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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.
Buffers in intravenous solutions: is the source of bicarbonate a source of confusion?
(BioMed Central, 2025-11-26) Ulsamer, Arnau; Betbesé Roig, Antoni Jordi; Campos Gómez, Ana; Centelles Serra, Josep Joan; Domínguez, Eduardo; Iglesias i Serret, Daniel; Lorente Olazábal, Juan V.; Pérez Fernández, Xosé Luis; Sabater Riera, Joan; Rigo Bonnin, Raúl; Kellum, John A.
There is a widespread belief that organic sodium salts included in intravenous solutions serve as bicarbonate precursors, and that this mechanism explains their effects on plasma pH. We aimed to explain why the effect of organic anions, such as citrate, acetate, gluconate, and lactate on the acid-base balance is independent of bicarbonate generation. For this purpose, we mainly focused on regional citrate anticoagulation (RCA). The sodium load provided with these buffers and its contribution to the plasma strong ion difference is a more suitable model for explaining and predicting their alkalinizing effect. Moreover, the bicarbonate generated from the metabolization of these buffers via the Krebs cycle results from CO2 dissolution in water, and thus yields bicarbonate together with a proton (H+). As such, metabolization of these buffers does not cause alkalosis per se.
Evaluating the quality of real-world data on adherence to oral endocrine therapy in breast cancer patients: How real-world data?
(MDPI, 2025) Navarro i Sabaté, Àurea; Font, Rebeca; Espinàs Piñol, Josep Alfons; Solà, Judit; Martínez Soler, Fina; Gil Gil, Miguel; Viñas, Gemma; Tibau Martorell, Ariadna; Borrell, Maria; Segui Palmer, Miguel Ángel; Margelí Vila, Mireia; Servitja, Sonia; Pérez Segura, Cristina; Domènech, M.; Nava, Maria Ángeles; Marin, Mar; Gonzalez, Sergi; Borràs Andrés, Josep Maria
Simple Summary: The objective of this study was to evaluate the validity of RWD-based adherence measurements obtained from accessible electronic health records in the Spanish national health system in all women diagnosed with breast cancer in the public healthcare system in Catalonia (Spain). Our results showed that nonadherence during the first year of treatment was around 11% in both cohorts, analysed using the RWD, and without significant differences between them. Furthermore, determinants associated with nonadherence (age and type of oral endocrine treatment) were similar in both approaches used. The results also show that it is fast and feasible to use RWD to identify individuals who are not refilling prescriptions as often as they should. In conclusion, the validity of the RWD method to estimate adherence has been confirmed and, at the same time, this method provides valuable evidence to help oncologists discuss adherence with their patients.
Critical thinking level in nursing degree students according tosociodemographic and academic variables: A correlational study
(Elsevier, 2024-05-22) Basco Prado, Luis; Biurrun Garrido, Ainoa; Zuriguel Pérez, Esperanza; Roldán Merino, Juan Francisco; Mestres i Soler, Olga
Aims To determine the level of critical thinking of undergraduate nursing students during their clinical practice, as well as to identify the relationship between sociodemographic and academic variables. Background Nursing degree programs should prioritize the development of critical thinking skills in their curriculum and regularly assess students to ensure the acquisition of core competencies. Design Multicenter, descriptive, cross-sectional, correlational, descriptive study. Participants included were students from the Degree in Nursing enrolled during the academic year 2020–2021. Students were selected by convenience from three universities located in Catalonia, Spain. Data were collected from 429 students, with 98 being excluded due to incomplete data. Methods Data were collected by administering the Nursing Critical Thinking in Students Questionnaire and an ad hoc form of sociodemographic and academic characteristics. The STROBE guidelines checklist were followed. The study involves a secondary analysis of data from a previous study that presented psychometric analysis. Results No significant differences were observed in total Critical Thinking scores across various parameters including academic year, current situation, work experience in healthcare, previous academic training, family situation, or recent stressful events. On average, students demonstrated moderate critical thinking scores. However, statistically significant relationships emerged between critical thinking scores and gender (p=0.046), institution attended for undergraduate studies (p=0.019) and having satisfactory social relationships despite experiencing stressful events (p=0.330). Conclusions The study delves into the correlation between critical thinking skills and sociodemographic and academic factors, identifying students who may benefit from specific interventions and advocating for adaptable educational methods. It emphasizes the pivotal role of trust in fostering critical thinking in nursing education and suggests a connection between critical thinking and strong social relationships. In conclusion, evaluating critical thinking is crucial for addressing healthcare challenges, validating teaching strategies and promoting continuous improvement in nursing education.
Humanización de la Sanidad y Salud Laboral: Implicaciones, estado de la cuestión y propuesta del Proyecto HU-CI
(Instituto Nacional de Medicina y Seguridad del Trabajo., 2017-06) Gálvez-Herrer, Macarena; Gómez García, José Manuel; Martín Delgado, María Cruz; Ferrero Rodríguez, Mónica; Miembros del proyecto HU-CI
The scientific and technical evolution of health care keeps growing exponentially, thus allowing a better patient care, new treatment forms and increasing survival rates. However, these important advances that improve health care have in many cases invaded the space that once belonged to the human act of caring. Promoting more humanized organizations will imply to establish actions directed to the environment and the workplace, as well as to all involved agents (patients, relatives and professionals). To that end, the humanization policies and their application to the health context are a reality in our days. These policies are being materialized in some specific proposals of certain organizations with the support of some official agencies. In this present work, we point out the interaction between the objectives of these humanization policies and the goals of occupational health in health care contexts. Common areas of work promoting the wellbeing for health professionals and the possibilities of integral management of both concepts are explored. Lastly, we provide a concrete example, like the Humanization Project of Intensive Care Units (HU-CI).
Europe’s beating cancer plan: Opening avenues for radiation oncology
(Elsevier España, 2025) Borràs Andrés, Josep Maria; Prades, Joan
Traditionally, healthcare policy and administration in the European Union (EU) have been firmly positioned under the remit of its Member States based on the principle of subsidiarity. However, in recent years, the division between European and national competencies in health care has become more porous, as evidenced by initiatives like the joint purchasing of vaccines for COVID-19 and the establishment of European Reference Networks for Rare Diseases (ERN) [1]. It is significant that the first EU healthcare plan focuses on cancer, underlining its high priority for countries and the shared perspective that European efforts in areas such as oncology can lead to significant improvements in the survival and quality of life for cancer patients in our countries.
Epidemiological evolution and healthcare services utilization in elderly dementia patients of Catalonia
(BioMed Central, 2025-11-12) Clèries, Montse; Melendo Azuela, Eva Maria; Lladó Plarrumaní, Albert; Vela, Emili; Mariscal, Sonia; Piñol Ripoll, Gerard; Santaeugènia Gonzàlez, Sebastià J.
Background Assessing the dynamics and burden of dementia is necessary to improve healthcare plans. This study aimed to describe the epidemiology and characteristics of dementia diagnoses in Catalonia (North-East of Spain) and evaluate healthcare services utilization and associated expenditures in people with dementia compared with people without. Methods Retrospective study including all the dementia population (2013–2020) using data from an administrative database, the Catalan Health Surveillance System, covering a 7.5–7.7-million population. Data included demographic, clinical, healthcare services utilization, and morbidity-associated risk variables, and was analyzed according to dementia type, including Alzheimer’s disease (AD), vascular dementia (VD), frontotemporal dementia (FTD), dementia with Lewy bodies (LBD), and unspecified dementia (UD). We compared comorbidities and morbidity-associated risk, healthcare services utilization and associated expenditures, and mortality rates between people with dementia and the population without dementia adjusted for age, sex, and income level. Results During the study period, dementia prevalence remained stable, and incidence modestly decreased. AD and VD incidence rates decreased, whereas UD modestly increased, being the highest in 2019. Patients with dementia had a higher prevalence of comorbidities, morbidity-associated risk, healthcare services utilization, specially admissions in nursing homes and intermediate care, healthcare-associated expenditures, and mortality than people without dementia adjusted by age, sex, and income level in 2019. An expenditure €1311.7 per person per year was attributable to dementia, representing an increase of 44.1% of total healthcare costs. Compared to other dementia types, AD and VD had increased admissions, and VD had the highest expenditures. The use of antidepressants and benzodiazepines progressively decreased. Conclusions Using a population dataset, this study showed that dementia is associated with a high burden and healthcare needs, providing useful information to design improved healthcare plans.
Efficacy of the intensive care unit diary: a mixed-method study protocol
(BioMed Central, 2026-01-19) Muñoz Rey, M. Pilar; Romero García, Marta; Anglès-Sabatè, I.; Ausió-Dot, Albert; Alonso-Fernández, Sergio; Alcalá Jiménez, Isidro; Huertas Zurriaga, Ariadna; Tur-Rubio, Carlos; Delgado-Hito, Pilar
Background Multiple international studies report on the use of diaries in intensive care units focusing on benefits for patients, families, and occasionally professionals. Most studies use quantitative methods and have limitations such as small sample sizes and short follow-ups. Therefore, further research with larger samples and a longer follow-up period, employing a mixed-methods approach is suggested. This protocol aims to assess the efficacy of the use of intensive care unit diaries for patients and families and explore professionals’ experiences and satisfaction. Method/Design Mixed-method study: a quantitative phase followed by a qualitative phase. Phase 1: Randomised, parallel, non-blinded, multicentre clinical trial, with an experimental group (diary) and a control group (no diary), to identify the efficacy of the diary in improving quality of life and preventing post-traumatic stress and anxiety/ depression in patients and family. Measurement tools include the SF-36 Health Questionnaire, EIE-R scale, and HADS scale, administered 2-, 6- and 12-months post-discharge. Each group comprises 120 cases. Data analysis will use IBM-SPSS (v.24) To evaluate the satisfaction of professionals a survey will be carried out. Phase 2: Hermeneutic phenomenological study with theoretical sampling. Size of 38–72 patients/family members until theoretical data saturation is reached. Data collection from in-depth interviews and field diary 6 months after discharge. Phenomenological analysis according to Smith. Guba and Lincoln’s rigour criteria. Discussion This research will provide knowledge regarding the benefits and limitations of the use of diaries, based on quantitative and qualitative data, and will promote reflection on their implementation, considering patients, family, and professionals. This study will provide new knowledge about the satisfaction of professionals with diary implementation. This multicentre study will provide valuable information on the contribution of diaries in clinical practice and their impact on patient recovery and the experiences of families and professionals. If the efficacy of the diary is confirmed, it will mark a significant advancement in the care of critically ill patients, contributing to the expansion of their use.
SIMUPICS: curso basado en simulación para la prevención del síndrome post-UCI
(Elsevier, 2026-02-03) Raurell Torredà, Marta; Zaragoza-García, Ignacio; Sánchez-Chillón, Francisco Javier; Torralba-Melero, Martín; Arrogante, Oscar; Frade-Mera, María-Jesús; Maestre, Elena; Farrés-Tarafa, Mariona
Introducción: El síndrome post-Cuidados Intensivos (post-UCI) (Post Intensive Care Syndrome [PICS]) se puede prevenir aplicando los componentes del paquete ABCDE (principalmente manejo del dolor, sedación, delirium y movilización precoz).Objetivo: Diseñar y validar el curso SIMUPICS, basado en simulación, para entrenar conocimientos y habilidades relacionados con la aplicación del paquete ABCDE.Métodos: Estudio descriptivo de carácter métrico. Análisis de la validez facial y de contenido del curso con expertos de los grupos de trabajo de la Sociedad Española de Enfermería Intensiva y Unidades Coronarias (SEEIUC). Prueba piloto con mínimo 30 enfermeras de Unidades de CuidadosIntensivos (UCI) para valorar aplicabilidad del curso en las UCI.Resultados: Se realizaron dos rondas Delphi hasta conseguir el acuerdo del 85% de los ítems como óptimos y una V de Aiken entre 0,82 y 1. Las enfermeras que participaron en la prueba piloto (n = 38) opinaron que la simulación recibida les había ayudado a identificar actuaciones clave en la prevención del síndrome post-UCI (5 [4-5]) con escala Likert de 1 totalmente en desacuerdo a 5 totalmente de acuerdo, y que la estructura del curso (estaciones, duración, dinámicas) facilitaba el aprendizaje práctico (5 [4-5]).Conclusiones: El curso SIMUPICS, validado por expertos/as enfermeros/as referentes en prácticas de analgosedación, delirium y movilización, es útil para entrenar habilidades y conocimientos relacionados con el paquete ABCDE. Su diseño basado en simulación clínica, lo convierte en una estrategia adecuada para la formación continuada de profesionales de la salud, tanto in situ en la propia UCI como en centros de simulación

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