Objective: To evaluate the psychological consequences (anxiety, depression and body image dissatisfaction) of symptomatic macromastia and the effectiveness of breast reduction surgery in re-establishing the mental health of the patient in the short and long term. Method: 119 patients over 18 years old who had been diagnosed with symptomatic macromastia were assessed, before surgery, one month after the operation and one year later. Patients completed the Hospital Anxiety and Depression Scale (HADS) and the Body Image Dissatisfaction subscale of the Eating Disorders Inventory (EDI-2). Participants were also asked about their physical appearance, social relationships and their satisfaction with regards to clothing and dress. Results: The average age of the patients was 40.7 (SD = 12.02), 80.2% had a body mass index ≥25 kg/m². Before surgery, we found psychological distress with values indicating clinical anxiety and body image dissatisfaction. Younger women (< 36 years old) were more psychologically affected. At one month after surgery, there were significant improvements: there were lower scores for anxiety (p < 0.001), depression (p < 0.001) and body image dissatisfaction (p < 0.001). When compared with the pre-surgery scores, all these results showed improvement one year after the intervention (p < 0.001). There were also improvements in social relationships (p < 0.001) and satisfaction with clothing and dress. Conclusion: Reduction mammaplasty can alleviate the psychological impact of symptomatic macromastia.

Prolonged sitting time has negative consequences on health, although the population is not well aware of these harmful effects. We explored opinions expressed by primary care patients diagnosed as overweight or moderately obese concerning their time spent sitting, willingness to change, and barriers, facilitators, goals and expectations related to limiting this behaviour. A descriptive-interpretive qualitative study was carried out at three healthcare centres in Barcelona, Spain, and included 23 patients with overweight or moderate obesity, aged 25 to 65 years, who reported sitting for at least 6 hours a day. Exclusion criteria were inability to sit down or stand up from a chair without help and language barriers that precluded interview participation. Ten in-depth, semi-structured interviews (5 group, 5 individual) were audio recorded from January to July 2012 and transcribed. The interview script included questions about time spent sitting, willingness to change, barriers and facilitators, and the prospect of assistance from primary healthcare professionals. An analysis of thematic content was made using ATLAS.Ti and triangulation of analysts. The most frequent sedentary activities were computer use, watching television, and motorized journeys. There was a lack of awareness of the amount of time spent sitting and its negative consequences on health. Barriers to reducing sedentary time included work and family routines, lack of time and willpower, age and sociocultural limitations. Facilitators identified were sociocultural change, free time and active work, and family surroundings. Participants recognized the abilities of health professionals to provide help and advice, and reported a preference for patient-centred or group interventions. Findings from this study have implications for reducing sedentary behaviour. Patient insights were used to design an intervention to reduce sitting time within the frame of the SEDESTACTIV clinical trial.

Mammary hypertrophy or macromastia can cause a wide range of symptoms (physical, psychosomatic or behavioral), which affect patients' quality of life. Breast reduction can, in most of the cases, solve the problem. However, certain factors could have a negative effect on the outcome of surgery. The aims of this study were to discover the degree of patient satisfaction (short- and long-term) and to evaluate results of reduction mammoplasty, and also to ascertain which factors may have a negative role on the effectiveness of breast reduction surgery. We carried out a prospective and longitudinal study of 121 patients who underwent breast reduction surgery. Quality of life, outcome of surgery (complications and sequelae) and degree of patient satisfaction were evaluated at 1 month and at 1 year after reduction mammoplasty. Mean patient age was 40.71 (SD = 12.02). Among them, 35.5% were overweight, 44.6% were obese and 34.7% were smokers. The most common symptom was pain. The mean amount of resected breast tissue was 1785 g (SD = 876). A total of 27.3% of the patients suffered complications and 30.60% suffered sequelae. Our results show an improvement in symptoms (p < 0.001) and quality of life (p < 0.001 to p = 0.002) 1 month after and 1 year after breast reduction compared with the preoperative situation. Neither age, body mass index, smoking habit nor the amount of tissue removed had a negative effect on the results of surgery. One year after surgery, the majority of patients were satisfied with the outcome (96.6%), they would recommend it to others (96.6%), and they would undergo surgery a second time (95.8%). Breast reduction is highly efficient in resolving symptoms and in improving quality of life. It leads to a high level of short- and long-term satisfaction irrespective of each patient's individual characteristics.

Background: Nurse managers face great challenges in responding to organizational demands. There exists a general mismatch between managerial span of control and the demands of the job post, which can lead to overburdening and attrition. The aim of this review was to identify the effects of the nurse manager span of control on hospital organizations. Methods: An integrative literature review was carried out on nurse manager span of control using the Medline, Embase and Web of Science databases. Results: 21 articles were included. Our findings indicate that the span of control of nursing managers influences outcomes in inpatients, professionals, nurse managers, and the organization. Conclusions: The span of control of each nurse manager must be assessed and adjusted to each case. An appropriate span of control will lead to improved outcomes for stakeholders and the organization as a whole. Implications for nursing management: Tools must be developed and implemented to measure and evaluate the span of control of nurse managers. This study was not registered.

There is little information on the evaluation of family functioning in adult patients with chronic non-psychiatric illness. The objective of this systematic review was to identify family functioning assessment instruments of known validity and reliability that have been used in health research on patients with a chronic non-psychiatric illness. We conducted a search in three biomedical databases (PubMed, Science Direct, and Web of Science), for original articles available in English or Spanish published between 2000 and 2019. The review was conducted in accordance with PRISMA guidelines. Fourteen articles were included in the review. The instruments Family Assessment Device, Family Adaptability and Cohesion Evaluation Scales, Family Functioning Health and Social Support, Family APGAR, Assessment of Strategies in Families-Effectiveness, Iceland Expressive Family Functioning, Brief Family Assessment Measure-III, and Family Relationship Index were identified. All of them are reliable instruments to evaluate family functioning in chronic patients and could be very valuable to help nurses identify families in need of a psychosocial intervention. The availability and clinical application of these instruments will allow nurses to generate knowledge on family health and care for non-psychiatric chronic conditions, and will eventually contribute to the health and wellbeing of adults with a non-psychiatric chronic disease and their families.