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

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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
Somatic mutations in cervicovaginal samples: assessing their role in ovarian cancer detection and prognosis
(Elsevier, 2026-02-23) Pelegrina, Beatriz; Paytubi Casabona, Sònia; Benavente, Yolanda; Marín, Fátima; López-Querol Marta; Onieva, Irene; Frias Gomez, Jon; Pavon Diaz, Claudia; Martínez García, Jose Manuel; Fernandez Gonzalez, Sergi; Dorca Duch, Eduard; Vidal-Bel, August; Barahona, Marc; Pérez Escanilla, Yolanda; Brunet, Joan; Pineda, Marta; Pijuan, Lara; Ponce i Sebastià, Jordi ; Matias-Guiu, Xavier, 1958-; Alemany i Vilches, Laia; Costas, Laura
Background: Most patients with ovarian cancer are diagnosed at a late stage because of the lack of early stage symptoms or effective screening methods. To address this issue, we evaluated the presence of DNA somatic variants in cervicovaginal samples to aid the detection and prognosis of ovarian cancer. Methods: We employed next-generation sequencing (NGS) with molecular identifiers to analyze samples from a case-control study involving women diagnosed with ovarian cancer and age-matched controls. The study included Pap smear samples from 43 patients with ovarian cancer and 99 controls, 27 paired vaginal self-samples, 16 endometrial aspirates, and 13 tumor samples from cases, for a total of 198 samples. Results: Pathogenic and likely pathogenic variants were identified in 25.6 % (11/43, 95 % confidence interval -CI-:13.5–41.2) of Pap smear samples from patients with ovarian cancer. These variants were also found in 33.3 % of the control samples, leading to a specificity of 66.7 % (66/99, 95 %CI:56.5–75.8 %). Among the paired samples, we observed pathogenic and likely pathogenic variants in 14.3 % (2/14, 95 %CI:1.78–42.8) of the vaginal samples, 77.8 % (7/9, 95 %CI:40.0–97.2) of the endometrial aspirates, and 69.2 % (9/13, 95 %CI:39.6–90.9) of the tumor samples. In the age- and stage-adjusted survival models, women with variants detected in Pap smear samples had poorer overall survival than those without variants (hazard ratio -HR-=4.27, 95 %CI:1.06–17.23; P = 0.041). Conclusions: DNA somatic variants in cervicovaginal samples have limited diagnostic value for detecting ovarian cancer. However, their presence may have prognostic significance, warranting further investigation. Future research could explore multimodal strategies that integrate molecular markers with imaging or other approaches to improve early detection.
Impact of Lactation Consultants on the Breastfeeding Prevalence at 6 Months: Systematic Review and Meta-Analysis
(Mary Ann Liebert, 2025-12-01) Pascual Tutusaus, Mireia; Migliorelli, Federico; Goberna Tricas, Josefina; Arranz Betegón, Angela; Archs, Joana; Martí, Helena; Marcè, Natàlia; Manresa Lamarca, Margarita
Background:International Board-Certified Lactation Consultants play a crucial role in protecting and promoting breastfeeding. Their specialized training and advanced practice skills enhance care quality and contribute to improved breastfeeding outcomes. However, evidence regarding their long-term impact on breastfeeding maintenance remains limited.Aim:This systematic review and meta-analysis aim to evaluate the effectiveness of lactation consultants’ interventions on exclusive breastfeeding (EBF) at 6 months and to identify the most effective strategies in sustaining EBF through that period.Methods:A systematic review was conducted using electronic databases to identify studies published until March 2024. Eligible studies assessed prenatal, intranatal, and postnatal programs involving pregnant women intending to breastfeed or postpartum women in the lactation period.Findings:Nineteen studies involving 1,475 women were included. Interventions combining intranatal and postnatal support from lactation consultants showed a positive effect on EBF maintenance at 6 months (risk ratio [RR] for EBF vs. not EBF at 6 months = 2.04; 95% confidence interval [CI], 1.27–3.27). Individual face-to-face intranatal care had a positive effect (RR for EBF vs. not EBF at 6 months = 1.42; 95% [CI], 1.19–1.70).Discussion and Conclusions:Lactation consultant support initiated during hospitalization and continued through the postnatal period has the potential to improve breastfeeding outcomes. A dose–response relationship was observed, with interventions offering extended follow-up up to 6 months showing more favorable results. Face-to-face interventions that ensure direct contact and build trust with the mother appear to foster better breastfeeding outcomes. Standardization and rigorous monitoring of such programs are critical priorities
Validation by expert groups of the conceptual and structural dimensions in the AcompdogSMP+ nursing program: a dog-assisted therapy to promote positive mental health
(Wiley, 2025-02-18) Balaguer-Sancho, Judith; Puig Llobet, Montserrat; Tinoco Camarena, José Manuel; Agüera, Zaida; Lluch Canut, Ma. Teresa; Moreno Arroyo, M. Carmen
Introduction: AcompdogSMP+ is a nursing program for the promotion of positive mental health using a dog-assisted therapy for individuals with severe mental disorders. Objective: To validate the content validity of the four conceptual and the three structural dimensions that shape AcompdogSMP+. Design and Methods: Three expert groups with a total of 28 participants were convened, associated with the three core areas of the program (i.e., the multifactorial model of positive mental health, the “animal-assisted therapy” nursing interventions taxonomy, and the animal-assisted therapy as a complementary intervention model). The qualitative data were analyzed using an existing text analysis method, and the notes taken by the moderator and an assistant. The quantitative data were analyzed through the content validity index (CVI) for 68 different items that made up the seven dimensions of the AcompdogSMP+ program, through the data obtained from an ad hoc Likert-type scale. Results: The degree of agreement of the experts was complemented with the values obtained in the results of the quantitative data. CVI values of virtually all items were excellent (greater than 0.78). Only one item had a CVI considered good (I-CVI = 0.68). The values of the Scale Content Validity Index (S-CVI/Ave) ranged from 0.88 to 1.00, with most of the indices being excellent (above 0.90). Conclusion: The results supported the content validity of the seven dimensions, of the AcompdogSMP+ program. The validation might allow its clinical validation, through its implementation in healthcare practice, as well as the evaluation of its effectiveness. Implication for Practice: To our knowledge, this is the first animal-assisted therapy nursing program to promote positive mental health validated by expert judgment. By confirming the content validity of each dimension, robustness and empirical evidence is given to integrate the program into clinical practice with confidence, offering a structured and complementary intervention aimed at improving mental health outcomes and overall well-being of patients with severe mental disorders. This could lead to greater patient engagement, improved therapeutic outcomes, and a more holistic approach to mental health.
Patient Satisfaction With the Level of Competence of theTriage Nurse in Hospital Emergency Departments
(John Wiley & Sons, 2024-12-31) López Hernández, Meritxell; Puig Llobet, Montserrat; Higon Fernández, Sergio; Franco Freirut, Marta; Moreno Mateos, Yolanda; Galimany Masclans, Jordi
Aims: To analyse the level of patient satisfaction regarding the care received in triage and its relationship with the competency level of clinical nurses in a hospital setting. Design: A cross-sectional, prospective and multicentre study of nurses in hospital emergency triage and the patients they attended. Method: Data were collected between October and November 2019 using two questionnaires; one collected sociodemographic factors, professional experience of the nurse and the competency assessment questionnaire for clinical nurses in the hospital set- ting (COM_VA). The other questionnaire recorded the age of patients, reason for consultation, pain and the Patient Satisfaction with Emergency Nursing Care Scale (CECSS). The abstract includes an indication of the chosen checklist, specifically the STROBE checklist for descriptive observational studies. Results: The study included a sample of 624 patients and 77 nurses. The findings indicated that the nurses' level of competence, with an average score of 8.61, is significantly correlated with patient satisfaction. A total of 90.2% of patients reported being satisfied with the care they received during triage, highlighting the technical competence and empathy of the nurses as highly valued attributes. However, areas for improvement were identified, particularly in pain management and addressing the emotional needs of patients. Other factors related to nursing competence that influenced patient satisfaction included perceived safety in clinical practice and the sense of respect from the multidisciplinary team. Additionally, the intensity of pain experienced by patients during triage was a significant determinant of their overall satisfaction. Conclusions: The results of this study indicate that the higher the level of nursing competence, the more satisfied the patients. In addition to knowledge and skills in triage, aspects such as empathy, concern and assertive listening influence patient satisfaction, and, therefore, perceived quality of care. Reporting Method: In preparing the manuscript, the authors adhered to the relevant EQUATOR guidelines and the STROBE checklist for descriptive observational studies. Public or Patient Contribution: No public or patient or professional contribution outside of participation for data collection purposes. Trial Registration: N/A. This was not a clinical trial
Dexibuprofen ameliorates peripheral and central risk factors associated with Alzheimers disease in metabolically stressed APPswe/PS1dE9 mice
(BioMed Central, 2021-07-22) Ettcheto Arriola, Miren; Sánchez López, E. (Elena); Cano Fernández, Amanda; Carrasco, Marina (Carrasco Pérez); Herrera, Katherine; Manzine, Patricia; Espinosa Jiménez, Triana; Busquets Figueras, Oriol; Verdaguer Cardona, Ester; Olloquequi, Jordi; Auladell i Costa, M. Carme; Folch, Jaume; Camins Espuny, Antoni
Several studies stablished a relationship between metabolic disturbances and Alzheimer´s disease (AD) where inflammation plays a pivotal role. However, mechanisms involved still remain unclear. In the present study, we aimed to evaluate central and peripheral effects of dexibuprofen (DXI) in the progression of AD in APPswe/PS1dE9 (APP/PS1) female mice, a familial AD model, fed with high fat diet (HFD). Animals were fed either with conventional chow or with HFD, from their weaning until their sacrifice, at 6 months. Moreover, mice were divided into subgroups to which were administered drinking water or water supplemented with DXI (20 mg kg-1 d-1) for 3 months. Before sacrifice, body weight, intraperitoneal glucose and insulin tolerance test (IP-ITT) were performed to evaluate peripheral parameters and also behavioral tests to determine cognitive decline. Moreover, molecular studies such as Western blot and RT-PCR were carried out in liver to confirm metabolic effects and in hippocampus to analyze several pathways considered hallmarks in AD. Results: Our studies demonstrate that DXI improved metabolic alterations observed in transgenic animals fed with HFD in vivo, data in accordance with those obtained at molecular level. Moreover, an improvement of cognitive decline and neuroinflammation among other alterations associated with AD were observed such as beta-amyloid plaque accumulation and unfolded protein response. Conclusions: Collectively, evidence suggest that chronic administration of DXI prevents the progression of AD through the regulation of inflammation which contribute to improve hallmarks of this pathology. Thus, this compound could constitute a novel therapeutic approach in the treatment of AD in a combined therapy.
Exploring Nursing Interventions for Frail Individuals in Primary Care: A Systematic Review
(Wiley, 2025-06-11) Moral-Pairada, Marta del; Laserna Jiménez, Cristina; Fabrellas i Padrès, Núria; López Poyato, Mireia
Aim: To report nursing interventions addressing frailty in older adults within primary care settings. Background: There is a very limited literature corpus on nursing interventions in primary care directed to elderly and frail individuals. Introduction: Primary care nurses play a key role in providing better care to frail older adults. Methods: A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, studying the PubMed, Cochrane, Scopus, and JBI databases from September 2013 to August 2023. Two reviewers screened the studies, and three reviewers independently assessed the risk of bias. Results: Fourteen studies made the final cut. Three categories of interventions were identified: (i) assessments derived from Comprehensive Geriatric Assessments (CGA), such as fall prevention programmes, pain diagnostic evaluations, and assessments of social problems and sociodemographic characteristics, like gender and age; (ii) frailty diagnoses using NANDA terminology; and (iii) nursing care interventions at home and the relationship of trust. Discussion: Despite the fact that primary care is mainly reactive to the needs of frail elderly individuals, it is also important to be willing to collaborate with them on implementing preventive plans. In the same spirit, establishing a relationship of trust between the health professional and the older adults is a key factor when nursing interventions are carried out in the home of a frail individual. Frailty is a multidimensional concept that is not necessarily linked to age, as studies address frailty starting from the age of 60 and continuing up to 80. But, although frailty is not determined by age, it may be influenced by it. Conclusion and Implications for Nursing and Health Policies: There is no consensus on the starting age for frailty screening or on a single diagnostic tool to identify frailty. Nurses use standardised nursing language related to frailty, both to diagnose it and to implement person-centred care intervention plans. Healthcare policymakers, health organisations, and primary care nurses should consider the findings of this research to evaluate the inclusion of standardised tools to assess comprehensive frailty in older adults. In addition, it is also crucial to prioritise a relationship of trust between individuals and nurses to ensure adherence to nursing care plans.
Improving Emergency Department Staff Satisfaction Through Lean Thinking: Evidence From a Mixed Study
(John Wiley & Sons, 2026-03-20) Pastor-Puigdomènech, Andrea; Sánchez Sánchez, Miguel; Font Cabrera, Cristina; Fabrellas i Padrès, Núria; Benito-Aracil, Llúcia; Guix Comellas, Eva Maria
Aims: To compare job satisfaction among emergency department staff before and after the implementation of Lean Thinking and to explore staff experiences regarding this methodology, identifying associated satisfaction factors. Background: Lean Thinking, originally developed in the automotive industry, is increasingly applied in healthcare to optimise processes and improve patient care. Staff engagement and perceptions are key determinants of successful implementation. Methods: A mixed-methods pre–post design was conducted. The Font-Roja job satisfaction questionnaire was administered preintervention and 1 year postimplementation, and semistructured interviews were conducted with emergency department staff. Results: Overall job satisfaction increased (3.31–3.43; p = 0.029), with significant improvements in job monotony (3.30–3.64; p = 0.038) and physical work setting (3.31–3.75; p = 0.007). Qualitative analysis revealed ten subthemes including improved organisation and teamwork, a more methodical workflow, the need for adaptation, and concerns about potential dehumanisation. Conclusion: Lean Thinking increased job satisfaction in the emergency department, favouring structured work and better interprofessional communication. The professionals supported its continuity and highlighted the need for follow-up meetings and constant improvements.
Bridging theory and practice in schizophrenia care: Nursing models and related psychiatric and psychosocial frameworks
(Elsevier, 2026-04) Morén Núñez, Constanza; Mezquida Mateos, Gisela; Penadés Rubio, Rafael; García Rizo, Clemente; Ramos Pozón, Sergio; Sánchez Balcells, Sara
Background: Schizophrenia is a complex and chronic mental disorder associated with significant cognitive, emotional, and social impairments. While pharmacological and psychosocial treatments are essential, nursing models and related psychiatric and psychosocial frameworks remain underutilized in guiding comprehensive and person-centered care strategies. Purpose: This narrative review aims to synthesize psychiatric nursing models and related theoretical and clinical frameworks with potential applicability in schizophrenia care, and to highlight their value in fostering recovery-oriented and multidisciplinary approaches. Methods: A comprehensive literature search was conducted in PubMed, Scopus, Web of Science, and CINAHL using broad terms related to psychiatric nursing and schizophrenia. Peer-reviewed studies were included if they addressed theoretical nursing frameworks and considering their potential implementation in schizophrenia. Selected models were categorized based on their principles, strengths, and relevance to clinical practice. Findings: Key psychiatric nursing models and complementary psychological and integrative frameworks relevant to schizophrenia care were identified, including the Tidal Model, Peplau's Interpersonal Relations Theory, Orem's Self-Care Model, Roy's Adaptation Model, Trauma-Informed Care, the Biopsychosocial Model, and Cognitive-Behavioral Therapy. These models align with the CHIME framework for personal recovery (Connectedness, Hope, Identity, Meaning, Empowerment) and support key dimensions of care such as empathy, autonomy, coping strategies, and social reintegration. Though limited, we explored empirical evidence on their direct application in schizophrenia, highlighting a need for further research and implementation efforts, through a multidisciplinary perspective. Conclusion: Existing psychiatric nursing models and related psychiatric and psychosocial frameworks offer valuable, person-centered frameworks that complement biomedical approaches in schizophrenia care. Their integration into multidisciplinary clinical practice could enhance recovery outcomes, promote patient autonomy, and humanize mental health care. This review underscores the importance of revalorizing nursing theories and psychiatric or psychosocial frameworks in the context of complex psychiatric disorders and calls for their greater inclusion in treatment planning, education, and research.
Enhancing the Therapeutic Relationship Between Mental Health Case Managers and Individuals With Serious Mental Health Conditions: A Participatory Action Research Study in Community-Based Services
(John Wiley & Sons, 2026-04-08) Subías Miquel, Martí; Ventosa Ruiz, Ana; Sánchez Balcells, Sara; Andrés Mora, Hilari; Romeu, Maria (Romeu Labayen); Puig Llobet, Montserrat; Moreno Poyato, Antonio Rafael
This study examined how community mental health case managers, most of whom were mental health nurses, modified their day-to-day practice to strengthen the therapeutic relationship within community services. Using a participatory action research design across 10 centres in Catalonia, Spain, 24 case managers and 105 patients engaged in two action-reflection cycles. Data from reflective diaries and focus groups were analyzed using inductive thematic analysis. Through cyclical observation and collaborative reflection, participants identified key facilitators and barriers to developing the therapeutic relationship and co-designed two practice innovations: (1) jointly-created informational materials clarifying case-management scope and expectations, and (2) regular mixed patient-professional reflective groups focused on the therapeutic process. Despite structural pressures, heavy workloads, service fragmentation, and limited opportunities for professional reflection, the participatory approach supported sustainable, relationally focused practice change grounded in patient-provider dialogue. Embedding structured reflective spaces within routine care emerged as a practical mechanism to consolidate therapeutic alliance and advance recovery-oriented practice. While findings apply across disciplines, they are particularly relevant to nursing-led and nurse-participating case-management teams, in which continuous therapeutic contact, coordination functions and relational expertise intersect. The study offers a replicable framework for enhancing person-centred care in community mental health settings, and it underscores the value of nurse-involved co-creation and structured reflection to maintain therapeutic presence, align expectations and integrate lived experience into ongoing quality improvement.
Conocimientos sobre el VIH y las ITS, factores asociados en los pacientes que acuden a una consulta de enfermería hospitalaria especializada
(Elsevier España, 2026-05-01) Lao-López, Cristina; Garriga Comas, Neus; Arnau, Anna; Crespo, Manuel; Pérez-Vidal, Rafel; Goberna Tricas, Josefina
Objetivos: Determinar el nivel de conocimientos sobre el virus de la inmunodeficiencia humana (VIH), transmisión del VIH e infecciones de transmisión sexual (ITS), hepatitis, profilaxis pre-exposición (PrEP) y profilaxis postexposición (PEP) en personas heterosexuales, homosexuales y bisexuales/otros, que acuden a una consulta enfermera hospitalaria de ITS. Analizar los factores sociodemográficos, clínicos, de comportamiento sexual, hábitos tóxicos, soporte social y estigma asociados al nivel de conocimiento. Métodos: Estudio observacional, transversal, analítico y unicéntrico en un hospital español. Se reclutaron 259 pacientes de forma consecutiva entre noviembre de 2021 y julio de 2022. Se utilizó la encuesta European Men to Men Internet Survey (EMIS) y se realizó análisis estadístico bivariado y multivariado. Resultados: El 66,0% de los participantes eran heterosexuales, 25,5% homosexuales y 8,5% bisexual/otros. La mediana de edad fue de 52 años [IQR: 41,5-59,0]. El mayor conocimiento sobre el VIH se observó en las personas homosexuales (69,7%). El 93% de las personas heterosexuales desconocía la PrEP y PEP. Los factores asociados con menor conocimiento fueron: orientación heterosexual, edad mayor de 40 años, mujer, bajo nivel educativo e ingresos, desempleo, consumo de alcohol y drogas, no uso de Internet, menor número de parejas sexuales, falta de sexo seguro y baja integración social. Conclusiones: Es prioritario reforzar la educación sobre el VIH y las ITS, especialmente en heterosexuales, mujeres, adultos mayores y personas bisexuales/otras. Las intervenciones deben adaptarse a cada grupo, desmitificar la transmisión del VIH, fomentar el uso de PrEP y PEP, y reducir el estigma, favoreciendo estrategias educativas más inclusivas y eficaces para disminuir la prevalencia del VIH y las ITS.
Mobile applications to prescribe physical exercise in frail older adults: review of the available tools in app stores
(Oxford University Press, 2023-12-28) Soto Bagaria, Luís; Eis, Sophie; Pérez, Laura Mónica; Villa García, Lorena; Solà Morales, Oriol de; Carrión Ribas, Carme; Giné Garriga, Maria; Inzitari, Marco
Introduction: Different remote interventions, such as applications (apps), have been used to continue promoting healthy ageing and preventing disability during the COVID-19 pandemic. The growing trend of apps in health is exponential and may facilitate scaling up physical activity prescription. Numerous tools are available, but little is known regarding their appropriateness, validation and recommendation, especially for frail older adults. Methods: In-house, we developed an application that makes both the Apple app Store and the Google Play Store searchable using topic-related keywords and facilitates the extraction of basic app-information of the search results. The study was aimed at apps available to an English-speaking market. The resulting apps were filtered using various inclusion and exclusion criteria. The resultant apps underwent a more in-depth characterisation and searches for scientific publications on each app website and PubMed. Results: From an initial search result of >2,800 apps, 459 met the initial inclusion criteria. After a more in-depth review of their features, 39 apps remained for possible app in older frail patients. After testing them, 22 apps were excluded. Seventeen apps fit the inclusion and exclusion criteria and were deemed appropriate after peer review. Of these, only one app, Vivifrail, had any type of publication/published evidence. Conclusion: Apps can be valuable tool in prescribing exercise for frail older adults living in the community. However, few apps seem useful on a large scale, and there is limited evidence to support their effectiveness. It is important to invest in adapting Information and Communication Technologies to this population group.

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