULTS The findings were related to the process of adaptation to dependency, the factors and the strategies used, the emotions, perceptions and feelings of care givers and older adults. The central category that emerged was 'Caring to achieve the maximum independence possible', and this could be seen as a transition period in which older adults and their families progressed in a mutually determined adaptation process. This category is made up of several redefinitions of concepts, phases, adaptation strategies and final responses to the process. CONCLUSIONS The findings show the interconnected nature of physical, material, social and emotional aspects of care; and the profound social impact of providing and receiving care. Relevance to clinical practice. The nurses can assist families and older adults to enhance adaptation to dependency, anticipating and helping to redefine the concepts of care.
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Affiliation(s)
- Eva Abad-Corpa
- Research Department, Murcia Health Service, Murcia and Carlos III Health Institute, Nursing and Healthcare Research Unit (Investen-isciii), Madrid, Spain.
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Abad-Corpa E, Cabrero-García J, Delgado-Hito P, Carrillo-Alcaraz A, Meseguer-Liza C, Martínez-Corbalán JT. Effectiveness of participatory-action-research to put in practice evidence at a nursing onco-hematology unit. Rev Lat Am Enfermagem 2012; 20:59-67. [PMID: 22481722 DOI: 10.1590/s0104-11692012000100009] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2011] [Accepted: 01/06/2012] [Indexed: 11/22/2022] Open
Abstract
The aim was to evaluate the effectiveness of evidence implementation through participatory-action research (PAR). A prospective quasi-experimental design with two non-equivalent and non-concurrent groups (2006 and 2008) was adopted. The research was conducted at the bone marrow transplant unit of a tertiary-level Spanish hospital. To put the evidence in practice, PAR was adopted as an "intervention studied". The dependent variables were: professional performance and patient outcomes (psycho-emotional area and adverse effects). In total, 125 patients were recruited (1(st) period=56; 2(nd) period=69). The results in the second period show significant improvements in professional performance in terms of the quality of the registers of signs and symptoms. In the psycho-emotional area, the psycho-social adjustment improved significantly; without caregiver burden or satisfaction showing any clear tendencies. Among the adverse effects, catheter-related thrombosis and catheter-related infection improved significantly; there were no significant differences in the level of pain or mucositis. Through the PAR, evidence could be put in practice and the outcomes under analysis could be improved.
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Affiliation(s)
- Eva Abad-Corpa
- Technical Training and Research, Consejería de Sanidad, Murcia, Spain.
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Abad-Corpa E, Royo-Morales T, Iniesta-Sánchez J, Carrillo-Alcaraz A, Rodríguez-Mondejar JJ, Saez-Soto AR, Vivo-Molina MC. Evaluation of the effectiveness of hospital discharge planning and follow-up in the primary care of patients with chronic obstructive pulmonary disease. J Clin Nurs 2012; 22:669-80. [PMID: 22830974 DOI: 10.1111/j.1365-2702.2012.04155.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
AIMS AND OBJECTIVES To evaluate the effectiveness of protocolised intervention for hospital discharge and follow-up in the primary care of patients with chronic obstructive pulmonary disease (COPD). BACKGROUND Chronic obstructive pulmonary disease is one of the main causes of morbidity and mortality internationally. DESIGN A quasi-experimental design was adopted, with a control group and it was pseudorandomised by services. METHODS Patients with COPD admitted to two tertiary-level public hospitals in Spain were recruited (2007-2008). The outcome variables included: readmission rate, patient satisfaction (LOPSS12), quality of life (St. George's Respiratory Questionnaire) and level of knowledge about COPD. 48 hours after admission, both groups were evaluated by specialist coordinating nurses. At the hospital, a coordinating nurse visited each patient in the experimental group every 24 hours to identify the main caregiver, provide information about the disease, explain treatment, identify care problems and needs and facilitate communication between professionals. 24 hours after discharge, the coordinating nurses informed the primary care nurses about patient discharge. The two nurses made the first home visit together. There were follow-up phone calls at 2, 6, 12 and 24 weeks after discharge. A total of 143 patients were recruited (Intervention group=56; Control group=87). RESULTS The results showed a significant improvement in the evolution of quality of life, at 12 and 24 weeks after discharge; the level of knowledge about COPD revealed significant differences between the groups. There were no differences according to satisfaction or readmission rate. Multivariate analysis (non-conditional logistic regression) showed the intervention to be ineffective in reducing the readmission rate. CONCLUSIONS The planning of discharge for patients with COPD is effective in terms of improving the patients' quality of life and level of knowledge about the disease. RELEVANCE TO CLINICAL PRACTICE The characteristics of patients with COPD make it necessary to include them in hospital discharge planning programmes.
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Affiliation(s)
- Eva Abad-Corpa
- Research and Training Department, Murcia Health Service, Murcia and Carlos III Health Institute, Nursing and Healthcare Research Unit (Investen-isciii), Madrid.
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Abad-Corpa E, González-Gil T, Barderas-Manchado AM, de la Cuesta-Benjumea C, Monistrol-Ruano O, Mahtani-Chugani V, Martínez-Hernández A. Research protocol: a synthesis of qualitative studies on the process of adaptation to dependency in elderly persons and their families. BMC Geriatr 2010; 10:58. [PMID: 20738846 PMCID: PMC2939542 DOI: 10.1186/1471-2318-10-58] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2010] [Accepted: 08/25/2010] [Indexed: 11/22/2022] Open
Abstract
Background Dealing with dependency in the elderly and their families leads us to explore the life experience of those involved together with the processes of adaptation to this condition. A number of original studies have been published which, following a qualitative methodology, have dealt with both dimensions. Methods/Design Objectives: 1) To present a synthesis of the qualitative evidence available on the process of adaptation to dependency in elderly persons and their families; 2) to conduct an in-depth study into the experiences and strategies developed by both to optimise their living conditions; 3) to enable standards of action/intervention to be developed in the caregiving environment. A synthesis of qualitative studies is projected with an extensive and inclusive bibliography search strategy. The primary search will focus on the major databases (CINAHL, MEDLINE, EMBASE, PsycInfo, PSICODOC, Cochrane Library, JBI, EMBASE, LILACS, CUIDEN, CUIDEN qualitative, CUIDATGE, British Nursing Index, SSCI). The secondary search will be conducted in articles taken from the references to studies identified in the articles and reports and the manual search in congresses and foundation papers. Article quality will be assessed by the guide proposed by Sandelowski & Barroso and data extraction done using the QARI data extraction form proposed by the Joanna Briggs Institute for Evidence-Based Practice. The synthesis of the findings will be based on the principles and procedures of grounded theory: coding, identification and relationship between categories, and synthesis using constant comparison as a strategy. Discussion This synthesis of qualitative evidence will enable us to detect health needs as perceived by the receivers in their own interaction contexts.
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Affiliation(s)
- Eva Abad-Corpa
- Research Department, Zone VI Management Vega Media del Segura, 30008 Murcia, Spain.
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Abad-Corpa E, Meseguer-Liza C, Martínez-Corbalán JT, Zárate-Riscal L, Caravaca-Hernández A, Paredes-Sidrach de Cardona A, Carrillo-Alcaraz A, Delgado-Hito P, Cabrero-García J. Effectiveness of the implementation of an evidence-based nursing model using participatory action research in oncohematology: research protocol. J Adv Nurs 2010; 66:1845-51. [PMID: 20557394 DOI: 10.1111/j.1365-2648.2010.05305.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIM To generate changes in nursing practice introducing an evidence-based clinical practice (EBCP) model through a participatory process. To evaluate the effectiveness of the changes in terms of nurse-sensitive outcome (NSO). BACKGROUND For international nursing science, it is necessary to explore the reasons for supporting EBCP and evaluate the real repercussions and effectiveness. METHODS A mixed methods study with a sequential transformative design will be conducted in the bone marrow transplant unit of a tertiary-level Spanish hospital, in two time periods >12 months (date of approval of the protocol: 2006). To evaluate the effectiveness of the intervention, we will use a prospective quasi-experimental design with two non-equivalent and non-concurrent groups. NSO and patient health data will be collected: (a) impact of psycho-social adjustment; (b) patient satisfaction; (c) symptom control; (d) adverse effects. All patients admitted during the period of time will be included, and all staff working on the unit during a participatory action research (PAR). The PAR design will be adopted from a constructivist paradigm perspective, following Checkland's "Soft Systems" theoretical model. Qualitative techniques will be used: 2-hour group meetings with nursing professionals, to be recorded and transcribed. Field diaries (participants and researchers) will be drawn up and data analysis will be carried out by content analysis. DISCUSSION PAR is a rigorous research method for introducing changes into practice to improve NSO.
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Affiliation(s)
- Eva Abad-Corpa
- Research Unit, General University Hospital, J. M. Morales Meseguer, Murcia, Spain.
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Abad-Corpa E, Carrillo-Alcaraz A, Royo-Morales T, Pérez-García MC, Rodríguez-Mondejar JJ, Sáez-Soto Á, Iniesta-Sánchez J. Effectiveness of planning hospital discharge and follow-up in primary care for patients with chronic obstructive pulmonary disease: research protocol. J Adv Nurs 2010; 66:1365-70. [DOI: 10.1111/j.1365-2648.2010.05284.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Abad-Corpa E, Meseguer-Liza C, Martínez-Corbalán JT, Zarate-Riscal L, Caravaca-Hernández A, Paredes-Sidrach de Cardona A, Carrillo-Alcaraz A. [Descriptive study of nursing-sensitive outcomes in oncohematological patients and nursing interventions]. Enferm Clin 2009; 19:184-90. [PMID: 19604715 DOI: 10.1016/j.enfcli.2009.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2008] [Accepted: 01/26/2009] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To assess the main nursing-sensitive outcomes in oncohematological patients admitted to hospital and to evaluate nursing interventions. MATERIAL AND METHODS We performed a prospective, observational study in the oncohematological units of the Morales Meseguer Hospital. The sample included patients admitted from March 2006 to June 2007. RESULTS A total of 56 patients were studied. Of these, 39 patients (69.6%) had some degree of mucositis but only six patients (10.7%) were assessed objectively by nurses. Fifty-two patients (92.9%) received anti-emetic treatment, but there were no reports of nausea or vomiting in 27 (48.2%). Ten patients (17.9%) were referred to the nutritional unit. Anxiety levels and psychosocial impact decreased during hospital admission and patient satisfaction increased but family members experienced greater stress. Pressure ulcer developed in only one patient. Four catheters (8.2%) became infected and there were five cases of catheter-related bacteremia. There were 22 cases of catheter obstruction (39.9%). CONCLUSIONS The incidence of mucositis, pressure ulcer and catheter-related bacteremia was lower than in other studies. There was no standard assessment of pain, nausea or vomiting. Anxiety levels were lower than in other studies. Improvement and psychosocial adjustment suggested a process of adaptation to the disease. The increase in caregiver burden was related to the disease in the long term. Satisfaction with nursing care was 55 points on a 70-point scale.
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Affiliation(s)
- E Abad-Corpa
- Consejería de Sanidad, Región de Murcia, Murcia, España.
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