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Nursing faculty perspectives on integrating emerging technologies in undergraduate nursing education: A qualitative descriptive study
(Elsevier, 2026-10-09) Cazorla Calderón, Sergio; Pedregosa Fauste, Sara; Fernández García, Elena; Barrientos-Trigo, Sergio; Garcia-Díaz, Fernando; González Concepción, Melinda
Background: Emerging technologies (ET), including virtual, augmented, mixed, and extended reality alongside simulation-based tools, are increasingly available for undergraduate nursing education, yet their institutional and pedagogical integration remains uneven. Nursing faculty are central to this process, but their own experiences and perceptions of adopting ET have received limited empirical attention. Aim: To explore nursing faculty's experiences and perceptions of integrating emerging technologies into undergraduate nursing education. Design: Qualitative descriptive study with a contextual quantitative component. Settings: Three university nursing faculties in Spain. Participants: Twenty-two nursing faculty members. Methods: Three focus groups were conducted and analyzed using template analysis, a form of thematic analysis. An ad hoc questionnaire provided descriptive data on participants' self-reported experience with specific technologies, used to contextualize the qualitative findings. Results: Three themes emerged: Resources and Integration, Teaching and Learning, and Navigating the Digital Divide in Nursing Education. Faculty recognized the pedagogical value of ET, particularly of well-established tools such as high-fidelity simulation, but identified limited institutional support, unequal training opportunities, and concerns about preserving humanistic and relational aspects of care as central barriers. Low-cost technologies already accessible to most institutions were seen as a complement to, rather than a replacement for, theoretical instruction. Conclusions: Nursing faculty view emerging technologies as pedagogically valuable but constrained by institutional support, training, and equity considerations. Because this study captures the perspective of faculty only, future research should examine how nursing students experience these same tensions.
Emotion regulation and positive mental health in nursing students: Pre-post changes following an educational program
(Elsevier, 2026-09-09) Agüera, Zaida; Sánchez Balcells, Sara; Sánchez Ortega, Mª Aurelia; Mantas Jiménez, Susana; Mora López, Gerard; Roldán Merino, Juan Francisco; Arcos Pros, Maria Del Mar; Moreno Poyato, Antonio Rafael; Moreno Arroyo, M. Carmen; Prats Arimon, Marta; Ventosa Ruiz, Ana; El Abidi El Ghazouani, Khadija; Moreno Hernández, Andrea; Lluch Canut, Ma. Teresa; Puig Llobet, Montserrat
Background: Emotion regulation difficulties and positive mental health (PMH) are key determinants of well-being and professional development among nursing students. However, evidence on the combined examination of these constructs and on changes following PMH-based educational programs during the early stages of nursing education remains limited. Gender-related similarities and differences in emotion regulation and PMH have also received limited attention in this population. Aim: This study aimed to assess emotion regulation and PMH levels among first-year nursing students, with gender comparisons examined as an exploratory secondary objective, and to evaluate pre–post changes following participation in a PMH-based educational program. Design: A quasi-experimental one-group pretest–posttest study was used. Methods: A total of 195 first-year nursing students from a Spanish university participated. Emotion regulation was assessed using the Difficulties in Emotion Regulation Scale (DERS), and PMH was measured using the PMH Questionnaire (PMHQ). Baseline gender differences were examined using independent samples t-tests. Pre–post changes were analysed using paired samples t-tests, and gender differences in change scores using independent t- tests. Results: At baseline, students showed variability in emotion regulation and relatively stable PMH levels. Exploratory gender comparisons found no significant differences in overall emotion regulation or PMH, except for higher prosocial behavior in female students. Following participation in the educational program, significant pre-post changes were observed in several DERS dimensions, including non-acceptance, goal-directed behavior, access to regulation strategies, emotional clarity, and total DERS score (p < .05). Changes in PMH were limited, with a small but significant decrease observed only in autonomy. Gender differences in pre–post change scores were exploratory and minimal, with only emotional clarity showing a small significant difference. Conclusions: Following participation in the PMH-based educational program, pre-post changes were observed in several dimensions of DERS, whereas changes in PMH were limited. Exploratory analyses identified few gender differences, although these findings should be interpreted cautiously given the imbalance in gender
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.
Idoneidad de la implementación de la estrategia de reperfusión en los códigos IAM en zonas montañosas alejadas de una unidad de hemodinámica
(Publicaciones Permanyer, 2025-12-29) Navarra Llorens, Montserrat; Martínez Alonso, Montserrat; Azeli, Youcef; Ferrandis Barrés, Sílvia; Canelles Seix, Montse; Duch Grau, Laura; Forradelles Rey, Ana; Martínez Momblán, Ma. Antonia; Jiménez i Fàbrega, Xavier
Introducción y objetivos: El infarto agudo de miocardio (IAM) con elevación del segmento ST requiere una reperfusión coronaria precoz para reducir la mortalidad y mejorar el pronóstico. En las zonas rurales, los tiempos de acceso a los tratamientos de reperfusión (fibrinolisis o intervención coronaria percutánea primaria [ICPp]) se ven comprometidos por aspectos logísticos y asistenciales. El objetivo de este estudio es determinar los factores asociados a los retrasos en la reperfusión y los asociados a la mortalidad en pacientes con código IAM en una región montañosa europea. Métodos: Se realizó un estudio observacional, retrospectivo y cuantitativo en la región del Alt Pirineu-Aran, en Cataluña (España), entre 2015 y 2020. Se analizaron los factores sociodemográficos y geográficos, el estado clínico de los pacientes, la gestión de los recursos y el tratamiento realizado, utilizando los datos del registro del código IAM y del Sistema d’Emergències Mèdiques. Resultados: Durante el periodo de estudio, 221 pacientes con código IAM fueron atendidos en el Alt Pirineu-Aran. Los pacientes tenían entre 27 y 96 años, con una media de 64,7 años, y el 72,4% eran varones. De ellos, 47 pacientes recibieron fibrinolisis como tratamiento de reperfusión y 173 fueron trasladados a un hospital con unidad de hemodinámica, donde 162 recibieron ICPp; en 11 casos se desactivó el código. La mayoría de los pacientes trasladados para ICPp experimentaron un retraso superior a 120 minutos desde el electrocardiograma diagnóstico. El uso de helicópteros mejoró los tiempos de tratamiento, especialmente en los traslados primarios. La tasa de mortalidad a los 15 días fue del 8,1%. Conclusiones: La mayoría de las fibrinolisis y de las ICPp no se realizaron dentro de los tiempos recomendados según las guías europeas. Se evidencia una marcada infrautilización de la fibrinolisis.
Evaluation of good humanisation practices and organisational determinants in paediatric intensive care units: A multicentre observational study
(Elsevier B.V., 2026-09-01) García Fernández, Javier; Romero García, Marta; Segura Encinas, Vanessa; Rossell Ruiz, Noemi; Rodríguez Salvador, Laura; Pérez Restrepo, Alejandra; Tole-Barreto, Dayanna Andrea; Albujar Font, Maria del Mar; Pelejero Manzano, Jordina; Rodríguez Forner, Omar; Cambra Lasaosa, Francisco José; Heras-La Calle, Gabriel; Velasco Bueno, José Manuel; Delgado-Hito, Pilar
Objectives: To evaluate compliance with the Manual of Good Practices in Humanisation in Paediatric Intensive Care Units in Spain, identifying strengths and areas for improvement, and exploring the association between organisational determinants and the degree of implementation. Methods: Descriptive, cross-sectional and multicentre observational study conducted between January and September 2025 in four paediatric intensive care units in Catalonia (Spain), covering 83.9% of regional bed capacity. The manual comprises 132 items across seven strategic lines and three levels (basic, advanced, excellent). Adherence was assessed via observation, documentary review, and interviews as implemented, in progress, or not implemented. Data were analysed using descriptive statistics, the Mann–Whitney U test, and Spearman's correlation (p < .05). Results: Units implemented a median of 66.3% of practices (range: 54.5%–72.7%). Basic practices showed greater implementation (61.9%–75.0%) than advanced (45.2%–77.4%) or excellent (35.3%–58.8%). Care for staff (85.8%), infrastructure (84.8%), and end-of-life care (77.3%) showed the highest implementation; post-intensive care syndrome and discharge preparation, the lowest (4.2%). Overall implementation correlated with human resources (nurses, nursing assistants, doctors; ρ = 1.000, p < .001), with a trend toward structural capacity (ρ = 0.949, p = .051). Conclusions: This evaluation documents moderate, variable implementation across centres and strategic lines, with post-discharge monitoring as the key gap. Human resources were the main determinant, underscoring the importance of adequate staffing. Implications for practice: The manual is a diagnostic and monitoring tool that units can integrate into audit-and-feedback cycles to prioritise improvement and benchmark practice across centres.
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.
Preparation of Australian and Spanish nursing students for intimate partner violence
(Sciedu Press Sciedu Press Sciedu Press, 2016-08-01) Gorman, Don; Rigol Cuadra, Assumpta; Honrubia Pérez, María; Sánchez Zaplana, Isabel; Rodríguez-Martín, Dolors; Tur Bujosa, Neus; Beccaria, Lisa; Martyn, Julie A.; Dawson, Rhonda; Beccaria, Gavin; Hossain, Delwar
Objective: Throughout the world intimate partner violence (IPV) is a significant issue and it is important that nurses contribute to policy development, as well as to the nursing care of families. Nurses are uniquely positioned to identify, and support women experiencing IPV. For them to contribute to policy development, they need firstly to develop a better understanding of the issue and to their role in addressing it. This study explored and compared perceptions, attitudes and knowledge of IPV of nursing students in Australia and Spain. Methods: Students from all levels of the nursing programs in both countries participated in focus groups and a follow up survey exploring their understanding of, and attitudes towards IPV. The data from the focus groups was analysed thematically and the quantitative data from the survey statistically. Results: Spanish nursing students had significantly more positive/comprehensive views about the role nurses have in managing IPV, had a stronger view about the nurses' role and that they were more prepared. Although the Australian and Spanish participants were not identical, for example, the Australian sample was predominantly female and over the age of 35, these factors do not explain why the difference. The study was only undertaken in one Australian University and one Spanish university so results cannot be generalised to either country. Conclusions: The findings suggest that there may be much more that could be done to prepare nurses to deal with issues of IPV and to take a lead role in recommending policy changes worldwide.
Safety recommendations on laboratory and blood count values for early mobilization in critically ill adults: an expert consensus.
(Associação de Medicina Intensiva Brasileira, 2026-08-21) Popayan, Andrés Mauricio Enriquez; Parada-Gereda, Henry Mauricio; Peña-López, Luis Alexander; Su, Longxiang; Santillán-Zuta, Milton; Lozano, Wilson Mauricio; Luo, Hongbo; Lago Borges, Daniel; Villalba, Darío Salvador; Pratto, Romina A.; Cruz-Touzet, José M.; Arias Rivera, Susana; Cerron Cabezas, Carmen Ana; Goñi Viguria, Rosana; Raurell Torredà, Marta; Stripari Schujmann, Debora; Sepúlveda Barisich, Patrick; Saavedra, Santiago Nicolas; Martínez Camacho, Miguel Ángel; Quevedo Florez, Leonardo Alexander; Arriagada, Ricardo; Silva Gutiérrez, Alexis; Soto Limo, Maritza Giovanna; Jimenez Salazar, Francisco
Although early mobilization is a cornerstone of modern critical care for reducing intensive care unit-acquired weakness, the duration of mechanical ventilation, and length of stay, its implementation remains highly variable due to the absence of standardized laboratory criteria to guide clinical decision-making. Therefore, this study aimed to generate safety recommendations regarding laboratory and blood count values to be considered prior to initiating early mobilization in critically ill adults, both with and without invasive supports, across different clinical conditions. To address this evidence gap, a modified Delphi process was conducted with 24 highly experienced intensive care unit staff, including physiotherapists, physicians, and nurses. All panelists met strict criteria related to clinical expertise, advanced training, and scientific productivity. Over eight iterative rounds, the panel achieved at least 85% agreement on 119 items across six clinical domains: respiratory, cardiovascular, renal, surgical, hematological/immunological, and neurological. Key laboratory parameters considered included hemoglobin, platelets, lactate, glucose, international normalized ratio, acid-base state (pH), and potassium in selected clinical contexts. The consensus also provides novel guidance in two previously underexplored areas: first, mobilization during blood product transfusions, recommending postponement of early mobilization until transfusion completion; and second, the importance of dynamic trends in routine laboratory tests, identifying clinically meaningful declines in hemoglobin: ≥ 2g/dL/24 hours and platelets: ≥ 20% within 24 hours as contraindications to mobilization. This consensus offers a pragmatic framework that has the potential to reduce interprofessional variability, enhance patient safety, and inform the development of local and national protocols, including in resource-limited settings. Nonetheless, prospective validation across different healthcare contexts is required to confirm its clinical impact and generalizability.
Multidisciplinary management of advanced ovarian cancer in Spain: expert recommendations for achieving maximum survival and improving patient care
(Springer, 2026-07-06) Barretina Ginesta, Maria Pilar; Madariaga, Ainhoa; Barahona Orpinell, Manel; Gallego, Alejandro; Guerra Alía, Eva María; Matias-Guiu, Xavier, 1958-; Sánchez Heras, Ana Beatriz; Casla Barrio, Soraya; Castaño, Fátima; González Concepción, Melinda; Navarro López, Mar; Hierro Racionero, Charo; Ruz Torres, Marcelo; Gaba García, Lydia
In advanced ovarian cancer, developments in tumor profiling, surgical techniques, and maintenance therapies have led to increased numbers of “long-term survivors” who remain relapse-free beyond five years. These developments require identifying best practices for disease management and patient care to maximize the chances of long-term survival. To meet this need, we implemented the “Health Evidence Achieving Long Survival” (HEaLS) project, which aimed to develop guidelines for optimal management, follow-up, and patient support in advanced ovarian cancer. Through literature review and collaborative discussions, we formulated guidance for nine topics: clinical, pathological and molecular diagnosis, genetic counseling, surgery, systemic therapeutic management, oncology nursing, psycho-oncology, nutrition, physical exercise, and biopsychosocial needs. Here, we present our recommendations for managing advanced epithelial ovarian cancer focusing on integrated care pathways and multidisciplinary collaboration. These recommendations can be used by healthcare teams looking to implement coordinated strategies for maximizing survival and quality of life in ovarian cancer.
The Relationship Between Breast and Gynecological Cancers and a Diagnosis of Serious Mental Illness: A Scoping Review
(Wiley, 2025-02-03) Tort Nasarre, Glòria; Galbany Estragués, Paola; Subías Miquel, Martí; Monistrol, Olga; Saz Roy, Mª Ángeles; Romeu, Maria (Romeu Labayen)
Women who are living with a diagnosis of serious mental illness face an elevated risk of premature mortality from breast and gynecological cancers. To understand the risk factors associated with prevalence and premature death from breast or gynecological cancer in women diagnosed with an SMI, a scoping review was conducted, using the Arksey and O'Malley framework in accordance with the PRISMAScR guidelines. Four electronic databases were searched for research from 2012 to 2024. The 21 selected articles identified potential factors associated with our target: clinical status, coordination of care across health services, and social and family support. The findings suggest that the keys to improving outcomes are conducting proper screening among women diagnosed with SMI, coordinating mental health and oncological care, and capitalizing on available family support.
Associations of safe nurse staffing coverage and care complexity factors with nursing-sensitive adverse events in cardiac inpatients: a cross-sectional multicenter study
(Frontiers Media, 2026-06-12) Asensio Flores, Susana; Adamuz, Jordi; Soldevila Cases, Rosa; Castellà Creus, Mònica; Zuriguel Pérez, Esperanza; Polushkina-Merchanskaya, Oliver; Delgado-Hito, Pilar; Juvé Udina, Eulàlia
Background: Adverse events (AEs) are linked to nurse staffing levels and care complexity factors; however, evidence in patients hospitalized for cardiac conditions is limited. The acute to intensive care (ATIC) patient classification system measures patient acuity according to required nurse hours per patient day (NHPPD), thereby enabling calculation of nurse staffing coverage. A prior study defined safe nurse staffing coverage as achieving ≥90% of the required NHPPD with the available nurse staffing. The aim of this study was to examine the associations between safe nurse staffing coverage and care complexity factors and AEs in patients hospitalized for cardiac conditions in three high-complexity hospitals in Catalonia between January and December 2022. Methods: This was a cross-sectional multicenter study that included patients admitted for cardiological reasons at three high-complexity hospitals of the Catalan Institute of Health in Catalonia between January and December 2022. Data regarding care complexity individual factors and patient acuity, according to the ATIC patient classification system, were obtained from electronic health records. The main outcomes were nursing-sensitive AEs that included falls, pressure ulcers, phlebitis, cardiorespiratory arrest, acute pulmonary edema (APE), and aspiration pneumonia. Safe nurse staffing coverage was defined as achieving ≥90% of the required NHPPD. Other clinical and sociodemographic variables were also collected. A descriptive and comparative analysis was performed. Results: Among the 6,873 patients included in the study, 11.4% experienced one of the AEs studied, the most common being APE, present in 5% of cases. The mean nurse staffing coverage was 64.3%. Patients admitted to step-down units and those admitted for surgical reasons received the highest nurse staffing coverage, at 97.7% and 65.7%, respectively. The risk factors independently associated with AEs were old age, consciousness disorders, chronic disease, hemodynamic instability, and transmissible infection. Safe nurse staffing coverage was a protective factor against AEs. Conclusions: Older age, consciousness disorders, chronic disease, hemodynamic instability, and transmissible infection were independently associated with nursing-sensitive AEs, while safe nurse staffing coverage was a protective factor. These findings should inform staffing decisions and shape future healthcare-management policies aimed at improving health outcomes among adults hospitalized in cardiology wards.
Validez y sensibilidad al cambio de la Clinical Frailty Scale-España en pacientes ingresados en cuidados intensivos
(Elsevier, 2025-07-03) Arias Rivera, Susana; Raurell Torredà, Marta; Moro-Tejedor, María Nieves; Thuissard-Vasallo, Israel John; Andreu Vázquez, Cristina; Frutos Vivar, Fernando
Introducción Las escalas de fragilidad, desarrolladas para evaluar a pacientes ancianos, se están implementando en pacientes críticos. Una de las más utilizadas es la Clinical Frailty Scale, adaptada recientemente al español (CFS-España). Objetivo Evaluar la validez y la sensibilidad al cambio de la CFS-España, en una cohorte de pacientes críticos ≥18 años. Metodología Estudio observacional prospectivo, multicéntrico, de carácter métrico llevado a cabo entre enero de 2020 y julio de 2024. Fueron incluidos pacientes adultos con estancias en UCI >48 h y seguidos durante la estancia y hasta un año del alta. Variables: fragilidad, características sociodemográficas, calidad de vida, comorbilidades, gravedad (SAPS3), variables de evolución en UCI, estancia y destino al alta. Análisis estadístico: exploratorio, regresión bivariante para evaluar la relación entre fragilidad y las variables registradas; regresión multivariante de variables significativas en bivariante. Correlación de Spearman de CFS-España con variables cuantitativas. Comparación de medias con t de Student para sensibilidad al cambio. Resultados Fueron incluidos 493 pacientes, 17,4% frágiles (CFS-España = 5-9). La edad, ser mujer y ser dependiente aumentan el riesgo de fragilidad, además de los días de ingresos previos, comorbilidades, peor calidad de vida física, bajo nivel académico y rentas anuales bajas. La fragilidad es predictiva de debilidad muscular, hipoglucemias, necesidad de depuración extrarrenal, ventilación mecánica invasiva, fármacos vasoactivos, reanimación cardiopulmonar o limitación del tratamiento de soporte vital y se asocia con mortalidad. La fragilidad no muestra relación con la calidad de vida mental, SAPS3, SOFA o estancia en UCI ni en hospital. El mayor cambio observado ha sido entre el ingreso y los 3 meses del alta. El tamaño del efecto de los cambios de la CFS-España entre ingreso, puntos intermedios y alta fue elevado (d = 0,832). Conclusiones La CFS-España muestra buena validez convergente con edad, mujeres, dependencia, peor calidad de vida física, días de hospitalización previa, nivel académico y rentas anuales bajas. También muestra validez predictiva para el nivel de soporte vital en UCI, mortalidad y destino al alta hospitalaria.
Puzzle-based pedagogic activity to address rote learning of antibiotic classes in clinical pharmacology course for undergraduate nursing students
(BioMed Central, 2026-05-12) Morén Núñez, Constanza; Ruiz Mariscal, Emi; Negredo Esteban, Mónica; Preciado, María; Martínez, Gemma; Llauradó Serra, Mireia; Rosa Castillo, Antonio; González Concepción, Melinda; Rodriguez Ferret, Natalia; Martinez Rodriguez, Laura
Objective: We aimed to evaluate the impact of an active learning strategy, the Puzzle technique, on nursing students’ knowledge acquisition and engagement in Clinical Pharmacology, focusing on antibiotics. Background: Absenteeism and low motivation among university students pose significant challenges in higher education. Traditional rote learning methods often lead to disengagement, particularly in content-heavy subjects such as Clinical Pharmacology. Within this field, learning antibiotic classes requires extensive memorization, which may hinder students’ performance and retention of knowledge. Given the increasing role of nurses in antibiotic prescription, enhancing their pharmacological training is essential. Design: Educational intervention study with three intervention groups and two control groups, including within-group pre-post assessments. Methods: A total of 330 second-year nursing students from the University of Barcelona participated. Three groups (A, B, and C) engaged in the Puzzle intervention, while two groups (D and E) served as controls, thereby receiving only the standard theoretical instruction without any additional activity. The intervention consisted of a peer-to-peer collaborative activity where students were assigned specific antibiotic topics to teach their peers. Learning outcomes were assessed through a quiz, midterm, and final exams. Results: Intervention groups demonstrated significantly higher accuracy in quiz (p< 0.001) and exam accuracy percentages (p< 0.001) compared to controls. Among the intervention groups, students who participated in the activity outperformed their intra-group controls. Additionally, students reported high satisfaction and perceived applicability in learning consolidation. Conclusions: Our findings specifically pertain to undergraduate nursing students and undergraduate nursing education. The Puzzle technique effectively enhanced knowledge retention of antibiotic drug classes within Clinical Pharmacology. This peer-to-peer approach may serve as a valuable pedagogical tool for improving learning outcomes in nursing education, particularly in complex pharmacological subjects.
Exploring women's experiences and needs during the climacteric to enhance positive mental health and self-care
(Frontiers Media, 2026-07-22) Sánchez Ortega, Mª Aurelia; Sánchez Balcells, Sara; Prats Arimon, Marta; Moreno Arroyo, M. Carmen; Rodríguez Ávila, Núria; Maestre, Elena; Crespo Mirasol, Esther; Agüera, Zaida; López Gimeno, Encarnación; Martínez Bueno, Cristina; Lluch Canut, Ma. Teresa; Puig Llobet, Montserrat
Background: The climacteric is a stage in women's lives that, even today, remains taboo in many regions of the world where social contexts are otherwise highly advanced. Although women's experiences have generated growing interest there is still a need for greater understanding. Learning about and studying the experiences and needs that determine women's emotional well-being during the various stages of the climacteric provides a knowledge base that allows future research to design evidence-based, high-quality health promotion and intervention programs aimed, from a holistic perspective, at fostering well-being during this stage of life. In this sense, a project was proposed to explore these experiences and needs and to co-create a Decalogue for Positive Mental Health during the climacteric. Methods: A qualitative, interpretive phenomenological study was conducted. Data were collected through an online questionnaire and two focus groups (n = 12) between February and April 2025. The sample was recruited by convenience. Inclusion criteria were women currently experiencing the climacteric who were available to participate in the focus groups. All discussions were recorded, transcribed verbatim, and analyzed using ATLAS.ti version 25 through content analysis. Results: Three main categories emerged: symptoms, self-care, and aesthetic pressure. A total of 59 codes were identified, and sentiment analysis was conducted, showing predominantly neutral and negative results across the three categories. Conclusions: The modern lifestyle has transformed the profile of women experiencing the climacteric. Today, they are more aware of this stage and demand clear information and standardized protocols to better understand it. Furthermore, self-care and positive mental health have consolidated as key elements to navigate this transition period with well-being.
Detection of Dating Violence Among University Students in Health Sciences: A Multicentric Cross-Sectional Study in Spain and Colombia
(Frontiers Media, 2026-06-26) Puig Llobet, Montserrat; Sanchez-Ortega, M. Aurelia; Prats Arimon, Marta; Agüera, Zaida; Rodríguez-Martín, Dolors; Moreno Arroyo, M. Carmen; Maestre, Elena; Lluch Canut, Ma. Teresa; Roldán Merino, Juan Francisco; Moreno Poyato, Antonio Rafael; Saz Roy, Mª Ángeles; Mantas Jiménez, Susana; Giménez Bonafé, Pepita; Vergés Bosch, Núria; Ferran Ferrer, Núria; Faure Carvallo, Adrien; Manzanares Céspedes, María Cristina; Astudillo-Rozas, Wilson; Rodríguez Ávila, Núria; Casanovas Cuellas, Cristina; Huertas Zurriaga, Ariadna; Torrubia Pérez, Elisabet; Mora López, Gerard; Vives Espelta, Judit; Sanromà Ortiz, Montserrat; Roca Llobet, Judith; Cogollo, Zuleima; Tuesca Molina, Rafael; Sánchez Balcells, Sara
Introduction: Dating violence (DV) represents a critical public health challenge that disproportionately affects adolescents and young people. Among Health Sciences students, early detection is doubly important, both for their personal wellbeing and for their future role as frontline professionals in the identification of victims. The aim is to determine the prevalence and dynamics of dating violence (DV) among Health Sciences university students in Spain and Colombia, analyzing patterns of victimization and perpetration. Material and methods: This multicenter cross-sectional study included 511 Health Sciences students from eight universities in Spain and Colombia. DV was assessed using the Multidimensional Dating Violence Scale (EMVN) developed by García-Carpintero et al. (2018). The study was approved by the Research Ethics Committees of all participating institutions. Results: The findings reveal that control and surveillance, together with sexual violence, are the predominant dimensions, far exceeding physical violence. Digital control behaviors (“persistently sending messages through social media”) and subtle grooming behaviors (“giving unsolicited gifts or favors”) emerged as the most frequently reported indicators. The bivariate analysis revealed critical gaps: men reported significantly higher levels of perpetration of physical and sexual violence. In addition, the geographical context proved to be a determining factor, showing significant cultural variations in how the phenomenon manifests. Conclusions: The results highlight that dating violence in this population is predominantly psychological and related to control. It is imperative to integrate education on equality and awareness of “warning signs” into the academic curriculum to transform these students into professionals capable of breaking the cycle of violence. Implications: This pioneering study provides an international perspective on the vulnerability and perceptions of future health professionals. Its multicenter nature makes it possible to design intervention strategies adapted to specific sociocultural contexts, thereby strengthening the response capacity of health systems to gender-based violence.
Conscientious Objection in Euthanasia and Voluntary Assisted Dying From the Perspective of Stakeholders: A Meta-Synthesis
(John Wiley & Sons, 2026-07-13) Pérez Capellades, Rosa; Ramos Pozón, Sergio; Pasten Araya, Daniel; Falcó Pegueroles, Anna M. (Anna Marta)
Aim: Analyse the meaning of conscientious objection to euthanasia and/or physician-assisted suicide from the perspective of health professionals, students, patients, family members and regulations. Design: Qualitative systematic review. This review was informed by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Methods: The Joanna Briggs Institute Critical Appraisal Checklist was used to evaluate the included articles. Data were extracted and analysed using meta-aggregation. Data Source: The CINAHL, PubMed, PsycINFO, Web of Science and Scopus databases were consulted between January and April 2024. The protocol was registered in PROSPERO (ID: 1007658). Results: We analysed 15 articles, mainly published between 2019 and 2023, from Canada, Australia, the United States, Spain, and the Netherlands. Two main findings were identified: non-moral motivations (perceived competence, social context, and emotional reactions) and moral motivations (ethical principles, moral consciousness, and religious beliefs). Conclusions: Conscientious objection is a complex phenomenon in which moral, emotional, and organisational factors converge. Differentiating between moral and non-moral motivations is essential to understanding this diversity of reasons for conscientious objection and avoiding oversimplifications. Clear institutional frameworks are needed to facilitate the handling of objections, balance the rights of professionals and patients, and foster a culture of ethical dialogue. Implications: Healthcare professionals, patients, and families need clear tools and criteria to manage conscientious objection related to euthanasia and physician-assisted suicide. The findings can contribute to the creation of precise institutional guidelines on the referral procedure and mechanisms that ensure a balance between rights and duties. Impact: This meta-synthesis provides an integrated view of conscientious objection from multiple perspectives. The results contribute to a better understanding of the ethical complexity of conscientious objection and the practical implications for health systems that are in the process of implementing euthanasia and medically assisted dying laws.
Construcción de la imagen profesional de enfermería durante la pandemia por Covid-19 a través de las noticias de prensa
(Fundación Index, 2022) Martinez Rodriguez, Laura; Muñoz Devesa, Aarón; Tejero Vidal, Lorena L.
Objetivo: Describir la imagen social de la enfermería durante la primera oleada de pandemia por Covid-19 a través de la prensa escrita generalista y especializada. Metodología: Estudio documental cualitativo descriptivo, análisis realizado bajo la teoría de Moscovici. Selección 95 noticias del 15 marzo a 15 de mayo. Se descartaron artículos con alusión puntual a las enfermeras o al personal sanitario general. Se incluyeron finalmente 37 noticias prensa general y 40 prensa especializada. Extracción de datos siguiendo 8 indicadores: lenguaje verbal, imágenes, grado trascendencia y difusión de la información, ámbito, personas implicadas, por qué trasciende la información, identificación de juicios por parte de los autores y elementos de construcción social. Resultados: Prensa general: 94,5% lenguaje periodístico frente 5,5% científico-divulgativo. Uso mayoritario del masculino, centradas en la actividad asistencial. Las principales categorías emergentes fueron: ámbito de trabajo/profesión (43,75%), contexto/entorno (34,71%), emociones (13,88%) y patrones de conocimiento (7,64%). Conclusiones: Las noticias publicadas en prensa generalista incorporan una visión reduccionista de la enfermera sobre su desempeño profesional, aunque le otorgan un gran valor social. Es necesario lograr el reconocimiento del rol autónomo, así como la visibilización de todos los campos de actuación. Se evidencia como un recurso necesario, a la vez que escaso, para la viabilidad del sistema de salud y los cuidados de la población.
Iron Matters: Comparative Impact of Beta-Adrenergic Stimulation and Iron Chelation on Cardiac Iron Metabolism and Mitochondrial Function
(MDPI, 2026-04-14) Francesch Manzano, Josep; Comín Colet, Josep; Tajes Orduña, Marta; Ramos Polo, Raúl; Enjuanes, Cristina; Ras Jiménez, Maria del Mar; Cosa, Andreea Eunice; Marinova, Katrin; Enrich Soria, Carla; Moliner, Pedro; Lorenzo Esteller, Laia; Jose Bazán, Núria
Iron deficiency (ID) is frequent in patients with heart failure (HF) and is correlated with adverse outcomes, yet its involvement in HF pathophysiology is not fully understood. Hyperactivity of the sympathetic nervous system (SNS) is the central feature of HF. We aimed to compare the effects of isoproterenol (ISO), a β-adrenergic agonist (SNS stimulation), with those of the iron chelator deferoxamine (DEF), to evaluate how β-adrenergic stimulation influences cardiac iron. In this study, H9c2 cardiac cells were challenged with ISO, DEF or both and several parameters related to iron metabolism were analyzed. In all cases, the cells decreased their intracellular iron levels. ISO induced alterations in key cardiac iron metabolism molecules that were, in most cases, comparable to those elicited by DEF, emphasizing the direct impact of β-adrenergic stimuli on iron metabolism and mitochondrial dysfunction. Nevertheless, unlike DEF, ISO triggered a shift in mitochondrial energy metabolism. These findings suggest that β-adrenergic stimulation, as a major component of neurohormonal activation, may contribute to the development of ID in cardiac cells, highlighting the importance of iron homeostasis and the need to further investigate iron dysregulation in this context.
Mental health assessment of Spanish frontline healthcare workers during the SARS-CoV-2 pandemic Análisis de la salud mental de trabajadores sanitarios españoles de primera línea durante la pandemia por SARS-CoV-2
(Elsevier España, 2022-12-01) Sobregrau Sangrà, Pau; Castro Ribeiro, Thais; Esteban-Sepúlveda, Silvia; Esther García Pagès; López Barbeito, Beatriz; Aguiló Llobet, Jordi; Pomar Moya-Prats, Josep Lluís; Pintor Pérez, Luis; Aguiló, Sira
The Covid-19 pandemic continues challenging health systems globally, exposing healthcare workers to constant physical and psychological stressors. To date, several studies have already shown the catastrophic impact on the mental health of medical personnel during the early period of the pandemic. Nevertheless, literature evidences the dearth of works that evaluate the effect over time, understanding the pandemic as a sustained extreme stressor. The present study examines the effect of the pandemic on the mental health of Covid-19 frontline healthcare workers at six months follow-up.
Complexity of care among pediatric patients in acute care settings: A systematic integrative review
(Elsevier B.V., 2026-07) García Ruiz, Rocío; Adamuz, Jordi; Ruiz Montaño, María; Barrientos-Trigo, Sergio
Background: The concept of complexity of care is well established in scientific literature; however, in pediatric populations, research has primarily focused on medical aspects, lacking a comprehensive approach that includes additional influencing factors. Purpose: This study aimed to identify the evidence on complexity of care among pediatric patients attending pediatric acute care settings. Methods: An integrative review was conducted the PRISMA guidelines (PROSPERO registration: CRD42023469426). The search included articles published up to July 2025 in PubMed, CINHAL, Scopus, and WOS. Both the quality and internal validity of the studies included were independently assessed by two reviewers. Results: Twenty-two articles were analysed, identifying 48 complexity-related factors and 39 assessment scales. Findings were grouped into four thematic categories, within each of which the following key complexity factors were identified: A) Clinical aspects of pediatric patients, such as diagnosis, patient type, and clinical stability; B) Environmental factors, particularly family involvement; C) Care provider aspects, such as direct/indirect nursing activities and workload; D) Organisational elements, especially nursing staff experience. Conclusions and implications: This review expands the understanding of complexity beyond patient pathology. It underscores the need for further research to explore healthcare professionals' perceptions of complexity and examine how the identified factors influence health outcomes. Developing integrated assessment tools may enhance care planning and resource allocation in pediatric settings.

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