Atencion primaria
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To identify nurses perceptions of Advance Directives (AD) and to analyse the influence of experience with AD on their perception. ⋯ Nurses have little experience with AD. They are available to respect the patient's will but did not feel able to address the issue on their own initiative. Most agree that the AD can "fail" if the patient does not reevaluate it periodically. Reflection and debate on the ethical issues surrounding AD should be promoted: promoting patient autonomy, care in vulnerable situations, team decisions and conscientious objection.
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Observational Study
Prevalence and determinants of insomnia symptoms among schoolteachers.
Insomnia is the most common sleep disorder. In Portugal, teachers have a specific socioeconomic situation, caused by the distance between home and workplace, unstable job situation and students' behavioral problems. The aim of this study was to determine the prevalence of insomnia in a sample of Portuguese schoolteachers. ⋯ Portuguese schoolteachers show a high prevalence of insomnia. Insomnia was associated with sociodemographic and occupational variables.
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Chronic kidney disease (CKD) is an important global health problem, involving to 10% of the Spanish population, promoting high morbidity and mortality for the patient and an elevate consumption of the total health resources for the National Health System. This is a summary of an executive consensus document of ten scientific societies involved in the care of the renal patient, that actualizes the consensus document published in 2007. The central extended document can be consulted in the web page of each society. ⋯ Integrated management of CKD patient in haemodialysis, peritoneal dialysis and renal transplant patients. Management of the uremic patient in palliative care. We hope that this document may be of help for the multidisciplinary management of CKD patients by summarizing the most updated recommendations.
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To identify the practices reported by health professionals on hand hygiene; To determine how the practices of hand hygiene are related to socio-demographic and professional variables and variables in the context of practice. ⋯ Most have knowledge about the practice of hand hygiene; however, some professional groups need to improve their practice of proper technique and the correct time to do so. Approximately a third did not attend specific training, leading us to reflect on the need to invest in training.
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The aging population is increasing worldwide, but the abuse and mistreatment in the elderly (often silenced forms) has also been increasing, with strong implications for their quality of life. ⋯ We found that the abuse and mistreatment are present in the everyday life of many seniors and are a difficult subject to approach. The evidence, invite us to reflect on the development of intervention strategies, particularly at the levels of emotional abuse, neglect, promotion of health and family functioning in order to contribute to the reduction or extinction of abuse and ill-treatment in the elderly.