Examinando por Autor "Alameda-Cuesta, Almudena"

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Chronic cardiovascular nursing care in Spanish primary care: A qualitative study
(Wiley, 2022-12-07) Lizcano-Álvarez, Ángel; Esteban-Hernández, Jesús; Alameda-Cuesta, Almudena; Cid-Expósito, María-Gema ; Palacios-Ceña, Domingo
Aims: We aimed to investigate the perspective of primary care nurses on their role with patients who have chronic cardiovascular disease and to identify cultural elements shared by nurses caring for people with chronic cardiovascular disease. In primary care, the role of the nurse is essential to promote self-efficacy in cardiovascular self-care. Individuals with chronic cardiovascular disease need to integrate the disease into their life, together with the health recommendations for management and follow-up. Methods: A qualitative, focused ethnographic study was conducted. Purposeful sampling was used to include nurses who were working in primary care during the study. Data collection took place between 20 January and 20 May 2014 and consisted of semi-structured interviews. A thematic analysis was applied using the data. Results: Eleven participants were included. Cardiovascular care forces nurses to reflect on their identity and role in primary care. The relationship between the nurse and people with chronic cardiovascular disease is a complex process, which may cause nurses to feel a sense of failure and monotony in their work. Conclusions: Our findings may help to understand the role of the nurse and the care provided in patients with chronic cardiovascular disease.
Compliance Behaviour After a Coronary Ischaemic Event:A Quasi-Experimental Study of Adherence to a ProtocolisedFollow-Up in Primary Care
(MDPI, 2024-12-19) Lizcano-Álvarez, Angel; Carretero-Julián, Laura; Talavera-Saez, Ana; Alameda-Cuesta, Almudena; Rodríguez-Vázquez, Rocío; Cristóbal-Zárate, Beatriz; Cid-Expósito, María-Gema; en behalf of the REccAP Group, (Cardiovascular CareNursing Network in Primary Care)
Following a coronary ischaemic event, it is essential to promote empowerment in self-care decision making. Primary care nursing is crucial for intensive follow-up to promote adherence to the therapeutic regimen. Objective: To ascertain whether adherence to a protocolised follow-up programme, with the support of a patient notebook, improves compliance behaviours in terms of physical activity, prescribed diet and medication. This is a quasi-experimental multicentre pre/post study. Population: Individuals aged 40–70 years, diagnosed with cardiac ischaemia in the last 18 months with a follow-up from March 2017 to January 2019, were included in a protocolised followup programme consisting of 11 visits over 12 months. A total of 194 patients started the programme and 132 completed it. Of these, 67.4% exhibited good adherence to follow-up, 31.8% exhibited medium adherence, and 0.8% exhibited poor adherence. Therefore, the patients were recoded into two variables: Medium–Low Adherence and High. The Nursing Outcomes Classification variables were significantly different between the Poor–Medium and Good Adherence groups and were always higher in the Good Adherence group (p-values < 0.05 t-student). There was a significant relationship between level of adherence and compliance behaviour. Good adherence to a follow-up plan led by primary care nurses improves compliance behaviours in terms of prescribed diet, physical activity, and medication. Early, intensive and protocolised follow-up by primary care nurses is essential to improve adherence to the therapeutic regimen and compliance behaviour among individuals with cardiac ischaemia. The use of a cardiovascular self-care notebook promotes adherence.
Fibromyalgia, Chronic Fatigue Syndrome, and Multiple Chemical Sensitivity: Illness Experiences
(2021) Alameda-Cuesta, Almudena; Pazos-Garciandía, Álvaro; Oter-Quintana, Cristina; Losa-Iglesias, Marta Elena
Fibromyalgia, chronic fatigue syndrome/myalgic encephalomyelitis, and multiple chemical sensitivity can be considered contested illnesses. The questioning of the status of these conditions as real diseases reduces feelings of legitimacy in those affected. The purpose of this study was to analyze subjectivity construction processes in people with these diseases. A qualitative exploratory study was conducted from the perspective of hermeneutic phenomenology and ethnosociology. We used life stories for compiling data (13 informants were interviewed face-to-face), and sociological discourse analysis was developed. Three main categories were identified: (a) self and grieving; (b) images and practices relating to fibromyalgia, chronic fatigue syndrome/myalgic encephalomyelitis, and multiple chemical sensitivity; and (c) relationships with health professionals. This study shows that daily experiences of people living with these diseases are marked by stigmatization processes. The ultimate purpose of nursing care for people with these conditions should be to reduce their vulnerability and exclusion.
Intensive nurse-led follow-up in primary care to improve self-management and compliance behaviour after myocardial infarction
(Wiley, 2023-08-01) Lizcano-Álvarez, Ángel; Carretero-Julián, Laura; Talavera-Saez, Ana; Cristóbal.Zárate, Beatriz; Cid-Expósito, María-Gema; Alameda-Cuesta, Almudena
Abstract Aims and objectives To assess the effects of intensive follow-up by primary care nurses on cardiovascular disease self-management and compliance behaviours in post-myocardial infarction patients. Background Although cardiovascular disease prevention and cardiac rehabilitation take place in hospital settings, a nurse-led approach is necessary in primary care during the first few months after a myocardial infarction. Therefore, it is important to assess self-management of cardiovascular disease and levels of compliance with the prescribed diet, physical activity, and medication. To facilitate patients’ self-efficacy, the use of health education tools such as a heart-healthy self-care notebook can be helpful. Design The study used a multicentre, quasi-experimental, pre-post design without a control group. Methods Patients with acute coronary syndrome from 40 healthcare facilities were included in the study. A total of 212 patients and 59 nurses participated in a programme including 11 interventions during the first 12-18 months after myocardial infarction. The following Nursing Outcomes Classification outcomes were assessed at baseline and at the end of the intervention: Self-management: Cardiac Disease (1617) and Compliance Behaviour: Prescribed Diet (1622), Compliance Behaviour: Prescribed Activity (1632), and Compliance Behaviour: Prescribed Medication (1623). Marjory Gordon’s functional health patterns and a self-care notebook were used in each intervention. Pre-post intervention means were compared using Student’s t-tests for related samples. The results of the study are reported in compliance with the TREND Statement. Results A total of 132 patients completed the intervention. Significant improvement in compliance with diet, physical activity, and prescribed medication was observed at pre-post follow-up, as well as in most indicators in the Self-management: Cardiac Disease outcome. Conclusion Intensive, immediate follow-up after myocardial infarction improves compliance behaviours and self-management of heart disease. A combined self-care and family care approach should be encouraged to empower post-myocardial infarction patients.
Investigación cualitativa sobre la conceptualización de la hiperfrecuentación por parte del personal médico de atención primaria
(2009) Alameda-Cuesta, Almudena; Pazos-Garciandía, Álvaro
Fundamentos: La hiperfrecuentación es un fenómeno preocupante para los sistemas sanitarios occidentales, por la gran carga de trabajo que genera y sus altos costes materiales y humanos. El objetivo de este trabajo es estudiar los significados, categorías y prácticas que las médicas y médicos de Atención Primaria vivencian en torno a la hiperfrecuentación. Métodos: Estudio cualitativo basado en una aproximación sociosubjetiva, a través de entrevistas en profundidad (ocho entrevistas a médicos/as de Atención Primaria de la Comunidad de Madrid). El material discursivo se analizó desde una perspectiva pragmatista. Resultados: La figura del médico de Atención Primaria se encuentra en la intersección de lógicas profesionales-institucionales contradictorias, lo que genera niveles altos de malestar profesional. Los aspectos sociales y psicológicos aparecen de forma confusa en relación con la consideración de todo aquello que no tiene que ver con lo físico como ajeno al ámbito de actuación de la medicina. La hiperfrecuentación resulta problemática porque se sitúa en el centro de la dicotomía signo-síntoma, su manejo requiere mucho tiempo, precisa de un abordaje integral, e imposibilita el cumplimiento del rol médico como profesional que diagnostica e instaura un tratamiento etiológico. Estas dificultades terminan por traducirse en conflictos en la relación profesional-paciente. Conclusiones: Los significados relativos a la hiperfrecuentación van a variar notablemente en función de las posiciones sociosubjetivas, por lo que abordajes como el que aquí se propone ayudan a comprender la complejidad de una problemática que se construye en el seno de las relaciones entre sujetos particulares, atravesados por dinámicas institucionales, conflictos laborales, trayectorias profesionales e ideologías diversas.
Malestares en el margen. Sujetos y tránsitos en la fibromialgia, el Síndrome de Fatiga Crónica y la Sensibilidad Química Múltiple
(Edicions Bellaterra, 2018) Alameda-Cuesta, Almudena
El objetivo de este estudio fue explorar los procesos de construcción subjetiva de las personas afectadas por fibromialgia, síndrome de fatiga crónica-encefalomielitis Miálgica y sensibilidad química múltiple. Para ello se llevó a cabo un estudio cualitativo con una orientación fenomenológica, utilizando los relatos de vida como herramienta de recogida de datos. Este libro no pretende hablar de enfermedades; este libro pretende hablar de personas. De personas a las que la enfermedad ha arrojado a un espacio de incomprensión y exclusión; de personas que pelean cada día por reconocerse y ser reconocidas. Frente a la invisibilidad, surge la resistencia de unos sujetos que luchan por escribir su historia en ese espacio marginal que les ha tocado habitar. Anotaciones en el margen que no sólo guían nuestra mirada hacia mundos habitualmente silenciados, sino que también permiten entender y, a veces, modificar el orden hegemónico situado en el cuerpo central de la página. Estas prácticas desde el margen arrojan luz sobre las fallas de nuestro sistema sociosanitario, constituyéndose en oportunidades para identificar y transformar funcionamientos ineficaces, generadores de exclusión y vulnerabilidad. La principal aportación de este trabajo es mostrar las experiencias cotidianas de personas afectadas por enfermedades contestadas, así como las formas en que dicho carácter contestado impacta en su propia subjetividad e incrementa el sufrimiento ligado al padecimiento de una enfermedad crónica.
NANDA-I and NOC Linkages for Six Psychosocial Nursing Diagnoses: A Validation Study
(Taylor & Francis, 2024-10-04) Alameda-Cuesta, Almudena; Oter-Quintana, Cristina; Lizcano-Álvarez, Ángel; Brito-Brito, Pedro Ruymán; Talavera-Sáez, Ana; Cid-Expósito, María-Gema
The aim of this study was to validate the diagnostic content and the NANDA-I and NOC linkages for six psychosocial nursing diagnoses. This multicentre, descriptive, cross-sectional validation study followed Fehring’s model. Expert nurses in nursing methodology and standardised nursing languages in Spain participated, with expertise criteria based on academic level and clinical, teaching, and research experience in the fields of nursing methodology and standardised nursing languages. This study adhered to the STROBE guidelines for cross-sectional studies. Eighty-seven professionals participated in the diagnostic content validation phase, and 57 in the NANDA-I and NOC linkages validation phase. The content validity indices of the six diagnoses ranged from 0.74 to 0.84, all considered valid. All 84 proposed defining characteristics were valid, with 42 scoring ≥0.8. Thirty-two linkages between diagnoses and NOC outcomes were proposed, all valid, with mean scores between 0.73 and 0.98. Each diagnosis was linked to 5–6 NOC outcomes, comprising 26 main outcomes and 6 supplementary outcomes. Overall coverage rates for each diagnosis ranged from 68.42% to 100%. All linkages between defining characteristics and NOC outcome indicators were validated. The six selected psychosocial diagnoses, their defining characteristics, and the proposed linkages between diagnoses and outcomes have been validated. The validation of linkages between NOC indicators and nearly all major defining characteristics of these six psychosocial diagnoses will make it possible to enhance diagnostic accuracy and enable continuous assessment of the effects of nursing interventions on the clinical progression of these diagnoses.
“Nursing (Her) Storytelling” An Ethnographic Fiction Proposal for Exploring Feminist Health Activism in Spain
(2023) Alameda-Cuesta, Almudena; Blanco-Fuente, Irene; Bonilla-Campos, Amparo; Casado-Aparicio, Elena; Domínguez-Castillo, M. Pilar; García-Dauder, Dau; Lara-Rodríguez, Ángel Luis; López-Sáez, Miguel Ángel; Velázquez-Berrio, Nerea; Romero-Bachiller, Carmen
The aim of this article is to share theoretical and methodological reflections on a project on feminist epistemologies and health activism. Based on the analysis of twelve life stories and one group interview, an approach based on ethnographic fiction is proposed through the creation of a serial story in podcast format. This approach helps in generating emotions to facilitate understanding and awareness of the issues raised and in showing everyday practices as ways of constructing knowledge. It also avoids turning life stories into academic artefacts with little transformational capacity.
Reliability and Repeatability of the Instrument for the Assessment of Stress in Nursing Students (ASNS)
(MDPI, 2019-09-24) Losa-Iglesias, Marta Elena; Jiménez-Fernández, Raquel; Alameda-Cuesta, Almudena; Cid-Expósito, María-Gema; Rodríguez-Vázquez, Rocío; Becerro-de-Bengoa-Vallejo, Ricardo
Background and objectives: Stress in nursing students is a very common experience, especially when they face clinical practice. The aims of this study were to perform a transcultural adaptation and to examine the reliability and repeatability of the Instrument for the Assessment of Stress in Nursing Students for a Spanish population. Methods: A test–retest analysis was carried out in two face‐to‐face sessions with the students with a lapse of 10 days between the two sessions. A cross‐sectional descriptive study was carried out between the months of May and June 2018. Sixtyfour nursing students were recruited with a consecutive sampling method that targeted individuals in the freshman class. Results: A good internal consistency was shown for the total score (α = 0.8861) and for each of the six domains. The test–retest reliability, using the Wilcoxon paired test, was not significant, indicating no differences between the total scores or the domain scores (p ≥ 0.05). Finally, Bland and Altman plots of visual distributions did not show differences between the total scores and the domain scores. Conclusion: The Instrument for the Assessment of Stress in Nursing Students was shown to be a reliable tool for measuring stress factors among Spanish nursing students.