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  • 1
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    Safe Care and Medication Intake Provided by Caregivers at Home: Reality Care Study Protocol
    MDPI AG ; 2023
    In:  Healthcare Vol. 11, No. 15 ( 2023-08-03), p. 2190-
    Details
    In: Healthcare, MDPI AG, Vol. 11, No. 15 ( 2023-08-03), p. 2190-
    Abstract: Justification: Providing care to patients with several conditions and simultaneously taking several medications at home is inexorably growing in developed countries. This trend increases the chances of home caregivers experiencing diverse errors related with medication or care. Objective: To determine the effectiveness of four different educational solutions compared to the natural intervention (absence of intervention) to provide a safer care at home by caregivers. Method: Prospective, parallel, and mixed research study with two phases. Candidates: Home-based caregivers caring a person with multiple comorbid conditions or polymedication who falls into one of the three profiles of patients defined for the study (oncology, cardiovascular, or pluripathological patients). First phase: Experts first answered an online survey, and then joined together to discuss the design and plan the content of educational solutions directed to caregivers including the identification of medication and home care errors, their causes, consequences, and risk factors. Second phase: The true experiment was performed using an inter- and intrasubject single-factor experimental design (five groups: four experimental groups against the natural intervention (control), with pre- and post-intervention and follow-up measures) with a simple random assignment, to determine the most effective educational solution (n = 350 participants). The participants will be trained on the educational solutions through 360 V, VR, web-based information, or psychoeducation. A group of professionals called the “Gold Standard” will be used to set a performance threshold for the caring or medication activities. The study will be carried out in primary care centers, hospitals, and caregivers’ associations in the Valencian Community, Andalusia, Madrid, and Murcia. Expected results: We expect to identify critical elements of risk management at home for caregivers and to find the most effective and optimal educational solution to reduce errors at home, increasing caregivers’ motivation and self-efficacy whilst the impact of gender bias in this activity is reduced. Trial Registration: Clinical Trial NCT05885334.
    Type of Medium: Online Resource
    ISSN: 2227-9032
    URL: Article
    DOI: 10.3390/healthcare11152190
    Language: English
    Publisher: MDPI AG
    Publication Date: 2023
    detail.hit.zdb_id: 2721009-1
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  • 2
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    Addressing Acute Stress among Professionals Caring for COVID-19 Patients: Lessons Learned during the First Outbreak in Spain (March–April 2020)
    MDPI AG ; 2021
    In:  International Journal of Environmental Research and Public Health Vol. 18, No. 22 ( 2021-11-16), p. 12010-
    Details
    In: International Journal of Environmental Research and Public Health, MDPI AG, Vol. 18, No. 22 ( 2021-11-16), p. 12010-
    Abstract: Objectives: To describe lessons learned during the first COVID-19 outbreak in developing urgent interventions to strengthen healthcare workers’ capacity to cope with acute stress caused by health care pressure, concern about becoming infected, despair of witnessing patients’ suffering, and critical decision-making requirements of the SARS-CoV-2 pandemic during the first outbreak in Spain. Methods: A task force integrated by healthcare professionals and academics was activated following the first observations of acute stress reactions starting to compromise the professionals’ capacity for caring COVID-19 patients. Literature review and qualitative approach (consensus techniques) were applied. The target population included health professionals in primary care, hospitals, emergencies, and nursing homes. Interventions designed for addressing acute stress were agreed and disseminated. Findings: There are similarities in stressors to previous outbreaks, and the solutions devised then may work now. A set of issues, interventions to cope with, and their levels of evidence were defined. Issues and interventions were classified as: adequate communication initiative to strengthen work morale (avoiding information blackouts, uniformity of criteria, access to updated information, mentoring new professionals); resilience and recovery from physical and mental fatigue (briefings, protecting the family, regulated recovery time during the day, psychological first aid, humanizing care); reinforce leadership of intermediate commands (informative leadership, transparency, realism, and positive messages, the current state of emergency has not allowed for an empirical analysis of the effectiveness of proposed interventions. Sharing information to gauge expectations, listening to what professionals need, feeling protected from threats, organizational flexibility, encouraging teamwork, and leadership that promotes psychological safety have led to more positive responses. Attention to the needs of individuals must be combined with caring for the teams responsible for patient care. Conclusions: Although the COVID-19 pandemic has a more devastating effect than other recent outbreaks, there are common stressors and lessons learned in all of them that we must draw on to increase our capacity to respond to future healthcare crises.
    Type of Medium: Online Resource
    ISSN: 1660-4601
    URL: Article
    DOI: 10.3390/ijerph182212010
    Language: English
    Publisher: MDPI AG
    Publication Date: 2021
    detail.hit.zdb_id: 2175195-X
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  • 3
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    Second Victim Support at the Core of Severe Adverse Event Investigation
    MDPI AG ; 2022
    In:  International Journal of Environmental Research and Public Health Vol. 19, No. 24 ( 2022-12-15), p. 16850-
    Details
    In: International Journal of Environmental Research and Public Health, MDPI AG, Vol. 19, No. 24 ( 2022-12-15), p. 16850-
    Abstract: There is limited evidence and a lack of standard operating procedures to address the impact of serious adverse events (SAE) on healthcare workers. We aimed to share two years’ experience of a second victim support intervention integrated into the SAE management program conducted in a 500-bed University Hospital in Granada, Spain. The intervention strategy, based on the “forYOU” model, was structured into three levels of support according to the degree of affliction and the emotional needs of the professionals. A semi-structured survey of all workers involved in an SAE was used to identify potential second victims. Between 2020 and 2021, the SAE operating procedure was activated 23 times. All healthcare workers involved in an SAE (n = 135) received second-level support. The majority were physicians (51.2%), followed by nurses (26.7%). Only 58 (43.0%) received first-level emotional support and 47 (34.8%) met “second victim” criteria. Seven workers (14.9%) required third-level support. A progressive increase in the notification rates was observed. Acceptance of the procedure by professionals and managers was high. This novel approach improved the number of workers reached by the trained staff; promoted the visibility of actions taken during SAE management and helped foster patient safety culture in our setting.
    Type of Medium: Online Resource
    ISSN: 1660-4601
    URL: Article
    DOI: 10.3390/ijerph192416850
    Language: English
    Publisher: MDPI AG
    Publication Date: 2022
    detail.hit.zdb_id: 2175195-X
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  • 4
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    Effectiveness of Digital Physiotherapy Practice Compared to Usual Care in Long COVID Patients: A Systematic Review
    MDPI AG ; 2023
    In:  Healthcare Vol. 11, No. 13 ( 2023-07-07), p. 1970-
    Details
    In: Healthcare, MDPI AG, Vol. 11, No. 13 ( 2023-07-07), p. 1970-
    Abstract: Long COVID syndrome has been recognized as a public health problem. Digital physiotherapy practice is an alternative that can better meet the needs of patients. The aim of this review was to synthesize the evidence of digital physiotherapy practice in Long COVID patients. A systematic review was carried out until December 2022. The review was complemented by an assessment of the risk of bias and methodological quality. A narrative synthesis of results was conducted, including subgroup analyses by intervention and clinical outcomes. Six articles, including 540 participants, were selected. Five articles were considered of high enough methodological quality. Parallel-group, single-blind, randomized controlled trials were the most commonly used research design. Tele-supervised home-based exercise training was the most commonly used intervention. Great heterogeneity in clinical outcomes and measurement tools was found. A subgroup analysis showed that digital physiotherapy is effective in improving clinical outcomes. Significant differences in favor of digital interventions over usual care were reported. Nevertheless, discrepancies regarding effectiveness were found. Improvements in clinical outcomes with digital physiotherapy were found to be at least non-inferior to usual care. This review provides new evidence that digital physiotherapy practice is an appropriate intervention for Long COVID patients, despite the inherent limitations of the review. Registration: CRD42022379004.
    Type of Medium: Online Resource
    ISSN: 2227-9032
    URL: Article
    DOI: 10.3390/healthcare11131970
    Language: English
    Publisher: MDPI AG
    Publication Date: 2023
    detail.hit.zdb_id: 2721009-1
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  • 5
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    Efficacy, Feasibility, Adherence, and Cost Effectiveness of a mHealth Telerehabilitation Program in Low Risk Cardiac Patients: A Study Protocol
    MDPI AG ; 2021
    In:  International Journal of Environmental Research and Public Health Vol. 18, No. 8 ( 2021-04-12), p. 4038-
    Details
    In: International Journal of Environmental Research and Public Health, MDPI AG, Vol. 18, No. 8 ( 2021-04-12), p. 4038-
    Abstract: Individual and group cardiac rehabilitation (CR) programs reduce cardiovascular morbidity and mortality by reducing recurrent events, improving risk factors, aiding compliance with drug treatment, and improving quality of life through physical activity and education. Home-based programs are equally effective in improving exercise capacity, risk factors, mortality, and health-related quality of life outcomes compared to hospital-based intervention. Cardio-telerehabilitation (CTR) programs are a supplement or an alternative to hospital rehabilitation programs providing similar benefits to usual hospital and home care. Despite this statement, implementation in the public and private healthcare environment is still scarce and limited. The main objective of this research was to evaluate the efficacy, feasibility, and adherence of a personalized eight-week mHealth telerehabilitation program in low-risk cardiac patients in the hospital of Melilla (Spain). The secondary aims were to investigate patient satisfaction, identify barriers of implementation and adverse events, and assess cost-effectiveness from a health system perspective. A study protocol for a single center prospective controlled trial was conducted at the Regional Hospital of Melilla (Spain), with a sample size of (n = 30) patients with a diagnosis of low-risk CVD with class I heart failure according to NYHA (New York Heart Association). Outcomes of this study, will add new evidence that could support the use of CTR in cardiac patients clinical guidelines.
    Type of Medium: Online Resource
    ISSN: 1660-4601
    URL: Article
    DOI: 10.3390/ijerph18084038
    Language: English
    Publisher: MDPI AG
    Publication Date: 2021
    detail.hit.zdb_id: 2175195-X
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  • 6
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    Telerehabilitation Intervention in Patients with COVID-19 after Hospital Discharge to Improve Functional Capacity and Quality of Life. Study Protocol for a Multicenter Randomized Clinical Trial
    MDPI AG ; 2021
    In:  International Journal of Environmental Research and Public Health Vol. 18, No. 6 ( 2021-03-12), p. 2924-
    Details
    In: International Journal of Environmental Research and Public Health, MDPI AG, Vol. 18, No. 6 ( 2021-03-12), p. 2924-
    Abstract: COVID-19 can cause important sequels in the respiratory system and frequently presents loss of strength, dyspnea, polyneuropathies and multi-organic affectation. Physiotherapy interventions acquire a fundamental role in the recovery of the functions and the quality of life. Regarding the recovery phases after hospital discharge, the current evidence available is very preliminary. Telerehabilitation is presented as a promising complementary treatment method to standard physiotherapy. The main objective of this research is to evaluate the effectiveness of a personalized telerehabilitation intervention after discharge from hospital for the improvement of functional capacity and quality of life compared to a program of health education and/or care in a rehabilitation center. As secondary objectives, to identify the satisfaction and perception of patients with the telerehabilitation intervention and the presence of barriers to its implementation, as well as to evaluate the cost-effectiveness from the perspective of the health system. This study protocol will be carried out through a single blind multicenter randomized clinical trial in the south of Spain. We hypothesize that the implementation of a telerehabilitation program presents results not inferior to those obtained with the current standard intervention. If the hypothesis is confirmed, it would be an opportunity to define new policies and interventions to address this disease and its consequences. Trial registration NCT04742946.
    Type of Medium: Online Resource
    ISSN: 1660-4601
    URL: Article
    DOI: 10.3390/ijerph18062924
    Language: English
    Publisher: MDPI AG
    Publication Date: 2021
    detail.hit.zdb_id: 2175195-X
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  • 7
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    The Effectiveness and Recommendation of Motor Imagery Techniques for Rehabilitation after Anterior Cruciate Ligament Reconstruction: A Systematic Review
    MDPI AG ; 2021
    In:  Journal of Clinical Medicine Vol. 10, No. 3 ( 2021-01-22), p. 428-
    Details
    In: Journal of Clinical Medicine, MDPI AG, Vol. 10, No. 3 ( 2021-01-22), p. 428-
    Abstract: Motor imagery (MI) reported positive effects in some musculoskeletal rehabilitation processes. The main objective of this study was to analyze the effectiveness of MI interventions after anterior cruciate ligament (ACL) reconstruction. A systematic review was conducted from November 2018 to December 2019 in PubMed, Scopus, Web of Science, The Cochrane Library, and Physiotherapy Evidence Database (PEDro). The methodological quality, degree of recommendation, and levels of evidence were analyzed. A total of six studies were included. Selected studies showed unequal results (positive and negative) regarding pain, anxiety, fear of re-injury, function, and activities of daily living. Regarding the range of motion, anthropometric measurements, and quality of life, the results were not conclusive. Muscle activation, strength, knee laxity, time to remove external support, and neurobiological factors showed some favorable results. Nevertheless, the results were based on a limited number of studies, small sample sizes, and a moderate-weak degree of recommendation. In conclusion, our review showed a broader view of the current evidence, including a qualitative assessment to implement MI after ACL surgery. There was no clear evidence that MI added to physiotherapy was an effective intervention after ACL surgery, although some studies showed positive results in clinical outcomes. More adequately-powered long-term randomized controlled trials are necessary.
    Type of Medium: Online Resource
    ISSN: 2077-0383
    URL: Article
    DOI: 10.3390/jcm10030428
    Language: English
    Publisher: MDPI AG
    Publication Date: 2021
    detail.hit.zdb_id: 2662592-1
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  • 8
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    The Effectiveness of a Four-Week Digital Physiotherapy Intervention to Improve Functional Capacity and Adherence to Intervention in Patients with Long COVID-19
    MDPI AG ; 2022
    In:  International Journal of Environmental Research and Public Health Vol. 19, No. 15 ( 2022-08-03), p. 9566-
    Details
    In: International Journal of Environmental Research and Public Health, MDPI AG, Vol. 19, No. 15 ( 2022-08-03), p. 9566-
    Abstract: Long COVID-19 has been defined as the condition occurring in individuals with a history of probable or confirmed SARS-CoV-2 infection, with related symptoms lasting at least 2 months and not explainable by an alternative diagnosis. The practice of digital physiotherapy presents itself as a promising complementary treatment method to standard physiotherapy, playing a key role in the recovery of function in subjects who have passed the disease and who maintain some symptomatology over time. The aims of this research are to explore the effect of a digital physiotherapy intervention on functional recovery in patients diagnosed with Long COVID-19 and to identify the level of adherence to the treatment carried out. A quasi-experimental pre-post study assessed initially and at the end of the 4-week intervention the functional capacity (1-min STS and SPPB) and the adherence (software) of a total of 32 participants. After the 4-week digital physiotherapy practice intervention with an individualised and customise exercise programme, a statistically significant improvement was observed (p 〈 0.05) with a small to medium effect size, high adherence rates and values above the minimal clinically important difference (MCID). We consider our intervention feasible, safe and consistent with our objectives. However, further randomised clinical trials and studies with larger samples are needed to draw extrapolable conclusions. Trial registration NCT04742946.
    Type of Medium: Online Resource
    ISSN: 1660-4601
    URL: Article
    DOI: 10.3390/ijerph19159566
    Language: English
    Publisher: MDPI AG
    Publication Date: 2022
    detail.hit.zdb_id: 2175195-X
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  • 9
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    Respiratory Muscle Function and Exercise Performance in Adult Patients with Fontan Circulation
    MDPI AG ; 2023
    In:  Journal of Clinical Medicine Vol. 12, No. 14 ( 2023-07-10), p. 4593-
    Details
    In: Journal of Clinical Medicine, MDPI AG, Vol. 12, No. 14 ( 2023-07-10), p. 4593-
    Abstract: At rest, a good Fontan circulation can provide a normal cardiac output (CO). However, as a consequence of its unique hemodynamic nature, the limitations of the Fontan circuit are exposed during exercise. We aimed to provide a comprehensive assessment of the pathophysiology of exercise in adult Fontan patients (FPs) and identify factors limiting their functional capacity (FC). In a single-center study conducted in 37 FPs aged ≥16 years and 19 healthy-controls (HCs) who underwent CPET on a cycle ergometer in February and March 2022, the mean peakVO2 was 21 ± 5.4 mL/kg/min, which was 55% of the predicted value. Morphologically, the left single ventricle showed a higher peakVO2% predicted value (57.4 ± 14.4% vs. 43.4 ± 8.1%, p = 0.045). The factors associated with low peakVO2 values were an early flattened or descending O2 pulse at maximal exertion (52 ± 14% vs. 62 ± 12.5, p = 0.04 and 47.6 ± 9% vs. 60 ± 14, p = 0.018, respectively) and chronotropic insufficiency (53 ± 12% vs. 69.8 ± 20%, p = 0.008). The OUES was found to be a useful parameter to assess the FC in FPs in maximal and submaximal exercise testing. A strong positive correlation was observed between the %OUES and peakVO2%predicted (r = 0.726, p 〉 0.001). The lung function was impaired in the FPs, mostly with a mild restrictive pattern (56.8%). The FPs showed lower inspiratory muscle strength compared to the HCs but it was not statistically associated with either the peakVO2 or VE/VCO2 slope. Regular intense physical activity improves one’s FC. Although FPs have inspiratory muscle weakness, its impact on their FC is unclear. The peakVO2% predicted grew progressively higher as the level of physical activity increased (low level 49.5 ± 14%, moderate level 55 ± 12%, intense level 69 ± 20%).
    Type of Medium: Online Resource
    ISSN: 2077-0383
    URL: Article
    DOI: 10.3390/jcm12144593
    Language: English
    Publisher: MDPI AG
    Publication Date: 2023
    detail.hit.zdb_id: 2662592-1
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  • 10
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    Blood Flow Restriction in Oncological Patients: Advantages and Safety Considerations
    MDPI AG ; 2023
    In:  Healthcare Vol. 11, No. 14 ( 2023-07-19), p. 2062-
    Details
    In: Healthcare, MDPI AG, Vol. 11, No. 14 ( 2023-07-19), p. 2062-
    Abstract: Background: Cancer, being a highly widespread disease on a global scale, has prompted researchers to explore innovative treatment approaches. In this regard, blood flow restriction has emerged as a promising procedure utilized in diverse clinical populations with favorable results including improvements in muscle strength, cardiovascular function, and postoperative recovery. The aim of this systematic review was to assess the efficacy of blood flow restriction in cancer survivors. Methods: An investigation was carried out using various databases until February 2023: PubMed, Scientific Electronic Library Online, Physiotherapy Evidence Database, Scopus, Web of Science, Cochrane Plus, SPORTDiscus, Physiotherapy and Podiatry of the Complutense University of Madrid, ScienceDirect, ProQuest, Research Library, Cumulative Index of Nursing and Allied Literature Complete Journal Storage, and the gray literature. To assess the methodological quality of the studies, the PEDro scale was utilized, and the Cochrane Collaboration tool was employed to evaluate the risk of bias. Results: Five articles found that blood flow restriction was beneficial in improving several factors, including quality of life, physical function, strength, and lean mass, and in reducing postoperative complications and the length of hospital stay. Conclusion: Blood flow restriction can be a viable and effective treatment option. It is important to note that the caution with which one should interpret these results is due to the restricted quantity of articles and significant variation, and future research should concentrate on tailoring the application to individual patients, optimizing load progression, ensuring long-term follow-up, and enhancing the methodological rigor of studies, such as implementing sample blinding.
    Type of Medium: Online Resource
    ISSN: 2227-9032
    URL: Article
    DOI: 10.3390/healthcare11142062
    Language: English
    Publisher: MDPI AG
    Publication Date: 2023
    detail.hit.zdb_id: 2721009-1
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