Prevención de la aparición de hernia paraestomal
Bibliographic record
Abstract
espanolObjetivo: conocer la evidencia disponible sobre las estrategias a seguir por los profesionales enfermeros para evitar o disminuir la incidencia de hernia paraestomal. Metodo: revision narrativa a traves de una busqueda bibliografica, en ingles, castellano y portugues, en bases de datos cientificas, revistas especializadas, libros o guias y recursos web, siguiendo criterios de inclusion predisenados. Las publicaciones encontradas son evaluadas y sus recomendaciones clasificadas segun la CTFPHC (Canadian Task Force on Preventive Health Care). Resultados: se seleccionaron seis articulos: tres presentan evidencia II-3 con grado de recomendacion (GR) C; uno presenta evidencia III con GR C; uno presenta evidencia II-2 con GR B; y otro es una revision bibliografica. De estos estudios parece intuirse que un programa de prevencion desde el alta hospitalaria reduce la incidencia y los costes. El programa de prevencion no invasiva incluye la disminucion de maniobras que aumenten la presion abdominal (tos, cargar pesos) durante los tres primeros meses del postoperatorio inmediato; posteriormente, ejercicios abdominales hipopresivos para fortalecimiento de la musculatura abdominal y uso de ropa y/o dispositivos que ayuden a homogeneizar la presion abdominal (como faja abdominal no fenestrada) desde el postoperatorio inmediato. Conclusiones: existe escasa evidencia sobre las estrategias a seguir por las enfermeras para evitar o disminuir la incidencia de hernia paraestomal. Los trabajos analizados tienen niveles bajos de evidencia. El mayor nivel encontrado es II-2 en un unico estudio con grado de recomendacion B, por ello los resultados deben ser considerados con cautela hasta nuevos estudios. EnglishObjective: to learn about the evidence available on the strategies to be followed by nursing professionals in order to prevent or reduce the incidence of parastomal hernia. Method: a narrative review through bibliographic search, in English, Spanish and Portuguese, in scientific databases, specialized journals, books or guidelines and web resources, following the pre-designed inclusion criteria. The publications found were evaluated and their recommendations were classified according to the CTFPHC (Canadian Task Force on Preventive Health Care). Outcomes: six articles were selected: three presented II-3 evidence with Grade of Recommendation (GR) C; one presented III evidence with GR C; one presented II-2 evidence with GR B; and the remaining one was a bibliographic review. The perception from these studies seems to be that a Prevention Program implemented from the time of hospital discharge will reduce the incidence and costs. The Non-Invasive Prevention Program includes a reduction in manoeuvres increasing abdominal pressure (coughing, carrying weight) during the first three months after surgery, followed by hypopressive abdominal exercises for strengthening the abdominal muscles, and use of clothing and/or devices that will help to homogenize the abdominal pressure (such as a non-fenestrated abdominal belt) immediately after the surgical procedure. Conclusions: there is little evidence about the strategies to be followed by nurses to prevent or reduce the incidence of parastomal hernia. The articles analyzed presented low levels of evidence. The highest level found was II-2 in one single study with Grade of Recommendation B; therefore, outcomes must be regarded with caution until there are new studies available.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; both teacher heads agree on what is shown here.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".