Articles publicats en revistes (Infermeria de Salut Pública, Salut mental i Maternoinfantil)

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Perceived Healthcare Interventions and Clinical Strategies Against Dating Violence: A Qualitative Exploration of Expert and Nursing Perspectives
(MDPI, 2026-09-04) Puig Llobet, Montserrat; Sánchez Balcells, Sara; Agüera, Zaida; Sanchez-Ortega, M. Aurelia; Ventosa Ruiz, Ana; El Abidi, Khadija; Vergés Bosch, Núria; Rodríguez-Martín, Dolors; Rodríguez Ávila, Núria; Juárez Sánchez, Alba; Maestre, Elena; Perau Campos, Mireia; Luque-Tintó, Alba; Martínez Bueno, Cristina; Aragón Castro, Liliana; Esteban Sanz, Cristina; Nebot Echeverria, Marina; Rigol Cuadra, Assumpta; Prats Arimon, Marta
Introduction: Dating violence is an early form of intimate partner violence characterized by controlling behaviors, psychological and sexual abuse, and digital coercion. Despite its high prevalence among adolescents and young adults, it remains underrecognized and insufficiently addressed in healthcare settings. Nurses are strategically positioned to identify and respond to dating violence due to their close contact with patients and holistic approach to care. However, important gaps remain between existing protocols and their implementation in clinical practice. Methods: An exploratory qualitative study was conducted within a constructivist paradigm as part of a multicenter research project on dating violence among health sciences university students. Twelve experts, including nurses, healthcare professionals, and representatives of survivor-led organizations, participated in focus groups and reflective journals between September and December 2025 at the University of Barcelona. Data were analyzed using an interpretative phenomenological approach, with inductive thematic analysis guiding coding and theme development. Methodological rigor was ensured following the Consolidated Criteria for Reporting Qualitative Research (COREQ). Ethical approval was obtained. Results: Four themes emerged: (1) barriers to identification, including the normalization of controlling behaviors, myths of romantic love, and limited recognition of psychological and digital violence; (2) challenges in nursing responses, such as insufficient training, clinical uncertainty, organizational barriers, and lack of screening tools; (3) identification strategies, including systematic screening, relationship-centered interviewing, emotional education, and recognition of subtle warning signs; and (4) actions following identification, focused on validation, confidentiality, risk assessment, interdisciplinary referral, and ongoing support. Conclusions: Findings highlight the need to update protocols to explicitly address digital violence and strengthen nursing-led interventions. Participants emphasized the need for enhanced professional training, context-appropriate screening tools, and intersectoral collaboration as potential strategies to improve the identification and response to dating violence.
Personalizing approaches in International Projecte Engaging Individuals with Vulnerabilities: The Lessions Learned for a Person-Centres Research
(MDPI, 2026-05-31) Chiappinotto, Stefania; Moreal, Chiara; Bayram, Aysun; Velikonja, Nevenka Kregar; Özsaban, Aysel; Solà Pola, Montserrat; Roselló Novella, Alba; Zdunek, Kinga; Dobrowolska, Beata; Palese, Alvisa
Background: The involvement of people living in situations of vulnerability has long been a central ethical issue in research, particularly in contexts marked by power asymmetries, limited access to resources, or restricted decisional autonomy. Although international ethical frameworks offer increasing guidance on protecting vulnerable participants, applying these principles in everyday research practice remains challenging, especially in qualitative and multi-country studies. This communication draws on the experience of the European Protecting You & Others project, an Erasmus+ initiative conducted across five countries. Methods: During the project design and implementation, the research team engaged in ongoing reflexive work to examine the ethical, methodological, and practical challenges encountered when defining vulnerability, involving participants living in situations of vulnerability, and adapting research activities and educational interventions to different specific needs. Reflexive notes and collective team discussions were used to identify recurrent challenges and the strategies adopted to address them. Results: Key challenges included (a) the difficulty of choosing an inclusive yet operational definition of vulnerability; (b) participants’ self-perceptions and tensions between externally assigned vulnerability; (c) risks of stigmatization associated with categorization; the use of respectful and context-appropriate language; and (d) the adoption of a shared international framework adapted to educational content across countries. Overall, vulnerability emerged as a dynamic and context-dependent condition that requires research designs, methodologies and interventions to remain open, flexible, and responsive throughout the study process. Conclusions: Studies involving people living in situations of vulnerability, particularly in international and multi-country contexts, should not rely solely on predefined classifications or standardized safeguards. Instead, adaptive procedures are needed to recognize how needs, barriers, resources, and forms of participation vary across individuals and contexts. Such openness may support more person-centered approaches to engagement, communication, and intervention adaptation, while preserving ethical consistency and methodological rigor across countries.
Factors Associated with Postsurgital Pain in Children and Adolescents with Cognitive Dysfunction
(John Wiley & Sons, 2026-05-11) Sierra Núñez, Débora; Bosch Alcaraz, Alejandro; Parada Almansa, Sandra; Castro Fernández, Mónica; Asensio Sales, Susana; Gracia Martínez, Daniel; Falcó Pegueroles, Anna M. (Anna Marta); Saz Roy, Mª Ángeles; Zuriguel Pérez, Esperanza
Aim: To describe the characteristics of paediatric postoperative patients with cognitive dysfunction and assess the prevalence of pain and associated factors. Design: A descriptive observational study. Methods: Cross-sectional study in children and adolescents who had undergone surgery in the previous 72 h with cognitive dysfunction impeding verbal communication of pain. The Spanish-language version of the revised Face, Legs, Activity, Cry and Consolability scale was used to assess pain intensity. Results: The 51 included patients underwent 1072 pain assessments. Moderate to severe pain was detected in 12.1% of the evaluations (n = 130). Girls showed more intense pain after analgesia than boys. Higher pain intensity before analgesia was associated with neurodegenerative disease and autism spectrum disorder. Conclusion: In children with cognitive dysfunction, female sex and baseline cognitive conditions seem to be associated with more intense postsurgical pain. Implications for the Profession and/or Patient Care: Hospital pain management protocols should differentiate between patients with cognitive dysfunction and patients with neurotypical development. Impact: - This study addresses the prevalence of postsurgical pain in paediatric patients with cognitive dysfunction and associated factors - 12.1% of postsurgical evaluations showed moderate to severe pain. Female sex and baseline cognitive conditions seem to be associated with more intense postsurgical pain. - This research will have an impact on the care of paediatric patients with cognitive dysfunction in postsurgical hospitalization units. Reporting Method: This study was performed according to EQUATOR GUIDELINES and the STROBE statement.
Psychometric validation of the Cannabis Withdrawal Checklist in a Spanish sample with cannabis use disorder
(Frontiers Media, 2026-05-15) Saura, Judith; Feliu, Ariadna; Enríquez-Mestre, Marta; Roca Tutusaus, Xavier; Ballbè i Gibernau, Montse; Fu Balboa, Marcela; Segura García, Lidia; Fernández Muñoz, Esteve; Martínez Martínez, Cristina
Introduction: Cannabis is used globally. In Spain, it is often used in combination with tobacco, which may exacerbate withdrawal severity. Currently, no validated instrument exists to assess cannabis withdrawal symptoms in Spanish populations. This study aimed to validate the 15-item Cannabis (Marijuana) Withdrawal Checklist (CWC) for Spanish-speaking individuals who co-use cannabis and tobacco. Materials and methods: This psychometric validation study was nested within a multicenter longitudinal project conducted across 10 substance use treatment programs in Catalonia (Spain). The CWC was forward- and back-translated following COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) recommendations. Internal consistency, construct validity, and sensitivity to change over time were assessed using Cronbach’s alpha, exploratory factor analysis (EFA), and mixed-effects analysis. Data from 82 participants were used to conduct the validation. Results: The adapted CWC demonstrated high internal consistency (Cronbach’s α = 0.918 at baseline; 0.885 at 2 weeks of treatment). EFA supported a unidimensional structure explaining approximately 60% of the variance. Although symptom severity did not significantly change over follow-up, withdrawal intensity was positively associated with the level of cannabis use. The scale effectively captured clinically relevant symptoms such as irritability, craving, and sleep difficulties. Conclusion: The Spanish CWC showed strong reliability and acceptable psychometric properties, supporting its use for assessing cannabis withdrawal symptoms in Spanish-speaking adults, particularly those who co-use tobacco products. The scale may be valuable in both research and clinical settings, particularly for monitoring withdrawal during treatment interventions. Further validation using larger, more diverse samples is warranted.
An Efficient Method for Neuron-Like Differentiation of SH-SY5Y Neuroblastoma Cells Using Retinoic Acid and Laminin-Rich Extracellular Matrix
(John Wiley & Sons, 2026-08-02) Grigoli, Marina Mantellatto; Pachane, Bianca Cruz; Fuzer, Angelina Maria; Dorta de Oliveira, Sabrina; Targas, Ana Beatriz Aparecida; Alexandre Silva, Vanessa; Selistre-de-Araújo, Heloisa Sobreiro; Manzine, Patricia; Cominetti, Márcia R.
The human neuroblastoma cell line SH- SY5Y is widely used in vitro as a model due to its ability to acquire neuron- like properties. Conventional differentiation protocols often rely on retinoic acid (RA), which can lead to limited stability of neuronal- like phenotypes over time. In this study, we evaluated a differentiation approach combining RA with a laminin- rich extracellular matrix (LrECM). This approach accelerated differentiation, with neuron- like morphology and neurite outgrowth observed as early as 4 days and sustained features for up to 10 days. Immunofluorescence analysis indicated increased NeuN expression, and Western blot confirmed the sustained presence of β3- tubulin during differentiation. Furthermore, a trend toward enhanced acetylcholinesterase (AChE) activity suggested partial cholinergic features. Altogether, these findings indicate that incorporating LrECM supports the stability of RA- induced neuron- like characteristics in SH- SY5Y cells and may provide a useful alternative for studies of neuronal–phenotype differentiation.
Patient-reported measures of physical activity level for older adults in the home care setting: a systematic review and assessment of psychometric properties
(BioMed Central, 2026-07-01) Martí-Tarradell, Roger; Villa García, Lorena; Pardo, Yolanda; Gonzalez de Luna, Ana; Rodríguez Blázquez, Carmen; Forjaz, Maria João; Idoate Iglesias, María; Ayala, Alba; Vilaró, Jordi; Pérez, Laura Mónica; Ribera, Aida
Introduction: Compared with conventional hospitalization, Comprehensive Geriatric Hospital at Home allows functional rehabilitation in a more realistic environment.Methodologically robust measurement tools are needed to monitor the functional recovery and quality of care of older adults in the home setting. To this end, PatientReported Outcome Measures (PROMs) provide a valid and efficient means to assessphysical activity in older adults. This systematic review aims to: (1) identify PROMs to monitor physical activity in older adults receiving home care and; (2) assess their psychometric properties.Methods: A systematic review was conducted in MEDLINE (PubMed), Scopus, and EMBASE databases, following PRISMA guidelines. The PROQOLID and BiblioPRO libraries were also checked. PROMs designed to assess physical activity levels were identified and screened against eligibility criteria and psychometric properties extracted. Psychometric properties were evaluated using the Evaluating the Measurement of Patient Reported Outcomes (EMPRO) tool, which scores range from 0 to 100, with higher scores indicating better psychometric properties.Results: A total of 435 articles met inclusion criteria, of which 59 described 21 PROMs assessing physical activity. Seven PROMs assessing physical activity level met criteria: Community Health Model Activities Program for Seniors Physical Activity Questionnaire (CHAMPS), International Physical Activity Questionnaire (IPAQ), Longitudinal Ageing Study Amsterdam Physical Activity Questionnaire (LAPAQ), Physical Activity Scale forthe Elderly (PASE), Paffenbarger Physical Activity Questionnaire (PPAQ), Rapid Assessment of Physical Activity (RAPA), and Short Questionnaire to Assess Health Enhancing Physical Activity (SQUASH). Scores were highest for reproducibility and lowest for responsiveness and internal consistency. The CHAMPS achieved the best overall performance (71.21), followed by the PASE (58.17) and LAPAQ (50.16); scores of 50 or above are considered acceptable; whereas the PPAQ (21.51) and SQUASH (28.10) scores were the lowest. CHAMPS showed the lowest administration burden. CHAMPS, IPAQ, LAPAQ, PASE, and SQUASH were validated against accelerometry, yielding heterogeneous results that indicated low-to-moderate correlations.Conclusions: CHAMPS, PASE, and LAPAQ showed the most acceptable psychometric properties. Most PROMs had limited responsiveness and inconsistencies. Implementation
Predictors of Developing Positive Attitudes and Increasing Perceptions of Training in Tobacco Control Among Catalan Nursing Students: A Follow-Up Study
(Lippincott, Williams & Wilkins. Wolters Kluwer Health, 2025-09-19) Laroussy El Tayea, Kenza; Fernández Muñoz, Esteve; Castellano, Yolanda; Fu Balboa, Marcela; Feliu, Ariadna; Tigova, Olena; Puig Llobet, Montserrat; Galimany Masclans, Jordi; Moreno Arroyo, M. Carmen; Martínez Martínez, Cristina
Background: The knowledge and attitudes toward tobacco control among nurses are important factors in ensuring appropriate management of the tobacco dependence. Therefore, we aimed to evaluate the predictors of developing positive attitudes toward tobacco control and increasing perceptions of tobacco-related training received during the nursing degree, among a cohort of Catalan nursing students.Methods: Observational prospective study of 1,097 Catalan nursing students. Participants completed a paper-and-pencil questionnaire at baseline (2015–2016) and an online survey at follow-up (2018–2019). We examined predictors of developing positive attitudes and increasing perceptions of training using Poisson regression models to compute the adjusted prevalence ratios (aPRs).Results: Students in their last years of studies at baseline were less likely than those in the first years to develop a positive attitude towards the exemplary role of nursing students in tobacco control at follow-up (aPR = 0.74). Former smokers were more likely than current smokers to develop positive attitudes towards the exemplary role of health care professionals (aPR = 1.55) and, together with never smokers, to come to recognize the importance of nursing students setting a good example (aPR = 2.23 and aPR = 2.32, respectively). Last year’s students were also less likely than those in the first years to increase their perceptions of tobacco-related training received (all aPR < 0.71). Never smokers were less likely than current smokers to increase their perception of training in pharmacological treatments other than nicotine replacement therapy (aPR = 0.81) and to consider themselves capable of helping smokers quit (aPR = 0.78).Conclusions: The year of school and smoking status were strong predictors of developing positive attitudes and increasing perceptions of training in tobacco control.
Quality of Psychiatric Care in Inpatient Mental Health Settings: Perspectives From Patients and Staff
(Wiley, 2026-08-12) Sánchez Balcells, Sara; Tomás Jiménez, Manuel; Moreno Poyato, Antonio Rafael; Domínguez del Campo, Marta; Schröder, Agneta; Lundqvist, Lars Olov; Puig Llobet, Montserrat; Lluch Canut, Ma. Teresa; Roldán Merino, Juan Francisco
The World Health Organization (WHO) recognises the need to improve the quality of care and ensure full respect for the human rights of people with mental health problems and psychosocial disabilities. The participation of both inpatients and professionals is essential to understand and improve mental health care. This study aimed to describe and compare the perceptions of care quality between inpatients and health professionals in mental health hospitalisation units, and to determine possible relationships between these perceptions and other study variables. A descriptive cross-sectional comparative study was conducted. The study population was recruited through nonprobabilistic convenience sampling. The quality of care was measured using the QPC-IP and QPC-IPS instruments, each with 30 items assessing six dimensions. A descriptive analysis of the database was performed, generating descriptive statistics for numerical variables and frequency tables for categorical variables. Data analysis was carried out using IBM SPSS v.28. The sample consisted of 150 inpatients and 163 professionals from mental health hospitalisation units in the Barcelona area (Spain). Final results showed high overall levels of care quality from both patients’ (<em>m</em> = 94.20 ± 15.59) and staff’s (<em>m</em> = 91.32 ± 12.42) perspectives. Both inpatients and staff gave high scores to the dimensions of Encounter (patients: 3.3 ± 0.6; professionals: 3.4 ± 0.5) and Support (patients: 3.2 ± 0.7; professionals: 3.4 ± 0.5), while the dimensions rated lowest in terms of quality were Secluded Environment (patients: 2.6 ± 0.7; professionals: 2.5 ± 0.8) and Secure Environment (patients: 2.9 ± 0.8; professionals: 2.5 ± 0.7). Conclusions: Continuous evaluation of quality in mental health hospitalisation settings is essential to ensure the highest quality of care. This guarantees full respect for rights and dignified care, considering the perspectives of the main stakeholders.
Estrategias para incrementar la motivación de las enfermeras asistenciales hacia la investigación
(Difusión Avances de Enfermería, 2020-05) Bueno Sánchez, María C.; Pérez Riart, María; Maestre Bernat, Lidia; Araujo Camacho, Verónica; Puig Llobet, Montserrat; Lluch Canut, Ma. Teresa; Bea Rodríguez, Núria
Objetivo: identificar estrategias de intervención que sean de utilidad para potenciar la motivación de las enfermeras hacia la investigación. Método: el estudio se desarrolló en el contexto del máster universitario de Liderazgo y Gestión de Enfermería 2018/2019 de la Universidad de Barcelona. Se aplicó un diseño cualitativo mediante análisis interpretativo de contenido. Los datos se obtuvieron a través de la elaboración de un plan de acción donde cada participante, a partir de unos objetivos, planteó unas estrategias de intervención para incrementar su motivación hacia la investigación. Para el análisis se agruparon las diferentes estrategias por dimensiones, estableciendo dos subcategorías: intervenciones autoaplicadas dirigidas hacia uno mismo, e intervenciones institucionales dirigidas a la institución. Resultados: prevalecieron las intervenciones dirigidas a la organización de la vida personal. Las propuestas más habituales de intervenciones autoaplicadas se relacionaron con aumentar el tiempo de dedicación a la investigación intentando optimizar el tiempo personal, incrementar la formación específica en investigación, el conocimiento de lengua inglesa y medidas destinadas a aumentar la motivación intrínseca. Mientras que las propuestas de intervenciones institucionales estuvieron enfocadas a disponer de tiempo para investigar dentro de la jornada laboral y tener acceso a los recursos necesarios. Conclusiones: los resultados obtenidos pueden ayudar a generar planes estratégicos de intervención en los que se potencie la investigación enfermera a partir de un modelo de implantación, elaborado por las propias enfermeras, tanto de intervenciones autoaplicadas como a desarrollar por la institución.
Los modelos en la práctica asistencial: visión de los profesionales y estudiantes de enfermería.
(Difusión Avances de Enfermería, 2009-05) López Parra, María; Santos-Ruiz, Susana; Sánchez Rueda, Guadalupe; Bardallo Porras, Lola; Fernández Donaire, Lidia; Zabalegui Yárnoz, Adelaida; Abril Sabater, Dolors; Varez Peláez, Susana; Tomás Sábado, Joaquín
Objetivo: indagar la percepción de los profesionales y de los estudiantes de Enfermería en relación al uso en la práctica de los modelos y teorías de Enfermería. Material y método: estudio descriptivo transversal. La muestra estuvo formada por los profesionales asistenciales y estudiantes matriculados en las escuelas que realizan prácticas clínicas en la Corporación Sanitaria del Parc Taulí durante 2006/2007. Resultados: el modelo aprendido durante la formación es Henderson en ambos grupos. En cuanto al uso del modelo en la práctica asistencial, los estudiantes usaban modelos en un 62% mientras lo hacían el 23% de los profesionales. Referente a si se identificaban con el modelo con el que atendían a las personas, los estudiantes dijeron sí en un 88% y los profesionales en un 83%. Conclusiones: ambos grupos muestran una gran variabilidad y confusión en algunos conceptos. El uso de un modelo o teoría en la formación no condiciona a identificarse con los conceptos de la autora estudiada. El metaparadigma enfermero no se nutre de un sólo modelo.
Regulatory elements in the Sox9 locus license the initiation of pancreatic ductal adenocarcinoma
(Elsevier, 2026-04-28) Ballester Frago, Marta; Kurilla, Anita; Dai, Yifan; Bergara Muguruza, Leire; Radke, Katarzyna; Maurer, Hans Carlo; Espinet, Elisa; Høj, Kristina; Marisch Delgado, Aida; Seymour, Philip A.; Omar, Saynab; Rift, Charlotte Vestrup; Hasselby, Jane; Klausen, Pia; Vilmann, Peter; Castellanos-Rubio, Ainara; Santin, Izortze; Sandelin, Albin; Arnes, Luis
Cellular plasticity enables tissue regeneration but can be hijacked by oncogenic programs. In the pancreas, Kras acts on tissue-specific enhancers to lock regeneration into a pro-inflammatory state that drives cancer initiation. Enhancer transcription, an early event during cell state transitions, generates long noncoding RNAs (lncRNAs) that influence transcription and genome organization, yet their roles in pancreatic regeneration remain unclear. We profiled epithelial lncRNAs and their targets during pancreatic ductal adenocarcinoma (PDAC) precursor formation, focusing on those transcribed from enhancers near cell identity regulators. LINC00673, expressed from a Sox9-associated super-enhancer during development, is reactivated in PDAC. Conditional deletion of LINC00673 accelerates acinar-to-ductal metaplasia resolution and impairs PDAC initiation. Moreover, LINC00673 harbors a variant associated with PDAC risk. In addition, our data are consistent with a contribution of transcribed super-enhancers to long-range gene regulation during pancreatic cancer initiation. These findings reveal a regulatory layer linking developmental enhancer activity, cellular plasticity, and pancreatic disease progression.
Evaluation of the effectiveness of training in basic and assisted communication techniques for intensive care nurses
(Elsevier, 2026-07) Prats Arimon, Marta; Puig Llobet, Montserrat; Eseverri Rovira, M.; Gallart, Elisabet; Téllez-Velasco, D.; Agüera, Zaida; Lluch Canut, Ma. Teresa; Hidalgo Blanco, Miguel Ángel; Moreno Arroyo, M. Carmen
Introduction: Specialised training in communication techniques is necessary for intensive care nurses to communicate effectively with critical care patients. Objective: To evaluate the effectiveness and satisfaction of a training programme in basic communication skills (BCS) and augmentative and alternative communication (AAC). Methods: A two-phase mixed-methods design was used: phase I was cross-sectional descriptive, and phase II was quasi-experimental. A total of 120 nurses working in the intensive care units of Vall d’Hebron Hospital were recruited for phase I, of whom 30 were included in phase II. The intervention consisted of a training programme in BCS and AAC, accredited by the University of Barcelona and comprising four modules, lasting six hours. Participants’ perception of their communication skills was assessed, as well as evaluation of the knowledge acquired through a written test and nurses’ satisfaction with the programme through an ad hoc questionnaire. Results: Regarding BCS, 71.4% (n = 86) of participants had received training and 78.3% (n = 94) stated they used them. Regarding AAC knowledge, 88.3% (n = 106) reported lack of familiarity with these techniques. Nurses who received training demonstrated significant improvements in their perception of verbal communication use (MD −0.46; p < 0.001), non-verbal communication (MD −1.20; p < 0.001), AAC knowledge (MD −1.96; p < 0.001) and importance of effective communication (MD −0.16; p = 0.02). The post-test knowledge level obtained an average score (>3 out of 4). 83% (n = 25) of nurses were very satisfied with the training and 18% (n = 5) were satisfied. Conclusion: Training in HCB and AAC led to significant improvement in ICU nurses’ knowledge regarding communication with critically ill patients experiencing communication difficulties. Furthermore, the training was positively received by nurses.
Risk factors of surgical site infection in total knee arthroplasty: Impact of an infection prevention and control intervention in a tertiary hospital in Barcelona, Spain
(Elsevier, 2026-06) Zules Oña, Ricardo; Otero Romero, Susana; Rodrigo Pendás, José Ángel; Minguell Monyart, Joan; Amat Mateu, Carles; Lung, Mayli; Martínez Gómez, Xavier; Quintana Alonso, Cristian; Limón, Enrique; Parés Badell, Oleguer
Background: In early 2018, we detected an increase in surgical site infections (SSI) after total knee arthroplasty in a tertiary hospital in Barcelona. We implemented an infection prevention and control (IPC) intervention reinforcing preventive bundles and reorganizing surgical schedules for high-risk patients and senior surgeons. We aimed to identify SSI-associated factors and evaluate the IPC intervention's impact. Methods: We conducted a retrospective cohort study in 2018 with 90-day follow-up. SSI rates were compared pre- and post-intervention. Preintervention risk factors were assessed using Cox models. Differences in associated factor distributions were estimated. Kaplan-Meier and log-rank tests evaluated incidence, and a sensitivity analysis was stratified by American Society of Anesthesiologists (ASA) and National Nosocomial Infection Surveillance (NNIS) risk. Results: Among 463 patients, overall SSI incidence was 0.52 per 1,000 patient-days. Incidence significantly declined postintervention (pre: 0.75; post: 0.26; P = .030). Obesity (HR: 3.63; 95% CI: 1.02-12.86) and afternoon surgery (HR: 3.02; 95% CI: 1.02-8.92) were associated. High ASA, NNIS risk, and inadequate prophylaxis significantly decreased (P < .001). The intervention reduced SSI risk by 66% (HR: 0.34; 95% CI: 0.13-0.94; P = .037). A nonsignificant reduction was seen in high-risk strata. Conclusions: Our study showed the impact of an IPC intervention addressing associated factors and significantly reducing SSI incidence rates.
Estrategia de toma de hemocultivos mediante venopunción única: alineación con las recomendaciones propuestas por la EU-JAMRAI 2
(Elsevier, 2026-06-20) López Rodríguez, Maria; Smithson Amat, Alejandro; Álvarez Fernández, Ana; Limón, Enrique
Hemos leído con gran interés el estudio de Gimeno-Gascón et al1, en el que los autores comparan, mediante un diseño observacional cuasi-experimental, una estrategia de toma de hemocultivos mediante extracción múltiple (EM) frente a la obtención de hemocultivos mediante extracción única (EU). Tras la implementación de la obtención mediante EU, los autores demuestran una reducción significativa de los hemocultivos aislados no emparejados y de la tasa de hemocultivos contaminados, sin impacto en la detección de bacteriemias verdaderas.
Population screening for liver fibrosis: Toward early diagnosis and intervention for chronic liver diseases
(Wiley, 2021-09-19) Ginès i Gibert, Pere; Castera, Laurent; Lammert, Frank; Graupera, Isabel; Serra Burriel, Miquel; Diaz Lorca, Maria Alba; Allen, Alina; Wong, Vincent W. S.; Hartmann, Phillipp; Roulot, Dominique; Thiele, Maja; Caballeria, Llorenç; Knegt Robert J. de; Grgurevic, Ivica; Augustin, Salvador; Tsochatzis, Emmanuel A.; Schattenberg, Jörn M.; Guha, Indra Neil; Martini, Andrea; Morillas, Rosa M.; Koning, Harry J. de; Garcia-Retortillo, Montserrat; Fabrellas i Padrès, Núria; Pich, Judit ; Ma, Ann T.; Díaz Lorca, Maria Alba; Roulot, Dominique; Newsome, Phillip N.; Manns, Michael; Kamath, Patrick S.; Krag, Aleksander; LiverScreen Consortium Investigators
Cirrhosis, highly prevalent worldwide, develops after years of hepatic inflammation triggering progressive fibrosis. Currently, the main etiologies of cirrhosis are non-alcoholic fatty liver disease and alcohol-related liver disease, although chronic hepatitis B and C infections are still major etiological factors in some areas of the world. Recent studies have shown that liver fibrosis can be assessed with relatively high accuracy noninvasively by serological tests, transient elastography, and radiological methods. These modalities may be utilized for screening for liver fibrosis in at-risk populations. Thus far, a limited number of population-based studies using noninvasive tests in different areas of the world indicate that a significant percentage of subjects without known liver disease (around 5% in general populations and a higher rate −18% to 27%-in populations with risk factors for liver disease) have significant undetected liver fibrosis or established cirrhosis. Larger international studies are required to show the harms and benefits before concluding that screening for liver fibrosis should be applied to populations at risk for chronic liver diseases. Screening for liver fibrosis has the potential for changing the current approach from diagnosing chronic liver diseases late when patients have already developed complications of cirrhosis to diagnosing liver fibrosis in asymptomatic subjects providing the opportunity of preventing disease progression.
Advanced practice nurses: Analysis of their role from a multicentre cross-sectional study
(Wiley, 2021-08-16) Sevilla Guerra, Sonia; Zabalegui Yárnoz, Adelaida; Comellas Oliva, Montserrat; Estrem Cuesta, Maria Mercè; Martín Baranera, Ma. Montserrat; Ferrús i Estopà, Lena
Background: Stronger healthcare models are increasingly sought to address new population needs, health workforce inefficiencies and nursing shortages. One strategy is to focus on employees’ strengths to capitalize on their competencies and maximize their scope of practice. Introduction: Globally, there is an exponential demand for advanced practice nursing services. This study aimed to identify the roles and positions of nurses who align with APN defining criteria at all levels of care in Catalonia, Spain. Methods: The first step of the study included the translation and validation to Catalan of the Advanced Practice Nurse Role Delineation Tool (IDREPA) and step 2 comprised a multicentre cross-sectional study, in which 126 healthcare centres participated: 1209 nurses were included in the study. The STROBE checklist was used to report this study. Results: Transcultural equivalence and validation of the instrument showed a content validity index of 0.958 and the reliability of the questionnaire. The instrument identified 269 nurses who align with international APN defined criteria. They worked in specialized care, mental healthcare and primary and community care, especially in chronic conditions, ageing and end-of-life care. Discussion: Most areas of Catalonia have access to nurses practicing at APN defining criteria. These nurses were developed as an optimal resource to respond to patient needs in the context of study. Both recognition and strategic implementation are necessary to apply their full competencies to solve healthcare problems. Conclusion: Understanding the supply of services delivered by nurses practicing at an advanced level and their scope of practice may lay the foundations for effective workforce planning in a dynamic context. Nurses who align with APN defining criteria are working mainly in large acute services without regulation and recognition. Implications for nursing: Advanced practice nurses show the value of their role and activities in healthcare services. Implications for health policy: Promoting the establishment of APN defining criteria that includes credentialing and a regulatory framework within international guidelines should be a priority to make an impact on healthcare policy.
Intervenciones enfermeras para disminuir la sobrecarga de cuidadores informales. Revisión sistemática de ensayos clínicos.
(Servicio de Publicaciones, Universidad de Murcia, 2022-10-01) Tinoco Camarena, José Manuel; Hidalgo Blanco, Miguel Ángel; Daifuku Sansano, Nara; Lluch Canut, Ma. Teresa; Raigal Aran, Laia; Puig Llobet, Montserrat
Introducción: Los cuidadores informales suelen ser miembros de la familia de un paciente, que conducen a la dependencia del paciente del cuidador. Esto puede resultar en perturbaciones en la calidad de vida de los cuidadores. Para abordar los efectos negativos de la atención informal, existen varios tipos de intervenciones eficaces para reducir las visitas médicas tanto de los cuidadores informales como de los pacientes a su cargo. Objetivo: Examinar la eficacia de las intervenciones de enfermería existentes diseñadas para reducir la sobrecarga del cuidador informal de personas con enfermedad crónica. Metodología: Diseño: Revisión sistemática. Fuentes de datos: Bases de datos como Pubmed (MEDLINE), Embase, The Cochrane Library y CINAHL fueron buscadas usando palabras clave sobre intervenciones de enfermería en cuidadores familiares. Los artículos publicados entre 2014-2019 fueron recuperados y sometidos a análisis de datos y síntesis de conocimientos Método de revisión: Dos revisores seleccionados de forma independiente. La evaluación de la calidad se basó en la lista de verificación de evaluación de declaraciones prisma. La síntesis es narrativa. Resultados: Noventa y cinco estudios fueron examinados en su totalidad, y setenta y siete fueron descartados por no proporcionar resultados adecuados. El recuento final de artículos incluidos en esta revisión fue de dieciocho que fueron todos ensayos clínicos aleatorizados. Conclusiones: El análisis de los diferentes estudios muestra eficacia en la reducción de síntomas como estrés, ansiedad, depresión o incluso necesidades insatisfechas. Las intervenciones más eficaces para reducir la carga del cuidador fueron las visitas domiciliarias y las intervenciones psicoeducacionales, tanto individuales como grupales.
Influencia de los entornos de práctica en la actitud hacia el diagnóstico enfermero y su utilización.
(ENE Ediciones, 2017-04) Lumillo-Gutiérrez, Iris; Fabrellas i Padrès, Núria; Brito Brito, Pedro Ruymán; Romero Sánchez, José Manuel
Cada vez existe más evidencia del impacto del uso del diagnóstico enfermero en la salud de la población. Múltiples investigaciones recientes asocian el uso del diagnóstico enfermero, enmarcado en el proceso enfermero, con la mejora del manejo clínico y adherencia terapéutica en problemas de salud crónicos (Rojas-Sánchez et al., 2009; Cárdenas et al., 2012; Pérez-Rivas et al., 2016). Incluso, se ha relacionado con menores gastos farmacéuticos y mayores coberturas de salud (Pérez-Rivas et al., 2016). Asimismo, los resultados de investigaciones defienden que también tiene beneficios para las propias enfermeras, como por ejemplo, el desarrollo del pensamiento crítico (Lunney, 2011), y para la disciplina y la profesión, ya que mejora la calidad de la documentación clínica (Müller, 2009). Esto permite incrementar la visibilidad de las intervenciones (Rutherford, 2008), realizar una medición adecuada de la calidad de los cuidados y una evaluación costo-efectiva de los mismos (Müller, 2009).
El principialismo bioético en la humanización de la asistencia al parto
(Universidad Pontificia de Comillas, 2018-10-22) Biurrun Garrido, Ainoa; Perelló-Iñiguez, Carme; Vidal Tegedor, Bárbara
Los cuatro principios bioéticos descritos por Beauchamp y Childress son habitualmente utilizados para resolver problemas éticos en ciencias de la salud. En este artículo se propone su aplicación en el ámbito de la atención humanizada en la asistencia al parto. Concretamente, se plantea un análisis desde una perspectiva crítica y contextualizada del principialismo, teniendo en cuenta las limitaciones de la teoría original.
Miedo al parto: revisión bibliográfica de los instrumentos de medida
(Ediciones Mayo, S.A., 2019-05) Ortega Cejas, Celia; Roldán Merino, Juan Francisco; Biurrun Garrido, Ainoa; Vicente Hernández, Ma. Mercedes; Lluch Canut, Ma. Teresa; Cabrera Jaime, Sandra
Objetivo: Analizar los instrumentos de evaluación del miedo al parto y sus características de validez. Metodología: Revisión bibliográfica en CINAHL, PubMed, Scopus y Cuiden de los estudios publicados entre 1982 y 2018, mediante combinaciones booleanas de palabras clave, que exploraran el miedo al parto mediante instrumentos validados o instrumentos con propiedades psicométricas de validez. Resultados: Se seleccionó un total de 12 artículos originales que presentan instrumentos de medición del miedo. Dos escalas evaluaban el miedo al parto antes del embarazo, mientras que las 10 restantes evaluaban el miedo durante el embarazo y/o el parto y tras el mismo. Todas las escalas muestran una buena fiabilidad con valores alfa de Cronbach >0,70. Conclusiones: La presente revisión ha permitido identificar 12 instrumentos que se han desarrollado con el fin de medir el miedo al parto. Presentan buenas propiedades psicométricas y han demostrado ser válidos en diferentes muestras culturales

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