Modelo de aprendizaje de cuidados paliativos basado en la teoría de aprendizaje transformacional de cuidados paliativos de los estudiantes de enfermería en Indonesia

IntroductionPalliative care competence is one of the competencies that must be possessed by generalist nurses. For this reason, strategies for developing palliative care learning models need to be carried out to ensure nursing students have palliative care competencies. Therefore, this study was structured to develop a transformation theory-based palliative care learning model that prioritizes the active participation of students to deal with palliative care in future practice.MethodsThis study was a cross-sectional study involving 189 nursing students as participants. The proposed model involves six variables, namely student characteristics, educator characteristics, learning media, palliative care competencies, transformative learning theory (TLT)-based palliative learning, and competency achievement. Data were collected using a questionnaire that was tested using the Structural Equation Modeling (SEM) technique.ResultsSEM analysis showed that the R² value of TLT-based palliative care learning was 0.707 or 70.7%. These results indicate that the diversity of TLT-based palliative care learning variables can be explained by the variables of students, educators, palliative competencies, and learning media by 70.7%. Each construct has a value of Q2 > 0, which means the model is satisfactory. The path coefficient value of 0.627 indicates that the characteristics of educators have the most significant contribution to the TLT-based palliative care learning model.ConclusionIt can be concluded that the teaching-learning process based on TLT is a promising strategy to support nursing students to achieve palliative care competence.     

Facteurs de risque de syndrome post-commotionnel prolongé sur une population de 501 athlètes de haut niveau

Introduction

Concussion mild head injury is an alteration of neurological functions due to an impact transmitted to the brain. It is to be usually found in contact sports. Post-concussion may be diagnosed afterwards, and it may not disappear before hours, days or months. Our point is to evaluate the risk factors related to a prolonged post-concussion syndrome, thus defined by the persistence of symptoms three weeks following the concussion.

娟de爱情

忽然想起要写这篇有关一个女人痴情的文章完全是L来我家造访后引起的。 L是我当年混迹街头巷尾的朋友,那时候我们都是些无事可干的小青年,青春的激情和热血全部泛滥在招惹是非追逐女孩和打群架上面。L是我们那群人的头儿,他长有我望尘莫及的浓眉和大眼,而且在他薄薄的嘴唇上蓄着两撇毛茸茸的胡子,在他     

Incidencia de flebitis secundaria por catéter venoso de acceso periférico e impacto de un protocolo de manejo

ObjectiveTo assess the impact on the incidence of PPIVC by implementing a catheter management protocol and to determine risk factors for PPIVC development in hospitalized patients.MethodA total of 3978 episodes of venous catheterization were prospectively included from September 2002 to December 2007. A catheter management protocol was implemented during this period of time. The incidence and variables associated to the occurrence of PPIVC were determined.ResultsThe incidence of PPIVC from 2002 to 2007 was 4.8%, 4.3%, 3.6%, 2.5%, 1.3% and 1.8% (p<0.001). Perfusion of amiodarone [adjusted OR (AOR) 25.97; 95% CI=7.29 – 92.55, p=0.0001] and cefotaxime (AOR 2.90; 95% CI=1.29 – 6.52, p=0.01) and the shift when the catheters were placed (AOR for morning vs. night shift 0.60; 95% CI=0.35 – 1.02, p=0.063) were independently associated to the development of PPIVC. A history of phlebitis was the only factor independently associated to phlebitis due to peripherally inserted central venous catheters (AOR 3.24; CI at 95% CI= 1.05 – 9.98, p=0.04).ConclusionsA catheter management protocol decreases the incidence of PPIVC in hospitalized patients. The risk of PPIVC increases for peripherally inserted central venous catheters when the patients have a history of phlebitis and for peripheral venous catheters when amiodarone or cefotaxime are infused. Catheterization of peripheral veins performed during morning shifts is associated with a lower incidence of PPIVC when compared with night shift catheterizations.