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Myocardial infarction (MI) is a major contributor to global disease burden with societal impact among survivors. This study aimed to estimate the population-level prevalence of MI among working-age adults in Spain and to examine associated sociodemographic, lifestyle, clinical and occupational factors focusing on sex differences.
Two-phase population-based study using data from the 2020 Spanish European Health Interview Survey, including adults of working age. First, weighted estimates were used to calculate the population-level prevalence and describe sociodemographic characteristics. Second, a matched cross-sectional analysis was performed to examine associations between MI and sociodemographic, lifestyle, clinical and occupation-related factors using logistic regression models, including sex-stratified analyses.
Population-based study in Spain.
A total of 400 participants from the Spanish European Health Interview Survey were included, of whom 80 reported MI.
Primary outcomes were the prevalence of self-reported MI and its association with sociodemographic characteristics, lifestyle behaviours, comorbidities and working conditions; secondary outcomes included healthcare utilisation and employment-related absences.
80 participants reported having a history of MI, corresponding to an estimated 137 646 working-age adults in Spain and a prevalence of 5.45 per 1000 population (95% CI 5.44 to 5.48), predominantly affecting men (74.2%) with a mean age of 52.7 years. MI prevalence was higher among individuals with lower educational attainment (OR 0.50; 95% CI 0.25 to 1); however, no employment-related factors remained associated with MI after adjustment. Sex-stratified analyses revealed that depression (OR 6.75; CI 2.23 to 20.4), obesity (OR 6.36; 95% CI 1.62 to 24.9) and COPD (OR 27.7; 95% CI 4.21 to 749) were more strongly associated with MI among women, while anxiety (OR 8.65; 95% CI 3.09 to 26.8) and hypertension (OR 4.11; 95% CI 2.24 to 7.62) among men.
MI among working-age adults in Spain is uncommon but concentrated among men with lower levels of education. The absence of independent associations with employment conditions and the presence of sex-specific comorbidity patterns highlight the need for gender-sensitive cardiovascular prevention strategies.
To synthesise and reinterpret qualitative evidence on how people with palliative care needs and their family caregivers experience the care process.
Palliative care aims to provide holistic, person- and family-centred care. Although qualitative research has explored multiple aspects of end-of-life care, existing knowledge remains fragmented, limiting its translation into coherent, humanised, and clinically applicable nursing care models.
A qualitative systematic review with interpretive meta-synthesis.
A qualitative meta-synthesis was conducted following PRISMA guidelines. Systematic searches were performed in PubMed, CINAHL, and Scopus for studies published between 2014 and 2024, in English or Spanish, involving adults with palliative care needs and/or their family caregivers from OECD countries. A total of 3232 records were identified. Following screening and full-text review, 13 qualitative studies were included. Methodological quality was appraised using the Critical Appraisal Skills Programme (CASP) checklist. Findings were synthesised through an interpretive approach using reflexive thematic analysis.
The care experience is configured as a dynamic, relational, and non-linear process, characterised by emotional, physical, and social demands. Family caregivers report a substantial caregiving burden, often exacerbated by a lack of support, constrained resources, and communication challenges with healthcare teams. From the perspective of people with palliative care needs, the experience of care is closely linked to respect for autonomy, preservation of identity, and the quality of relational presence. Dignity emerges as a cross-cutting theme, strengthened or undermined by nursing practices, interpersonal interactions, and organisational contexts.
Effective palliative care requires relational nursing practices that uphold dignity and support the family as a unit of care.
Nursing practice must systematically integrate relational competencies to preserve patient identity and support the family as a care unit. Bureaucratic healthcare structures often act as active barriers to care, necessitating organisational redesign to support family accompaniment.
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