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OBJECTIVES: To assess the effects of a vists prior to hospital admission on anxiety, depression and satisfaction of patients admitted electively to an intensive care unit (ICU). DESIGN: A randomised clinical trial [NCT03605407]. SETTING: A sample of 38 patients was recruited who were to be electively admiited to ICU divided into experimental (n = 19 patients receiving one visit prior to hospital ICU admission for surgery) and control (n = 19 patients not receiving a visit prior to hospital ICU admission for surgery) groups. MAIN OUTCOME MEASUREMENTS: Hospital Anxiety and Depression Scale (HADS) and Impact of Event Scale-Revised (IES-R) were self-reported by patients before ICU admission, at 3-days and 90-days after ICU discharge. Critical Care Family Needs Inventory (CCFNI) and Family Satisfaction with Care in the Intensive Care Unit (FS-ICU) were used to measure the users' satisfaction before ICU admission and 3-days after ICU discharge. RESULTS: There were statistically significant differences between experimental and control groups for FS-ICU, but not for HADS, IES-R and CCFNI. Indeed, control group patients were more satisfied with regard to emotional support, ease of getting information, control feeling, concerns and questions expression ability and overall score for decision-making satisfaction. CONCLUSIONS: The visit prior to hospital admission did not seem to modify anxiety or depression, but may impair satisfaction of ICU patients.

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BACKGROUND: Chlorhexidine and parachlorometaxylenol (PCMX) are antiseptics recommended for surgical hand antisepsis. To our knowledge, PCMX has not been evaluated for bactericidal efficacy "in vivo. METHODS: We conducted a randomized, double-blind, controlled crossover trial to compare the bacterial loads on fingertips and fingernails under laboratory conditions after use of antiseptic test products, including chlorhexidine digluconate 4%, PCMX 3%, and a reference solution of propan-1-ol 60% (P-1). We assessed bacterial load after a prewash with soft soap, immediately after application of an antiseptic, and 3 hours after application and wearing of sterile, powder-free gloves. Our procedures followed those specified by European Norm (EN) 12791 for evaluating surgical hand antiseptics and using cotton swab for fingertips and fingernails. RESULTS: Chlorhexidine digluconate 4% and PCMX 3% did not decrease bacterial load on the hands. The bactericidal performances of chlorhexidine digluconate 4% and PCMX 3% did not differ significantly. Chlorhexidine digluconate 4% and PCMX 3% increased bacterial load on the fingertips after participants had worn gloves for 3 hours. Fingernails had greater bacterial loads than skin on the fingertips. CONCLUSIONS: Chlorhexidine digluconate 4% and PCMX 3% had similar bactericidal efficacy, but they failed to meet the EN 12791 efficacy standard. Fingernails should be a particular focus of antisepsis in preparation for surgery.The trial was registered at ClinicalTrials.gov (ID: NCT02500758).

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Hallux valgus (HV) is a highly-prevalent forefoot deformity associated with progressive subluxation and osteoarthritis of the first metatarsophalangeal joint; it is believed to be associated with depression. The aim of the present study was to determine the association of patients with varying degrees of HV involvement to depression using the Beck Depression Inventory (BDI). The sample consisted of 102 participants (mean age: 45.1 ± 1.6), who attended an outpatient centre where self-report data were recorded. The degree of HV deformity was determined in both feet, and the scores on the BDI were compared. A total of 38.24% of the sample had depression, with an average BDI score of 10.55 ± 12.36 points. There was a statistically-significant association between the degree and presence of HV in both feet (P = 0.0001). People with a greater degree of HV deformity in any foot also have a significant increase in depression based on BDI scores, regardless of sex.

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The nursing environment is full of situations under ethical and legal constraints. Therefore this study focused on the knowledge, position and attitudes of nurses in relation to healthcare ethics and nursing legal regulations. We conducted a pretest and posttest study using a specific questionnaire administered to a convenience sample of nurses who worked in a healthcare system in Principado de Asturias, a northern state of Spain and were enrolled in a continuing nursing education program about ethical and legal aspects in the nursing profession. The main findings suggest that nurses are very concerned about situations that create ethical and legal conflicts but do not feel sufficiently trained. In general, they demonstrated sufficient knowledge to address the most frequent ethical and moral situations of nursing work, and the training received during a postgraduate course in ethics and legislation provided them with greater knowledge and tools to solve the dilemmas. In conclusion, although the nurses have university-level education about professional deontology, bioethics and nursing legislation, they require periodic continuing education.

El ámbito de la enfermería está llena de situaciones clínicas que comportan limitaciones éticas y legales. Por ello, este estudio se centró en demostrar el conocimiento, posicionamiento y actitudes de las enfermeras en relación con la las regulaciones ético legales inherentes a la práctica de enfermería. Se realizó un estudio pretest y posttest, mediante un cuestionario específico administrado a una muestra de conveniencia de las enfermeras que trabajaban en un sistema de salud en el Principado de Asturias de España, y que se habían inscrito en un curso de educación continua sobre los aspectos éticos y legales en la de enfermería profesional. Las principales conclusiones indican que las enfermeras están muy preocupadas por las situaciones que generan conflictos éticos y legales, pero no se sienten suficientemente capacitadas para resolverlas. En general, demostraron conocimientos suficientes para hacer frente a las situaciones ético-morales más frecuentes del trabajo enfermero, y la formación recibida durante un curso de posgrado en la ética y la legislación les proporcionó un mayor conocimiento y herramientas para resolver otros dilemas éticos. En conclusión, aunque las enfermeras tienen conocimientos aprendidos en la universidad sobre deontología profesional, bioética y legislación en enfermería, se requiere de una educación continua en el ámbito ético-legal en enfermería.

O âmbito da enfermagem está cheio de situações clínicas que comportam limitações éticas e legais. Por isso, este estudo se centrou em demonstrar o conhecimento, posicionamento e atitudes das enfermeiras com relação às regulamentações ético-legais inerentes à prática de enfermagem. Realizou-se um estudo pré-teste e pós-teste, mediante um questionário específico administrado a uma amostra de conveniência das enfermeiras que trabalhavam num sistema de saúde no Principado de Astúrias, Espanha, e que se inscreveram num curso de educação continuada sobre os aspectos éticos e legais da enfermagem profissional. As principais conclusões indicam que as enfermeiras estão muito preocupadas com situações que geram conflitos éticos e legais, porém não se sentem suficientemente capacitadas para resolvê-las. Em geral, demonstraram conhecimentos suficientes para fazer frente às situações ético-morais mais frequentes do trabalho de enfermagem, e a formação recebida durante um curso de pós-graduação em ética e legislação lhes proporcionou um maior conhecimento e ferramentas para resolver outros dilemas éticos. Em conclusão, ainda que as enfermeiras tenham conhecimentos aprendidos na universidade sobre deontologia profissional, bioética e legislação em enfermagem, se requer uma educação continuada no âmbito ético-legal em enfermagem.

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