Articles publicats en revistes (Infermeria Fonamental i Clínica)

URI permanent per a aquesta col·leccióhttps://hdl.handle.net/2445/18332

Estadístiques

Examinar

Mostrant 1 - 20 de 859

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.
Implementation of good humanization practices in a pediatric intensive care unit: An audit and feedback quality improvement study
(Elsevier B.V., 2026-05-08) García-Fernández, Javier; Delgado-Hito, Pilar; Segura Encinas, Vanessa; Rosell Ruiz, Noemi; Romero García, Marta
Objectives: To describe the implementation of the Manual of Good Practices in Humanization in Pediatric Intensive Care Units through an Audit and Feedback strategy and examine observed changes in compliance in a high-complexity unit. Methods: A comparative longitudinal observational study (pre–post) was conducted from January to December 2025 in a high-complexity pediatric intensive care unit in Spain. The implementation process followed a 12-month Audit and Feedback cycle structured in four phases: baseline audit, participatory prioritization, decentralized protocol development, and final evaluation. Compliance with 127 evaluable good practices was measured, and 95% confidence intervals were calculated using the Wilson score method. Results: Baseline compliance was 69.3% (88/127; 95% CI: 60.8–76.6). At final evaluation, overall compliance reached 72.4% (92/127; 95% CI: 64.1–79.5), representing an absolute increase of 3.1 percentage points (95% CI: −7.9 to +14.2). The prioritized strategic lines of Communication and Patient well-being showed gains of 14.3 and 8.3 percentage points, respectively; however, overlapping confidence intervals indicate that these changes cannot be distinguished from sampling variability. Among unimplemented practices, 87.2% required organizational and training actions, while 12.8% required direct financial investment. Conclusions: This implementation-focused quality improvement study suggests that Audit and Feedback may be feasible for structuring the monitoring, prioritization, and adoption of humanization practices in a high-complexity pediatric intensive care unit. Modest quantitative changes and organizational outputs were observed, but these findings cannot be considered evidence of intervention effectiveness. Future cycles should assess sustainability and incorporate patient-and family-level outcomes.
The role of the ethics expert in Spanish legislation on euthanasia and mental health
(Springer Nature, 2025-06) Ramos Pozón, Sergio
This article examines the assessment of mental capacity in the context of euthanasia,particularly when requested by patients with mental illnesses. It proposes a holisticalternative approach to the traditional functional model, arguing that the latter isinsufficient to capture the complexity of these patients’ decisions. Using approachesbased on narrative, hermeneutic, and dialogical ethics, it offers an evaluation thatconsiders the patient’s life story, values, and context. Shared decision-making andempathy are identified as fundamental components to ensure informed and consensualdecisions, promoting an environment of respect and mutual understanding. Thearticle reviews Spanish legislation on euthanasia, highlighting the need to includemedical ethics experts in the Guarantee and Evaluation Commissions. These expertsprovide a comprehensive ethical perspective essential for addressing the ethicalcomplexities in euthanasia requests and ensuring fair decisions that reflect the patient’strue will. It recommends reviewing and expanding current protocols, as wellas including continuous ethics training to improve medical practice in this context.The conclusions suggest that an assessment of mental capacity based on ethicalprinciples and an integrated narrative can significantly improve medical practiceand decision-making in euthanasia, especially for these patients. Furthermore, theinclusion of ethics experts in the commissions can provide a more humane andjust perspective, ensuring that decisions respect the patient’s dignity and autonomy.
Improving family-centered care in intensive care units: participatory action research to design and implement changes in nursing care
(Wiley, 2026-05-14) Cueva Ariza, Laura de la; Delgado-Hito, Pilar; Lluch Canut, Ma. Teresa; Benito-Aracil, Llúcia; Via-Clavero, Gemma; Cuzco, Cecilia; Romero García, Marta; Martínez Momblán, Ma. Antonia
Background: It is imperative to take care of the critically ill patient's family and meet their needs. Although there are evidence-based recommendations for doing so, their implementation is not widespread because changing the culture of care is difficult. Aim: To implement evidence-based changes in care for family members of critically ill patients in a tertiary hospital using a reflexive and participatory process and to assess their effects. Study Design: Participatory action research. A homogeneous theoretical sample of nurses from three intensive care units in a tertiary care hospital, with ≥ 5 years' experience and willingness to reflect on and critique their practice. Data were gathered through participant observation, documentary analysis, multilevel discussion groups and field diaries and a thematic analysis was performed. Results: Based on the identification of the causes and consequences of a variable and non-generalised approach to family care, a multicomponent, evidence-based set of strategies was designed and implemented. Subsequently, participants perceived important benefits: family members appeared more satisfied, collaborative and less anxious; patients reported feeling safer, emotionally supported and experiencing reduced stress, agitation or disorientation; and nurses perceived greater visibility of nursing care alongside enhanced professional satisfaction. Conclusions: Reflexivity, consensus and the active participation of healthcare professionals facilitated the change that ultimately enabled the genuine implementation of evidence-based recommendations. The training of the care team, the contextualisation of the strategies and the progressiveness of the process were key in generating change, reducing the variability of practice and leading to key benefits. Relevance to Clinical Practice: The interventions provide an adaptable guide for ICUs to implement and evaluate a multifocal approach to family-centred care, enhancing its benefits.
Clinical trial protocol for continuous glucose monitoring in critical care at Hospital Clinic of Barcelona (CGM-UCI23)
(Wiley, 2024-10-28) Pañero-Moreno, Marc; Guix Comellas, Eva Maria; Villamor Ordozgoiti, Alberto
Background: Hyperglycaemia is common in intensive care units (ICUs), with a prevalence of up to 86.2%, increasing mortality. Technology has evolved towards continuous glucose monitoring (CGM), and its use in ICUs began especially during the coronavirus pandemic (COVID-19). Various studies have evaluated the reliability of CGM, indicating that it is safe for use in critically ill patients. Aim: The aim of this study was to compare the use of CGM with point-of-care glucose (POC-G) testing in ICU. Specific objectives include evaluating the glycaemic control, the frequency of POC-G measurements, the incidence of hyperglycaemia, hypoglycaemia and morbidity and mortality at 90 days. Study Design: An experimental, controlled and randomized clinical trial with a singleblind design will be conducted at Hospital Clinic of Barcelona (HCB). A sample size of 376 participants will be recruited and randomly assigned to two groups: an experimental group, where glycaemic management will be based on CGM; and a control group, where glucose will be managed through POC-G testing, with a blinded CGM. Results: The primary variable considered will be time in range (TIR), with secondary outcomes including, time above range (TAR), time below range (TBR), number of POC-G measurements, incidence of hyperglycaemia and hypoglycaemia, and mortality. Hypothesis testing will use the Kolmogorov–Smirnov test to assess data normality, with appropriate statistical tests applied, considering a p-value <.05. Relevance to Clinical Practice: The results obtained will help us understand the impact of CGM on critically ill patients. CGM could potentially reduce the workload of nurses and improve the efficiency of decision-making by the ICU team, enabling early identification and treatment of glucose complications, thereby enhancing safety. Patient safety, a reduction in patient fingerstick and a decreased care burden are the criteria that add value to this research.
Impact of Prolonged Ischemia and Fixation on the Immunohistochemical Expression of PD-L1 in Non-small Cell Lung Cancer Specimens
(Xia & He Publishing, 2026-03-18) Barberà, Angels; González, Juan; Martin, Montserrat; Fernández, Pedro L.; Oriol, Albert; Martínez Soler, Fina; Santalucía Albi, Tomàs; Mate, José L.
Humanized antibodies targeting PD-1 or PD-L1 are established standards of care for non–small cell lung cancer (NSCLC), and there seems to be a correlation between tissue expression of PD-L1 and response rate in patients.1,2 Most of the analytical challenges in the immunohistochemical evaluation of PD-L1 expression have been extensively analyzed.3 However, preanalytical issues have been scarcely explored. The impact of prolonged ischemia and tissue fixation on PD-L1 false-negative cases has been established, and the fixation time window to obtain optimal results in control tissue,4 most commonly tonsil, has also been determined.5,6 Extrapolation of such results to specific tumor tissues should be made with caution, as tonsil tissue is less affected by variability than tumor samples. Heterogeneity of expression may preclude the adequate interpretation of suboptimally processed samples.7 Moreover, small-size samples, including bronchoscopic biopsy specimens or cytology blocks, may be even more sensitive to prolonged prefixation periods.8 The main objective of this study was to determine the proportion of routine samples processed within acceptable preanalytical times and to evaluate the extrapolatability to NSCLC samples of ischemia and fixation time limits established for the assessment of PD-L1 expression in control tissue. We retrospectively reviewed consecutive and unselected samples received at a referral pathology unit, selected from the unit database over a one-year period. Samples were eligible if they included an NSCLC diagnosis and PD-L1 determination. Sample processing was uniform across all the evaluated period (see File S1). Age, gender, biopsy site and method, processing method, histological subtype, and PD-L1 results, including proportion and intensity of positive cells, were recorded for each patient (Table 1, Table S1). Samples were considered PD-L1 positive if at least 1% of tumoral cells were positive, although other cut points were also explored. Based on previous studies in control tissue, an optimal preanalytical time of up to 72 h was defined. Time from surgical procedure to laboratory admission and time from laboratory arrival to end of fixation were obtained from the traceability system, and their addition was considered the full preanalytical time. Bivariate analysis was performed to assess significant relationships between the duration of the preanalytical process and PD-L1 results. The R-package version 3.0.1 was used for all statistical analyses (R Foundation for Statistical Computing, Vienna, Austria. https://www.R-project.org/ ). The study was approved by the the Comitè d’Etica de la Investigació amb medicaments, Hospital Universitari Germans Trias i Pujol (PI-18-072 approval number) and performed in adherence to the STROBE guidelines.
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.
Prognostic value of jugular, pulmonary and inferior vena cava ultrasound in decompensated heart failure in primary care
(Elsevier B.V., 2026-01-10) Cendrós Cámara, Victoria; Navas, Elena; Miranzo, Esther; Muñoz, Miguel A.; Pirretas, Laura; Pifarrè, Leila; Inzoli, Marco; Enjuanes, Cristina; Sierra, Verónica; Roger, Ana; Caballol Angelats, Rosa; Verdú Rotellar, Jose María
Background: Multiparametric ultrasound combining pulmonary and venous assessment (inferior vena cava [IVC] and internal jugular vein) is a feasible tool for characterizing hemodynamic congestion in patients with heart failure (HF) managed in Primary Care. Objective: To evaluate the short-term prognostic value of pulmonary and venous ultrasound in patients with decompensated HF treated with intravenous diuretics in community settings. Methods: Prospective cohort study including patients with decompensated HF attended between April 2024 and September 2025 across seven Primary Care teams of the Catalan Health Institute. Clinical, analytical, and ultrasound variables (IVC, jugular vein, and 8-zone lung ultrasound) were recorded. The primary outcome was a composite of death, HF hospitalisation, or new intravenous treatment within seven days. Results: A total of 197 patients were included (56.4 % women; mean age 84.7 ± 7.5 years). Signs of venous and pulmonary congestion were frequent at inclusion. Within seven days, 14.8 % of patients experienced the composite outcome. In multivariate analysis, IVC collapsibility <25 % (OR 3.70; 95 % CI 1.13–14.53; p = 0.039) and prior heart failure hospitalisation (OR 4.47; 95 % CI 1.48–14.10; p = 0.008) were independently associated with events, whereas lung and jugular ultrasound parameters were not. Conclusions: Multiparametric ultrasound performed in Primary Care allows identification and quantification of hemodynamic congestion in decompensated HF. Among evaluated parameters, only IVC collapsibility showed independent short-term prognostic value, supporting its integration into community-based risk stratification models.
Barriers and facilitators for mental-health professionals in the management and implementation of advance directives
(Elsevier, 2026-04-01) Ramos Pozón, Sergio; Falcó Pegueroles, Anna M. (Anna Marta); Poveda-Moral, Silvia; Andrés Mora, Hilari; Fabregat Marcos, Raquel; Mir Abellán, Ramon; Baladón Higueras, Luisa; Román Maestre, Begoña; Robles del Olmo, Bernabé; Garrido Aguilar, Eva María
Background: The Advance Directive (AD) serves as a fundamental legal and ethical instrument for safeguarding patient autonomy, ensuring that clinical decisions align with individual values when decision-making capacity is compromised. Despite the established legal framework in Spain since 2002, its practical implementation within mental health services remains largely under-researched. The objective of our study is to describe the barriers and facilitators perceived by mental-health professionals regarding the clinical management and implementation of the Advance Directive (AD). Methods: A descriptive, cross-sectional study was executed between December 2022 and March 2023 at Parc Sanitari Sant Joan de D´eu (Barcelona, Spain). The sample comprised 215 healthcare professionals across various disciplines—including nursing, psychiatry, psychology, and social work—representing a participation rate of approximately 20% of the 1035 eligible institutional staff. Findings: Results reveal a profound discrepancy between theoretical appraisal and clinical practice. Although 96.7% of professionals acknowledge the utility of the AD, practical engagement remains residual: only 20.0% of participants report direct experience with a patient's document. Critical operational barriers were identified, as 74.4% of respondents were unfamiliar with procedures for retrieving an AD from the official registry. Furthermore, 71.6% of professionals perceive an absence of adequate technical or administrative resources provided by their institution. Conversely, facilitators are rooted in ethical commitment; 88.3% maintain that a patient's anticipatory wishes should be respected even when they conflict with clinical advice. Conclusions: Findings underscore a significant gap between the ethical-legal ideal of autonomy and its clinical execution within the Spanish mental health context. Positive professional attitudes are insufficient without robust systemic support. Effective implementation necessitates a multidimensional strategy: strengthening specialized continuing education, streamlining access protocols within electronic health records, and fostering institutional policies that prioritize patient-centered psychiatric care.
Coercive measures in disability and mental health care services: Mechanical restraints from a bioethical and legal perspective in Spain
(Elsevier, 2025-01-16) Ramos Pozón, Sergio; Román Maestre, Begoña; Blánquez Gómez, Blas
This article explores the use of coercive measures, particularly mechanical and pharmacological restraints, indisability care settings and mental health services from a bioethical perspective, focusing on how these practicesimpact the human rights of individuals with mental disorder, focusing on how these practices impact the humanrights of individuals with mental disorders. A robust bioethical framework is presented, advocating for principlesof autonomy, beneficence, non-maleficence, dignity, dialogical justice, distributive justice, and vulnerability.These principles are integrated to reframe interventions and promote respect for patient rights. The articleprovides a detailed account of the legal framework governing these practices in Spain, addressing both nationaland regional legislation, and emphasizing its significance in protecting human rights. Finally, practical recommendationsare offered, which have proven effective in significantly reducing the need for coercive interventions.The article concludes by advocating for a transformation in clinical practices, promoting dignifiedand respectful care in line with a human rights framework, and moving away from unnecessary coercivemeasures.
The Evaluation of a Nursing Care Model for Breast Cancer: What Are Women's Priorities?
(John Wiley & Sons, 2025-04-26) Rodriguez Ortega, Ana; Ferro, Tàrsila; Ochoa Arnedo, Cristian; Campos, Gloria; Valverde, Yolanda; Medina, Joan Carles; Borràs Andrés, Josep Maria
Aim: To assess patient satisfaction with the breast care nurse (BCN) model and its adequacy in meeting patients’ needs for information and support. Background: The BCN is a core multidisciplinary member of the breast cancer team. The evaluation of care models is necessary to detect gaps and improve the quality of care. Material and Methods: This cross-sectional descriptive study took place in a breast pathology unit and included patients with early breast cancer seen between 1 July 2016 and 30 June 2017 after finishing their treatment. Between July and December 2018, sociodemographic and clinical variables were collected from the clinical history, and satisfaction was measured using a questionnaire sent to the patients. Results: Of the 139 patients included, 99.3% reported that the BCN provided information correctly, 96.2% reported that she provided adequate information on self-care at home (96.2%), and 97.8% reported that the words of the BCN helped them feel better. However, some patients were unsure whether the BCN would have been willing to discuss alternative therapies (41%). Conclusions: Patients were satisfied with the BCN, including her role in meeting information and support needs. However, some issues needed to be sufficiently addressed. Comprehensive, continuous assessment is required to understand patient needs. Training and specific studies on topics that are of interest to patients can help respond to these needs. Implications for Nursing Management: BCN functions are being developed in some countries. BCN results make it easier for healthcare managers to commit to this role and for nurses to develop all their competencies. BCN models must respond to international guidelines but are also determined by organizational resources. The evaluation of these models is essential and must be considered by users. Advanced practice nursing roles, including the BCN, are well established in some countries but developing in others. BCN results make it easier for healthcare managers to commit to this role and for nurses to develop all their skills. BCN models must respond to the elements determined by organizations that work to improve the quality of care for patients with breast cancer. However, they are also determined by organizational resources. The evaluation of these models is essential to correct deficiencies and improve the quality of care. An important part of the evaluation must take into account the user who receives the care, in terms of satisfaction and the form of patient-reported outcome measures (PROMs).
Second Victim Experiences Among ICU Nurses: Findings From a Mixed-Methods Study.
(Wiley, 2026-03-30) Kappes, Maria; Romero García, Marta; Delgado-Hito, Pilar; Sánchez Sepúlveda, María Paz; Urrutia, Maria-Teresa; Riquelme Contreras, Verónica; Strametz, Reinhard
Background: Adverse events are common in intensive care units (ICUs), and nurses involved may experience the second victim phenomenon (SVP), which includes a range of physical and psychological symptoms. This study aimed to understand the SVP among ICU nurses in Chilean public hospitals by describing its prevalence and characteristics and by exploring nurses’ personal experiences. Methods: A sequential explanatory mixed-methods design was used. The quantitative phase involved a cross-sectional, multicenter study with ICU nurses selected through cluster probabilistic sampling. The Second Victim Experience and Support Tool (SVEST) and a safety culture checklist were applied. Analyses were conducted using SPSS. The qualitative phase was designed to deepen understanding of the quantitative findings and included in-depth interviews and a focus group with nurses meeting predefined criteria for second victim distress; qualitative data were analyzed following an interpretive descriptive approach, supported by ATLAS.ti. Results: Among 326 ICU nurses, 81.9% reported involvement in at least one adverse event. Psychological distress emerged as the most affected domain, with guilt reported as the predominant emotion. Peer support was the most valued, while institutional support was considered limited. Quantitative findings also indicated high intention to absenteeism, reduced professional self-efficacy, and significant regional differences. Qualitative findings from 11 participants revealed intense emotional responses, including fear, guilt, and helplessness. A lack of institutional support and the presence of a punitive culture were frequently reported. Peer and family support were essential for coping and encouraged individual and collective learning. The absence of formal support mechanisms intensified the psychological burden. Conclusions: SVP is highly prevalent among ICU nurses in Chile and significantly impacts their emotional well-being. While peer support plays a crucial role in recovery, the lack of institutional support reinforces a punitive environment. These findings underscore the need to develop structured support strategies that foster a culture of safety and promote the well-being of healthcare worker.
Risk Factor Prediction Model for Catheter-AssociatedBloodstream Infections (CABSIs) in Midline and CentralVenous Catheters: A Cohort Follow-Up Study
(MDPI, 2026-04-24) Lafuente Cabrero, Elisabeth; Terradas Robledo, Roser; Civit Cuñado, Anna; García Sardelli, Diana; Molina Huerta, Carla; Gerez Acevedo, Inés; Giro Formatger, Dolors; Lacueva Perez, Laia; Esquinas López, Cristina; Tortosa i Moreno, Avelina
Background: Venous catheter placement is the most common invasive procedure performed in hospitals. Despite their widespread use and importance in healthcare, these devices can cause complications such as catheter-associated bloodstream infections (CABSIs). Although several studies have investigated potential risk factors, including sociodemographic, medical history, and clinical variables, the results remain inconsistent and inconclusive. Objectives: The aim of this study was to identify independent risk factors for CABSIs and to develop and validate a predictive model for CABSIs in patients with midline catheters, centrally inserted central catheters (CICCs), and peripherally inserted central catheters (PICCs). Methods: We conducted an observational cohort follow-up study including hospitalized patients with a CICC, PICC, or midline catheter between January 2016 and March 2022. Devices were randomly assigned to derivation (n = 6036) and validation (n = 1549) cohorts. Candidate predictors with p < 0.25 in univariate analysis entered a multivariable logistic regression model, and final variables were selected by backward stepwise regression. Performance in the validation cohort was assessed by calibration and discrimination using the Hosmer–Lemeshow test and AUC. Results: The prevalence of CABSIs in the derivation cohort was 1.8%. Independent risk factors for CABSIs included tracheostomy, a history of bacteremia within 3 months before catheter placement, the presence of a synchronous central catheter, active oncohematological disease, and having received total parenteral nutrition (TPN). The presence of these five variables increased the probability of CABSIs to 42.1%. The final model demonstrated good predictive performance with an area under the curve (AUC) of 0.73 in the derivation cohort and 0.77 in the validation cohort. Decision curve analysis showed that the predictive model offered a greater net clinical benefit than the “treat-all” or “treat-none” strategies among threshold probabilities between 0.5% and 5%. Conclusions: The model can help identify high-risk patients, guide risk-based clinical decisions, reduce unnecessary catheter use, and support infection prevention and antimicrobial stewardship.
New Values, New Lives, and Emerging Dating Violence: Insights on Detection and Intervention from Health Sciences Students
(MDPI, 2026-04-23) Sánchez Balcells, Sara; Sanchez-Ortega, M. Aurelia; Prats Arimon, Marta; Giménez Bonafé, Pepita; Vergés Bosch, Núria; Puig Llobet, Montserrat
Gender-based violence in dating relationships is a multifaceted issue that encompasses diverse forms. In university settings, high prevalence rates have been reported, with psychological violence being the most common. New forms of digital violence, such as cyberbullying, control through social media, and digital aesthetic pressure, further complicate the phenomenon. Purpose: This study aimed to explore Health Sciences students’ perceptions of gender-based violence in dating relationships to identify key dimensions for understanding and intervention. Methods: A qualitative design was employed using focus groups with ten participants, analyzed through Interpretative Phenomenological Analysis (IPA). Results: Four main themes emerged: characteristics of gender-based violence in dating relationships, types of violence identified, aesthetic pressure within affective relationships, and strategies for detecting and responding to violence. Conclusions: Findings emphasize the importance of incorporating students’ voices into prevention strategies and propose educational interventions that address both offline and online dynamics of gender-based violence in dating relationships.
La futilidad médica en salud mental y el papel de la psiquiatría paliativa
(2025-12-26) Ramos Pozón, Sergio; Robles del Olmo, Bernabé
Propósito/Contexto. Analizar la futilidad médica en salud mental y psiquiatría paliativa, explorando cómo la comprensión y aplicación de este concepto se han transformado con los desarrollos tecnológicos y éticos recientes. El artículo se enfoca en la complejidad de la futilidad en psiquiatría, cuestionando las nociones convencionales de éxito y eficacia, y resaltando el creciente papel de la psiquiatría paliativa en mejorar la calidad de vida y aliviar el sufrimiento. Metodología/Enfoque. Enfoque teórico-reflexivo, revisando teorías y estudios sobre futilidad médica y psiquiatría paliativa. Análisis crítico de la literatura existente, abordando tanto la futilidad cuantitativa como cualitativa. Además, se examina cómo la psiquiatría paliativa redefine las metas terapéuticas cuando los tratamientos convencionales no son eficaces. Hallazgos. La futilidad en psiquiatría es controvertida debido a la subjetividad en la definición de beneficios y la variabilidad en la respuesta a los tratamientos. La psiquiatría paliativa se propone como una alternativa necesaria, destacando la importancia de un enfoque que respete los valores, las preferencias y la calidad de vida de la persona, proporcionando un marco para reevaluar las metas terapéuticas y priorizar el bienestar integral de las personas con problemas de salud mental. Discusión/Conclusiones/Contribuciones. La psiquiatría paliativa ofrece una visión más humana y compasiva en salud mental, priorizando la calidad de vida y el alivio del sufrimiento. Se propone la integración de enfoques personalizados y multidisciplinarios, promoviendo una atención centrada en la persona que respete su dignidad y autonomía. Este artículo contribuye significativamente a la literatura existente al integrar un análisis bioético y clínico en un modelo de cuidado holístico y personalizado. Palabras clave: futilidad, psiquiatría, salud mental, bioética, salud, persona, futilidad médica, psiquiatría paliativa, calidad de vida, tratamiento holístico, autonomía.
Burnout en adjuntos de Oncología Médica y Radioterápica
(Elsevier España, 2025-06-01) González Concepción, Melinda; Rodríguez Bruzos, Eva; Blasco Blasco, Tomas
El síndrome de burnout, causado por el estrés laboral crónico, se caracteriza por agotamiento físico y emocional, despersonalización y baja realización personal. Este síndrome preocupa no solo por sus efectos negativos en el bienestar de los profesionales, sino también por la calidad asistencial, ya que reduce la empatía y la seguridad en la atención médica. Se ha estudiado en residentes de Oncología1, 2, 3, pero desconocemos si esta problemática está también presente entre los/as profesionales que ya han superado esa etapa de formación médica. Por este motivo, entre el 1 de marzo y el 30 de junio de 2023 realizamos un estudio descriptivo transversal utilizando un cuestionario en línea anonimizado para evaluar el nivel de burnout en médicos/as adjuntos/as de Oncología Médica y Radioterápica en Cataluña, y analizar si su incidencia está vinculada a factores profesionales y sociodemográficos específicos.
Nurse-led Management of Atrial Fibrillation in Patients With Implanted Cardiac Devices
(Elsevier Inc., 2025-04) Cano-Valls, Alba; Martínez Momblán, Ma. Antonia; Domingo Criado, Rebeca; Niebla Bellido, Mireia; Venturas Nieto, Montserrat; Roca Luque, Ivo; Tolosana, José M. (José María); Mont Girbau, Lluís; Guasch i Casany, Eduard
This report describes the management of atrial fibrillation (AFib) events diagnosed through cardiac implantedelectronic devices in an advanced nurse practitioner-led clinic. AFib events necessitating medical evaluationwere managed with a standardized decision tree and recorded for 1 year. Among 1980 follow-up assessments, 6% experienced AFib events (n ¼ 119), mostly because of de novo AFib (58%), rapid ventricular rate (22%), and symptomatic AFib (20%). Only 11% were referred to the emergency department, and 83% were assessed by the general practitioner in the same month. Advanced nurse practitioners offer prompt AFib event management in patients with cardiac implanted electronic devices, supported by a structured care pathway ensuring timely medical assessment and treatment.
Activity, triage levels and impact of the pandemic on hospital emergency departments: A multicentre cross-sectional study.
(John Wiley & Sons, 2025-03-01) Font Cabrera, Cristina; Juvé Udina, Eulàlia; Adamuz, Jordi; Díaz Membrives, Montserrat; Fabrellas i Padrès, Núria; Guix Comellas, Eva Maria
Aim: Describe the activity of hospital emergency departments (EDs) and the sociodemographic profile of patients in the eight public hospitals in Spain, according to the different triage levels, and to analyse the impact of the SARS-CoV-2 pandemic on patient flow. Design: An observational, descriptive, cross-sectional and retrospective study was carried out. Methods: Three high-tech public hospitals and five low-tech hospitals consecutively included 2,332,654 adult patients seen in hospital EDs from January 2018 to December 2021. Hospitals belonging to the Catalan Institute of Health. The main variable was triage level, classified according to a standard for the Spanish structured triage system known as Sistema Español de Triaje. For each of the five triage levels, a negative binomial regression model adjusted for year and hospital was performed. The analysis was performed with the R 4.2.2 software. Results: The mean age was 55.4 years. 51.4% were women. The distribution of patients according to the five triage levels was: level 1, 0.41% (n = 9565); level 2, 6.10% (n = 142,187); level 3, 40.2% (n = 938,203); level 4, 42.6% (n = 994,281); level 5, 10.6% (n = 248,418). The sociodemographic profile was similar in terms of gender and age: as the level of severity decreased, the number of women, mostly young, increased. In the period 2020-2021, the emergency rate increased for levels 1, 2 and 3, but levels 4 and 5 remained stable. Conclusion: More than half of the patients attended in high-technology hospital EDs were of low severity. The profile of these patients was that of a young, middle-aged population, mostly female. The SARS-CoV2 pandemic did not change this pattern, but an increase in the level of severity was observed. Impact: What problem did the study address? There is overcrowding in hospital EDs. What were the main findings? This study found that more than half of the patients attended in high-technology hospital EDs in Spain have low or very low levels of severity. Young, middle-aged women were more likely to visit EDs with low levels of severity. The SARS-CoV2 pandemic did not change this pattern, but an increase in severity was observed. Where and on whom will the research have an impact? The research will have an impact on the functioning of hospital EDs and their staff.
Modelo de Gestión y formación del Trabajo de Final de Grado de la Facultad de Enfermería: un enfoque participativo e innovador
(ICE Universitat de Barcelona, 2025-10-28) Agüera, Zaida; Poveda-Moral, Silvia; Santalucía Albi, Tomàs; Sánchez-López, Sònia; Morén Núñez, Constanza; Esquinas López, Cristina; Ramos Pozón, Sergio
INTRODUCCIÓN. El Trabajo Final de Grado (TFG) es clave en la formación en enfermería, integrando competencias académicas y promoviendo la reflexión crítica. Su gestión enfrenta retos como garantizar la transparencia en la asignación, reducir la subjetividad en la evaluación y optimizar la gestión de aulas. Para solucionarlo, se implementó un modelo basado en la digitalización y estandarización de procesos. MÉTODO. Se analizó la gestión del TFG en los campus Bellvitge y Clínic (2023-2024), implementando asignación digital, rúbricas estandarizadas y sesiones formativas. Además, se hizo un análisis descriptivo de modalidades y calificaciones. Se trata de un enfoque descriptivo de todo el proceso del TFG. En particular, de describir la experiencia docente del proceso de TFG y de gestión del proceso del TFG. RESULTADOS. Se logró digitalizar rúbricas, optimizar la evaluación y mejorar la asignación de trabajos. La revisión bibliográfica fue la modalidad más elegida, seguida de proyectos de investigación. DISCUSIÓN. La digitalización optimizó la gestión del TFG, asegurando asignaciones equitativas y evaluaciones objetivas. Persisten áreas de mejora, como la variabilidad en tutorías y las limitaciones de modalidad según la nota. Futuras ediciones deberán centrarse en reducir estas diferencias y perfeccionar la gestión administrativa para consolidar un modelo más eficiente y justo.
Shunt íleo-cava intraoperatorio transitorio en la resección de adenocarcinoma de cabeza de páncreas localmente avanzado: ¿rompiendo un techo?
(Elsevier España, 2026-02) Busquets Barenys, Juli; Peláez Serra, Nuria; Secanella Medayo, Lluis; Sorribas Grifell, María; Iborra Ortega, Elena
[spa] La reseccioń de adenocarcinoma de cabeza de páncreas localmente avanzado con oclusioń de la vena mesenterica ́ superior (VMS) y afectacioń del confluente esplenomesentericoportal ́ (EMP) obliga en ocasiones a un clampaje venoso prolongado con riesgo de isquemia intestinal. La utilizacioń de shunts venosos intraoperatorios ha sido publicado por grupos de referencia para permitir la reseccioń con exito. ́ En nuestro centro realizamos una duodenopancreatectomía total por adenocarcinoma de cabeza de páncreas localmente avanzado con oclusioń de VMS y confluente EMP. El uso de un shunt íleo-caval transitorio mediante un injerto venoso permitióla reseccioń del tumor sin repercusioń en el intestino. La cirugía finalizócon el cierre del shunt, anastomosis del injerto a la vena porta y reconstruccioń digestiva. El paciente presentó buena tolerancia a la cirugía, siendo dado de alta el 7 o día posoperatorio. El estudio anatomopatologico ́ describió adenocarcinoma pancreático ypT1N0(R0) grado regresioń GRT2/IIa, con 0/30 adenopatías afectas.

Examinar

Enviaments recents