NPunto

24

Authors: Fernández Arias, I

Suicide is a complex problem of great magnitude, as a result of the interaction of different factors. Currently, an increase in their numbers has been observed in two population groups: adolescents and the elderly. Suicidal behavior affects three levels: emotional, behavioral and cognitive, in which common characteristics appear: ambivalence, impulsiveness and stiffness. The most important risk factor is suicide attempt, since it is the most predictive. The preventive interventions used must be multisectoral and comprehensive, targeting different populations: universal, selective and indicated strategy. The psychological autopsy analyzes suicide and with the data obtained we can design and implement prevention strategies. The most relevant intervention is the clinical interview, it consists of a dialectical process, the therapeutic alliance is promoted and results in the achievement of consensual objectives. Other interventions that can be used are psychotherapeutic therapies. The mourners form a significant group, we must use preventive strategies to avoid chronicity, the pathologization of mourning and the decrease in the use of psychotropic drugs. The nurse acquires a valuable role, coordinates with other professionals and ensures that the patient receives multidisciplinary and comprehensive care as possible.

25

Authors: Marco Ramo, E

The mourning of relatives and close friends who have lost a member to suicide is different from mourning for another cause. The great emotional impact, the stigma, the feelings of shame and guilt, the misunderstanding of the event and the ruminative thoughts focused on seeking an explanation mean that the evolution of grief does not follow the phases of normal grief. The suicide loss of a loved one has consequences for the rest of the family, physical and psychological, it increases the risk of suicide of another member. It affects intra- and extra-family relationships and academic and work performance. The evolution of the duel will depend on each individual case, but there are factors such as the relationship with the deceased, the farewell messages, the method used or the possibility of receiving support, which will influence the process. After receiving such traumatic news, at first, family members seek support in their closest circle, but this support becomes insufficient and they need the attention of mental health professionals. Therefore, it is essential that professionals are trained in this area and know the particularities of a duel due to suicide compared to a normal duel.

40

Authors: Álvarez García, A

Background Suicide is one of the most tragic events facing this Society. The constant increase in the number of cases, as well as the fact that it affects younger and younger people, makes it necessary to implement measures for its prevention. Due to its easy application, its accessibility and its good cost-benefit ratio, physical exercise, through its multiple physical and psychological effects, can be one of the most useful ways to chieve this porpouse. Methodology A single researcher has carried out a bibliographic review between April and June 2023 in the main databases: PUBMED, MEDLINE, LILACS, IBECS, ENFISPO, COCHRANE and CUIDEN, using the different keywords combined through the different boolean operators,115 articles, published in English or Spanish, in the last 5 years, had been identified. Results Seven articles have been selected for analysis. All of them, studied the effect of physical exercise on suicidal behavior in adolescents. The difference between sexes and the most appropriate type, intensity, volume or frequency of physical exercise have also been analyzed. Conclusion Physical exercise, in all its variants, prevents suicidal behavior in adolescents and improves their mental health. This relationship is clearer in the case of boys than in the case of girls, for whom more studies would be needed. The methodological irregularity of the studies prevents establishing a more useful form of exercise but collective exercises are recommended.

21

Authors: Gómez Brusi, C

Patients who undergo surgical interventions present a degree of anxiety in the preoperative period, generally in adult patients. When patients enter surgery they are in an exorbitant emotional state so the body prepares itself to face the situation. Nursing in the field of surgical anesthesiology is of vital importance, since the surgery block is a multidisciplinary team whose objectives are common, which is to safeguard the health of the patient. This team is made up of the nursing staff, auxiliary nursing care technicians, orderlies, clerks, and cleaners. However, what concerns this question is the importance of the professional. This professional is not only involved in the technical knowledge of the profession, such as the preparation of the operating room, intervention of the operation or helping the surgeon, but is also concerned with the emotional well-being of the patient. In fact, the nursing professional is in charge of minimizing the anxiety and stress of the patient in the preoperative and postoperative periods. In short, nursing plays an important role in the work of anxiety prevention in surgical patients, directing their care and activities to improve their quality of hospital stay. OBJECTIVE: The purpose of this bibliographic review study is to examine the literature on nursing professional interventions for the management of anxiety in surgical patients who are anesthetized, management of techniques and detection and immediate action. METHODOLOGY: To carry out this bibliographic review, a search was carried out in different databases Pumbed, Scielo, SciencieDirect, Google Scholar. RESULTS: there was a search of 200 articles of which 102 were discarded by title, date and year, 50 of mere interest were observed and 21 were selected of which the rest were excluded. CONCLUSIONS: this review shows the importance of the nursing staff in surgical anesthesiology for the reduction of anxiety in the pre-surgical patient.

24

Authors: Matas Caballero, S., Martín Martín-Peralta, G., Azahares Moiset, E

Pediatric airway management can be challenging for the anesthesiologist as the airway in this population group differs slightly from that of the adult in both anatomy and physiology. The work is a narrative literature review that aims to delve into the most recent literature, mostly articles since 2018, to get an updated bibliography on pediatric airway management and endotracheal intubation, as well as all the peculiarities of this technique in that population group. Currently, the anesthesiologist has several devices for airway management, each of them with a series of characteristics that will make them useful for different situations. Among these devices are nasopharyngeal cannulae and oropharyngeal cannulae such as the Guedel, both of which are useful for preventing airway obstruction and aspirating secretions. For airway management in situations of shorter duration, laryngeal masks can be chosen because they are less aggressive and have a lower risk of complications for the child. Currently, different types are available on the market, useful for the different situations and characteristics of the childs airway. While, for the management of the airway in a more definitive, safe way or for a long period of time, the technique of choice is endotracheal intubation, which consists of the introduction of a tube, generally made of hard plastic, through the trachea. Prior to endotracheal intubation, a correct anesthetic induction must be carried out, selecting both the ideal drugs for the patients age and procedure and the necessary doses. Anesthetic induction is carried out with hypnotics such as propofol, etomidate, ketamine and midazolam; muscle relaxants such as rocuronium and succinylcholine; and analgesics such as fentanyl.

5

Authors: Sánchez Rodriguez, N

- Introduction: Gender violence is the most extreme expression of inequality between men and women. This problem affects multiple spheres of women and their maintenance over time is conditioned by the "Cycle of Violence". - Objective: To know the existing methods for addressing gender violence from the PA consultation. - Methodology: A bibliographic review has been carried out with the keywords in the databases of Pubmed, Lilacs, Dialnet and the Cochrane Library. Likewise, information has been obtained from official websites (government). - Results: To be able to detect gender violence from the care consultation the nurse must take into account the main difficulties that arise in the consultation, as well as the most effective tools for detection. Also, the nurse will be obliged to know how to act in front of this violence taking into account the process in which women find themselves.

21

Authors: Giménez Tornero, M

Introduction: Cancer is one of the leading causes of death worldwide. It consists of an abnormal growth of cells that can affect nearby tissues and malignant them. The symptoms that appear in affected patients are: orange peel, asymmetry of the breasts, discharge in the nipple, retraction of the nipple, lump in the breast or lump in the armpit, among others. To diagnose it, it is necessary to perform tests such as a mammogram, ultrasound or PAAF in some cases. The pharmacological treatment that exists today is chemotherapy or radiotherapy depending on the stage and expansion of the tumor. In addition, there is also surgical treatment for the removal of the tumor or breast. Objective: Determine which intervention is most effective for the total elimination of breast cancer. Method: We carry out a bibliographic search of scientific documents found in databases such as Pubmed, Cochrane, Dialnet and Google Scholar published in English and Spanish in 2020-2021, which meet the objectives and inclusion and exclusion criteria raised. Results: Chemotherapy is a very important factor during the treatment of the tumor, it will generate side effects that will be associated with physical activity, producing an increase in quality of life in these patients. In addition, there is a surgical treatment that consists of performing mastectomy or traditional surgery. And, we will also see the importance of the role of nursing throughout the disease. Conclusions: Chemotherapy helps with tumor reduction, along with radiotherapy, but this entails the presence of side effects, such as vomiting, fatigue, hair loss, insomnia or lymphedema among others. Physical activity is a good factor for improving side effects. In turn, there is controversy about what treatment would be indicated for the end of the disease. We will also emphasize the figure of the nurse during this process.

25

Authors: Martínez Gutiérrez, R

Prostate cancer (PCa) is the second leading cause of cancer in men in the United States and in the European Union. Low-dose-rate brachytherapy (LDR-BT) represents a consolidated treatment option in the management of low risk and intermediate risk localized PCa. However, due to the higher sensitivity to fraction dose of PCa cells, High-dose-rate brachytherapy (HDR-BT) has emerged as a treatment option owing to its highly conformal dose distribution within the prostate and an abrupt dose fall-off outside, saving organs at risk. To realize the potential acute and chronic side effects as well as their impact on health-related quality of life (QoL), are considered important endpoints in the choice of a treatment modality. Despite this, the use of prospective validated questionnaires that assess long-term toxicity of LDR-BT and HDR-BT are rarely used. QoL results are scarce in literature. The aim of this review is to evaluate the evidence of LDR-BT and HDR-BT in the treatment of localized PCa as well as its potential acute and chronic toxicities and QoL impact.

16

Authors: Mifsud Grau, L

Attend emergency in primary care is fundamental in the structure of the Spanish public health. They suppose to extend the hours of the many health centers so that the medical consultation is available 24 hours a day, 365 days per year. Thousands of patients are evaluated by phisicians every day at this place but studies in this area are scarce. Therefore, we consider that knowing how is the patient who comes to this kind of health center, as well as assessing their quality of life through the SF-36 questionnaire will allow us to know better our patients and progressively try to offer a better service.

22

Authors: Moya Crespo, M.J

Introduction: United States is experiencing an epidemic due to the misuse of opioids, and in Spain, in the last 20 years, there has also been an increase in the prescription of opioids, which increases the risk of poisoning. In addition, the presence of new synthetic opioids without medical authorization is exacerbating the problem. Up to one in four patients on long-term opioid medical treatment struggle with opioid addiction. Objective: To know the impact that the consumption of opioids has on people and analyze the management of acute opioid poisoning, as well as if there are ways to identify it ahead of time and prevent it, identifying the approach from Nursing. Methodology: A total of 56 documents, in English and Spanish, have been selected to carry out this bibliographic review. For this, search engines such as PubMed, Scielo, Cochrane Library or scientific journals, among others, have been used. In addition to websites such as the World Health Organization or the Spanish Ministry of Health. Results: Opioid intoxication has a characteristic triad: Miosis, respiratory depression, and coma. The most effective measure is the administration of the antidote as soon as possible, Naloxone, which is usually administered intravenously and rapidly reverses unconsciousness and apnea caused by opioid intoxication. The initial dose undergoes some small variation according to the guidelines and the authors, but most fix it between 0.2 - 0.4 mg, depending on the severity of the symptoms. Conclusion: The administration of Naloxone can cause withdrawal syndrome, so it is recommended to administer it in low doses and repeat it if necessary. It is possible to prevent opioid intoxication in patients at risk of their misuse, for this it is necessary to carry out a multidisciplinary follow-up from Primary Care and establish alternative strategies such as pain treatment, within a multimodal technique that includes pharmacological treatment, non-invasive interventions. pharmacological, psychological support and rehabilitation.

28

Authors: Rascón Guijarro, M.P

Non-suicidal self-injury (NSSI) is a complex and worrisome phenomenon defined as the deliberate destruction of one’s own body tissue in the absence of suicidal intent. The significant increase in its prevalence in recent years and the multiple negative consequences of this behavior have led it to be considered a public health problem. Despite the inclusion of NSSI in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) as an independent diagnostic entity, it is still confused with suicidal behavior and other mental disorders. The purpose of this bibliographic review is to understand non-suicidal self-injury in order to find specialized modes of treatment in emergency care. Working on the stigma that surrounds the NSSI and offering training that changes the negative attitudes of professionals can encourage the person to stop hiding this problem and ask for help. Understanding the functions of the NSSI helps to make sense of this behavior, the most frequent function being emotional regulation, which tries to numb unbearable emotional pain through physical pain. A biopsychosocial approach offers a more comprehensive view of self-injurious behavior as complex, multicausal, and multifactorial behavior that stems from painful life experiences. Although there is not much data on the efficacy of interventions in NSSI, systematic reviews and meta-analyses suggest that psychological therapies can help people struggling with self-harm.

16

Authors: Corral Ardila, M

Cancer is a disease with a high prevalence in Spain. In addition, the course of this disease turns out to be very dangerous and difficult for patients who suffer from it. For this reason, many patients tend to suffer a strong emotional impact when knowing the diagnosis of it, also presenting negative emotional reactions, such as: denial, fear, stress, depression, insomnia, etc. Breast cancer, specifically, is the oncological variety that most develops in the female population and also has a high incidence in our country, producing a large number of deaths annually. For this reason, in this article, a bibliographic review has been carried out regarding the psycho-oncological and social aspects of breast cancer in patients, to know in depth how the experience of the disease affects the patients who have it and thus be able to look for some alternatives to improve their quality of life and alleviate the psychological, social and physical consequences that they may suffer.

21

Authors: Gutiérrez López, M.I

Borderline personality disorders are considered a major problem within mental health given their severity and their high epidemiology. The high dysfunctionality in their behavior derived from their severe difficulty of emotional regulation is a central feature of the disorder and is evidenced on numerous occasions in the form of self-destructive behaviors, being its maximum exponent suicide attempts. Borderline personality disorders involve high costs for health systems as well as for patients and their families themselves, especially if we consider that it is a disorder in which prolonged treatments and hospital admissions are usually performed when crises require it. It has also been reported that these patients are often hyperfrequenters of health services. Due to their characteristics, borderline personality disorders pose a significant therapeutic challenge. The complexity of its clinical expression, the high frequency of comorbid disorders and the presence of other elements that prevent the proper development of therapy, such as premature abandonment of treatment, make them often considered difficult patients and the therapy is seen by clinicians and therapists as complex and frustrating. Currently, psychotherapy is positioned as the first-line treatment for borderline personality disorders supplemented with pharmacotherapy aimed at reducing symptoms (1,2). Several psychotherapeutic models have adapted their intervention to limit personality disorders. Dialectical behavioral therapy is undoubtedly the treatment that has had the greatest expansion, being in the current literature frequent references to it. Other forms of treatment such as mentalization-based therapy or transfer-focused psychotherapy have received significant attention from the various authors. Regarding the effectiveness of psychotherapy in borderline personality disorders we find an encouraging situation that shows the benefits that the different therapies exert on improving the reduction of symptoms, reducing self-injurious behaviour or increasing functionality and interpersonal adjustment. Current evidence suggests that dialectical-behavioral therapy is the treatment of choice for borderline personality disorders, showing its effectiveness in both improving the symptomatology of boundary disorders(3) as in the reduction of self-injury and suicide attempts(4). Other therapeutic models such as transfer-focused psychotherapy, mentalization-based therapy or interpersonal psychotherapy, despite having an important place in the treatment of borderline personality disorders have been noticeably less studied compared to dialectical-behavioral therapy. Although the different authors find promising results in psychotherapy, it has been noted that the potency of the studies available to date is weak (3,5,6), so further analysis and study is recommended. The aim of this paper is to analyse new developments in the efficacy of psychotherapy in borderline personality disorders through a systematic review of the studies published in the last 5 years. It also seeks to know the predictors of therapeutic success as well as those that hinder therapy. A systematic review of the studies published in the last 5 years was carried out by searching for clinical trials present in PubMed, PsycINFO and The Crochrane Central Registrer of Controlled Trials databases. Following this review, there is a greater prevalence of studies focused on the analysis of the efficacy of dialectical-behavioral therapy, with the other therapeutic models being the object of less research production. In general, a benefit of psychotherapy is found in the treatment of borderline personality disorders. Some predictors of therapeutic change and abandonment of treatment were also discovered.

33

Authors: Urmeneta Roncal, C

Cancer is the leading reason for death from disease in children in developed countries, and the second most common cause of death in children over one year of age, with accidents being the first. Although cure rates in pediatric oncology have increased, their diagnosis continues to be a major crisis in the family nucleus. In addition to curing the disease, efforts should also be aimed at reducing the side effects and aftermath that the disease itself and its treatments may cause in the quality of life of children and family members. That is why the figure of the psychologist is basic for a good evolution and recovery.