Yoga has been shown to improve pain and function compared with no exercise in people with chronic low back pain (LBP), but treatment effects are small. Given that yoga is a mind–body intervention that addresses physical as well as psychological factors, it may be more effective for patients with chronic LBP who are at high risk of poor prognosis. The study aims to investigate the efficacy of a 12-week yoga programme combined with education in reducing pain and disability for individuals with chronic LBP at high risk of poor prognosis at short (12 weeks) and intermediate (24 weeks) terms, compared with a control group receiving education only.
A randomised controlled trial will include 110 adults with chronic non-specific LBP reporting an average pain intensity of 3 points or more on a 0–10 scale over the past week and classified as high risk of poor prognosis (ie, scoring 50 points or above) on the Orebro Musculoskeletal Pain Questionnaire short-form. Participants in the control group will receive an educational booklet and attend three face-to-face lectures over a 3-month period. In the intervention group, in addition to the booklet and lectures, participants will attend group yoga sessions twice a week for 12 weeks, totalling 24 yoga sessions. The primary outcome is disability assessed at 12 weeks, measured using the Roland-Morris Disability Questionnaire.
The study was approved by the Human Research Ethics Committee of Universidade Federal de Minas Gerais (Protocol number CAAE: 57028022.0.0000.5149). Findings will be disseminated to trial participants, clinicians and the broader public and scientific community.
To explore the roles and training of advanced practice nurses specialised in acute pain management, as reported in the current literature.
Scoping review.
We searched PubMed, Scopus and CINAHL in December 2023 to identify relevant studies published from 1996.
Relevant literature was identified, screened, and analysed using a structured scoping review process. Two reviewers independently selected and extracted data from eligible studies, with a third reviewer resolving any disagreements.
A total of 1682 records were screened, and 36 studies met the inclusion criteria. Four main themes emerged: job titles, roles, training, and barriers. The review revealed substantial variation in job titles and role descriptions across clinical settings and geographic regions, with more comprehensive role definitions found in countries like the United States and the United Kingdom. Training pathways, including postgraduate qualifications and certification, varied significantly and many low- and middle-income countries lacked structured training frameworks. Barriers identified included regulatory limitations, insufficient educational infrastructure and lack of legal authority to practice.
This review highlights significant international variation in the definition, training and regulation of advanced practice nurses in acute pain management. There is an urgent need to develop global standards, including unified competencies and certification pathways, to ensure consistent and effective care.
Standardising competencies and training will support role recognition, improve consistency in clinical practice and promote high-quality care for individuals experiencing acute pain.
This review addresses the global inconsistency in role definition and training of advanced practice nurses in acute pain management. Findings may inform educators, health professionals, policymakers and regulators, particularly in resource-limited settings.
This review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR).
No patient or public contribution.
To analyse the comfort needs of patients following renal transplantation, guided by Kolcaba's Theory of Comfort.
A qualitative design was employed.
This study was conducted at a Brazilian university hospital's renal transplant outpatient clinic. Forty-six post-transplant patients were purposively sampled by age, transplant time and clinic attendance. Face-to-face interviews were audio-recorded, transcribed and conducted using a semi-structured script. Data were analysed through thematic content analysis, guided by Kolcaba's Comfort Theory and relevant literature.
Participant narratives were categorised according to the contexts outlined by Kolcaba's Theory of Comfort: Physical, Environmental, Sociocultural and Psychospiritual. In the physical context, pain was identified as a major factor diminishing comfort after renal transplantation. In the environmental context, elements such as light, odour, sound, temperature and uncomfortable furnishings contributed to discomfort. In the sociocultural context, family support was highlighted as essential. In the psychospiritual context, religiosity played a key role in enhancing the comfort of transplant recipients.
Spirituality, strengthened social support networks and non-pharmacological comfort measures are essential for promoting comfort among patients following renal transplantation. These findings underscore the importance of integrated care approaches that address physical, emotional and social aspects to improve quality of life for this population.
Conceptual models in nursing provide a critical perspective for care and support the delivery of effective, evidence-based interventions. By identifying the multidimensional comfort needs of post-renal transplant patients, this study informs the development of targeted, holistic strategies for nursing and multidisciplinary practice in outpatient settings.
This study examined the multidimensional comfort needs of post-renal transplant patients and found that comfort is shaped by physical, environmental, sociocultural and psychospiritual factors. The results may guide global nursing and multidisciplinary outpatient care by informing integrated approaches that enhance the quality of life of transplant recipients.
This study was reported according to the COREQ framework.
No patient or public contribution.
by Giulia Simbula, Frederico M. Barroso, Enerit Saçdanaku, Gabriel Ene, Geanina Fănaru, Lekshmi B. Sreelatha, Miruna-Gabriela Vizireanu, Myrto Roumelioti, Nikoletta-Maria Boskovits, Sabina E. Vlad, Prem Aguilar, Miguel A. Carretero
Mesocosms, outdoor replicated ecological experiments within a controlled environment, have become a valuable tool for investigating a broad range of ecological questions across various sub-disciplines. This study presents a medium-sized mesocosm system (MS) designed for individual-level responses to abiotic factors and basic intraspecific interactions in small ground-dwelling reptiles, offering a practical alternative to large-scale facilities for resource-limited settings. Unlike large-scale facilities that are ideal for meta-community dynamics but impractical due to high costs and complexity, this system targets research contexts with limited resources requiring replicated experimental units. To validate the MS design, 16 units were constructed using cost-effective, widely available materials and equipped with a programmable irrigation system. A pilot test using Podarcis bocagei lizards provided a preliminary biological evaluation of the design and its suitability in housing wild-caught medium-small reptiles under semi-natural conditions over 7 months. Despite minor maintenance, the MS was resilient to environmental conditions, warranting an expansion to 32 units in subsequent years. Most individuals maintained or recovered body mass during the activity season, and displayed natural behaviours such as basking and foraging. The system’s modularity and adaptability offer a practical reference for ecological studies with similar constraints.Understanding contextual drivers of family planning is crucial for designing effective, context-specific policies and programmes. This study aimed to assess (1) the extent to which province-level contextual factors are associated with both coverage and wealth-related inequalities in demand for family planning satisfied by modern methods (mDFPS) across provinces in low- and middle-income countries (LMICs), and (2) whether these factors influence mDFPS at women’s level.
Observational study using multilevel modelling at both ecological and individual levels.
We analysed data from Demographic and Health Surveys between 2011 and 2022 in 46 LMICs.
Ecological analysis included 621 provinces. Individual-level analysis included 302 493 women aged 15–49 years, currently married or in union, and in need of contraception (unweighted).
Demand for family planning satisfied by modern methods (mDFPS) and wealth-related inequalities in mDFPS, assessed using the slope index of inequality (SII) and the concentration index (CIX).
In both income groups, at the province level, higher mean women’s schooling and greater proportion of employed women were positively associated with mDFPS coverage. In contrast, higher male-to-female educational attainment ratios were inversely associated with mDFPS. Provinces with higher means of women’s schooling also showed lower wealth-related inequalities in mDFPS. At the individual level, women residing in provinces with higher male-to-female educational attainment ratios were found to have lower odds of mDFPS, regardless of the income group. Additionally, the factors influencing individual women’s mDFPS varied depending on the income level of the country’s provinces.
Women’s empowerment and gender equality in education at the province level significantly influence family planning outcomes. Targeted interventions that address each region’s specific educational, economic and demographic contexts are crucial for improving coverage and reducing disparities in family planning services.
Objetivo: identificar, nas produções científicas, os fatores relacionados à construção da identidade
profissional do enfermeiro. Métodos: Trata-se de revisão integrativa realizada nas bases de dados
SCIELO, BDENF e LILACS disponíveis na Biblioteca virtual em saúde no intervalo temporal de
2015 a 2019 a partir dos descritores “Papel do profissional de enfermagem” AND “Cuidados de
enfermagem” OR “Competência profissional”. Resultados: A identificação profissional do
enfermeiro está relacionada à sua atuação no serviço de saúde com estratégias de atendimento
domiciliar, empreendedorismo, gerenciamento do cuidado e da equipe, educação em saúde,
consultas de enfermagem, procedimentos técnicos, articulação da rede de atenção, organização do
serviço e qualificação da equipe mas que sofrem algumas limitações individuais, organizacionais,
institucionais e sociais. Conclusão: A identificação dos fatores que caracterizam o enfermeiro e
fomentam sua identidade profissional exerce grande influência no empoderamento da categoria e
melhor autonomia nos diversos campos de atuação.
Descritores: Papel do profissional de enfermagem; Cuidados de enfermagem; Competência
profissional.
Objetivo. Comparar la percepción de la calidad de vida relacionada con la salud (CVRS) tras la COVID-19 en función del sexo. Metodología. Estudio observacional descriptivo y transversal en pacientes post-COVID de neumología-medicina interna del Complejo asistencial de Zamora, diagnosticados de COVID-19 al menos 3 meses antes. La CVRS se valoró mediante el cuestionario EQ-5D-5L. Resultados. Se incluyeron 192 pacientes, 91 mujeres (47,4 %), edad 57±13 años. 127 pacientes (66,0%) reflejaron un EQ-5D Index < 1, lo que supone una merma en su CVRS. En el análisis comparativo en función del sexo, las mujeres manifestaron mayor dificultad para las actividades cotidianas (38 [41,3%] vs. 22 [21,6%]; p=0,003), dolor/malestar de forma habitual (50 [54,3%] vs. 35 [34,3%]; p=0,005) y ansiedad/depresión (48 [52,2%] vs. 38 [37,3%]; p=0,037). La Escala Visual Analógica (EVA) fue mayor en hombres (69,8±18,7 vs. 63,1±19,5; p=0,016), así como el EQ-5D Index (0,84±0,22 vs. 0,76±0,25; p=0,023). La regresión lineal multivariante confirmó que las mujeres tenían una peor autopercepción de la CVRS independientemente del resto de factores analizados, tanto en el EQ-5D Index [b (IC95%): -0,090 (-0,153 a -0,026)] como en la EVA [b (IC95%): -6,858 (-12,083 a -1,633)]. Discusión. El sexo femenino es un factor de riesgo significativo para una peor calidad de vida auto percibida en pacientes que han pasado la COVID-19, con mayor incidencia de ansiedad, depresión, dolor y limitaciones en actividades cotidianas. Estos problemas fueron más prevalentes en mujeres, quienes mostraron diferencias significativamente menores en el índice EQ-5D y la escala EVA en comparación con los hombres.
ABSTRACT
Objective. To compare the health-related quality of life perception (HRQoL) after COVID-19 according to sex. Methodology. Cross-sectional study in post-COVID patients attending neumology and internal medicine consultation rooms at Complejo Asistencial de Zamora, diagnosed from COVID-19, at least 3 months before. HRQoL was evaluated using the EQ-5D-5L questionnaire. Results: 192 patients were included, 91 women (47,4 %), aged 57±13. 127 patients (66,0%) obtained EQ-5D Index < 1, what means a decrease in their HRQoL. Comparative analysis according to sex showed women had higher difficulties for daily activities (38 [41,3%] vs. 22 [21,6%]; p=0,003), usual pain/discomfort (50 [54,3%] vs. 35 [34,3%]; p=0,005), anxiety/depression (48 [52,2%] vs. 38 [37,3%]; p=0,037). Visual Analogue Scale (VAS) was higher among men (69,8±18,7 vs. 63,1±19,5; p=0,016), as well as EQ-5D Index (0,84±0,22 vs. 0,76±0,25; p=0,023). Multivariate linear regression confirmed women had a worse HRQoL perception with independence of the rest of the analyzed factors, in EQ-5D Index [b (IC95%): -0,090 (-0,153 a -0,026)] as well as VAS [b (IC95%): -6,858 (-12,083 a -1,633)]. Discussion: Female sex is a significative risk factor for a worse self-perceived quality of life in patients who had suffered from COVID-19, with a high incidence of anxiety, depression, pain, and limitations for daily activities. These problems were more prevalent in women, who showed significant lower differences in the EQ-5D index and the VAS scale compared to men.
Objetivo principal: El objetivo de estudio fue conocer que cambios supuso en su vida el desempeñar el rol de cuidador principal, y explorar cómo se sintió ante esta situación. Metodología: Para llevar a cabo este estudio se ha utilizado el relato biográfico; en concreto se siguió la metodología propuesta por Amezcua y Hueso. Resultados principales: La informante del relato es una mujer que tuvo que hacerse cargo del cuidado de su padre con demencia de Cuerpos de Lewy. Narra lo que ha implicado para ella y su familia el cuidado a una persona dependiente y el impacto que ha tenido en su vida emocional, laboral y social. Conclusión principal: Este es un tipo de relato que narra un problema frecuente de la sociedad, como es el cuidado de nuestros mayores, cómo afrontarlo; y cómo este cuidado afecta a la vida del cuidador principal.
Objetivo: Analizar las repercusiones de la pandemia por el nuevo coronavirus en la salud de los profesionales de enfermería. Método: Investigación cuantitativa, descriptiva, realizada en un hospital universitario de Salvador, Bahía, Brasil, entre septiembre y octubre de 2020. La recolección de datos se realizó a través de un cuestionario electrónico estructurado, que fue respondido por 209 profesionales de enfermería de la institución. El proyecto fue aprobado por un Comité de Ética en Investigación (nº CAAE 36841720.0.0000.0049). Resultados: La mayoría de los profesionales relató insomnio o dormir menos de lo necesario (62,67%); mostró aumento del deseo de comer (46,89%) o pérdida del apetito (16,75%); tuvo pérdidas en actividades de ocio (97,6%); relataron una disminución en la práctica de actividad física (91,87%); mostró alteraciones en el estado de ánimo (83,75%); reportó algún grado de ansiedad (89,95%); y tenía diagnóstico de covid-19 (28,23%). Conclusión: Los resultados indican las repercusiones que trajo la pandemia para la salud física y mental de los profesionales de enfermería.
Objetivo: Analizar las notificaciones de lesiones de piel en un hospital universitario. Método: Estudio descriptivo, realizado en un hospital universitario, localizado en Salvador, Bahia, Brasil, con datos secundarios de notificaciones de incidentes. Fueron investigadas características sociodemográficas de los pacientes con lesiones de piel y características de las lesiones notificas en los años 2016 y 2017. Los datos fueron recolectados entre los meses de septiembre 2018 y mayo 2019 y el estudio respetó los principios éticos de investigación. Resultados: Fueron notificados 96 casos de lesión de piel. La mayoría fue adquirida en la hospitalización (89,58%), siendo frecuente la lesión por presión (77,08%), en la región sacra o glútea (61,46%), con pérdida de piel (54,17%), en grado leve (89,58%) y que prolongaron la hospitalización (7,29%). Conclusión: A pesar de ser realizada evaluación del riesgo para lesión, en más de la mitad de las notificaciones se observa que el tipo más prevalente fue la lesión por presión.