by Jimmy Andreyvan Cainamarks-Alejandro, Liliana Cruz-Ausejo, Miguel Angel Burgos-Flores, Jaime Rosales-Rimache, Jonh Astete-Cornejo, David Villarreal-Zegarra
BackgroundThe COVID-19 pandemic marked an increase in depressive, anxiety, and post-traumatic stress disorder symptoms, more specifically among healthcare workers, teachers, and police officers. These workers face external and occupational factors which had a significant impact on mental health, significant increase in workload and direct exposure to the virus, shortage of personnel protective equipment, and instances of abuse, including discrimination. Mental health care in primary care requires a process of early identification and timely referral of complex cases. Telehealth emerges as an effective alternative for addressing challenges in mental health care, although its implementation encounters obstacles.
ObjectiveTo design a telehealth service that facilitates screening, initial management, and timely referral for mental health diagnoses in workers with prior SARS-CoV-2 infection, and to evaluate usability, acceptability, and user satisfaction.
MethodsMixed-method study with a user-centered design approach involving key external and internal service users in three sequential stages (pre-design, co-design, and post-design). The study phases lasted 6 months, involving a total of 23 participants in the pre-design phase (contextual inquiry and preparation and training), 12 participants in the co-design phase (framing the issue, generative design, and sharing design), and in the post-design phase, 4 participants were involved in service implementation, and 81 participants—drawn from the subgroup of 134 users who received psychoeducation—were included in the efficacy assessment.
ResultsThe proposal included the development and evaluation of a service model guide and a telehealth software platform. First, the participants took part in a series of workshops (Pre-design, Co-design) where they provided ideas for meeting the product requirements, based on the Design Thinking methodology framework. The telehealth service model was named TelePsico CENSOPAS. It comprised four processes: a) Service promotion; b) User pre-identification; c) Appointment management; d) Psychoeducation counseling and referral. The Telehealth platform was designed through three cycles of an iterative process and integrated a proprietary development platform with third-party service technologies for communication support and information exchange. During post-design, the pilot test involved 698 screened patients; 193 were identified with mental health risks, and 134 of them received psychoeducation sessions. In addition to user acceptance, the usability score of the platform was 86.1 ± 16.9 SD, satisfaction dimensions of the service was 45.1 ± 7.2 SD for satisfaction with care processes, and 36.7 ± 5.2 SD satisfaction with psychological care.
ConclusionThe proposal for mental health telehealth services and its supporting platform was successfully developed and accepted by both internal and external users, particularly within well-structured occupational health services in workplaces serving vulnerable occupational groups. In addition, it achieved higher satisfaction and usability scores than Peru’s outpatient care services. These findings support the replicability of user-centered design frameworks—such as design thinking—within the occupational health sphere.
Introducción. Los planes de cuidados en enfermería (PCE) son instrumentos para documentar e informar las actividades de enfermería. Actualmente existen varias herramientas digitales totalmente de PCE (softwares y/o aplicaciones móviles).
Objetivo: Comprender los significados de las experiencias vividas por los profesionales de enfermería que laboran en servicios de hospitalización de unidades de segundo y tercer nivel de atención de Sevilla y Alicante (España) con el uso de herramientas informáticas de PCE.
Metodología: Se realizó un estudio fenomenológico en unidades de segundo y tercer nivel de atención en salud de Sevilla y Alicante (España). Mediante muestreo intencional se incluyeron 9 profesionales de enfermería de servicios de hospitalización. Los datos se obtuvieron en septiembre y octubre de 2023 mediante una entrevista semiestructurada y fueron analizados mediante un enfoque fenomenológico interpretativo.
Resultados: Se comprendieron las siguientes categorías descritas por los profesionales de enfermería: experiencias positivas tales como generación de Planes de Cuidados Estandarizados de Enfermería, experiencias negativas como ambigüedad de las herramientas informáticas e inadecuada accesibilidad a las herramientas y la propuesta ideal para desarrollar un software de Planes de Cuidados Individualizado de Enfermería (PCIE).
Conclusiones: Se lograron comprender los significados de las experiencias vividas de los profesionales de enfermería acerca del uso de las herramientas informáticas de PCE, las cuales posteriormente sirvieron para generar un software de PCIE que permita responder a las necesidades actuales en salud de individualizar el cuidado de enfermería.
To analyse predictors of burnout in nursing professionals during and after the COVID-19 pandemic.
Cohort study.
A two-phase study conducted during the COVID-19 pandemic's peak (2020) and post-vaccination period (2022). Data from nursing professionals of four hospitals in southern Brazil included sociodemographic, occupational, lifestyle, and health variables, and Maslach Burnout Inventory responses. Multivariate logistic and linear regression analyses were used to identify independent predictors of burnout syndrome. The study was approved by the Research Ethics Committee (approval no. 4.152.027).
A sample of 163 participants were assessed at two distinct time points. In 2020, 9.2% of nursing professionals experienced burnout syndrome, decreasing slightly to 7.4% in 2022. As for the burnout dimensions, emotional exhaustion was reported by 27% of professionals in 2020 and 26.4% in 2022. Depersonalisation affected 28.2% during the pandemic and 25.2% afterward. Low professional accomplishment was identified in 29.4% of professionals in 2020, increasing to 30.1% in 2022. Distinct predictors were identified for overall burnout and its specific dimensions. The main predictors included: perceiving a mental health impact from the pandemic, previous mental health issues, recent medical leave, and working directly with COVID-19 patients.
Burnout syndrome remained stable post-pandemic. Key predictors were identified, highlighting the need for preventive mental health interventions.
Identifying predictors of burnout in nursing professionals supports the development of targeted interventions to protect mental health, improve job satisfaction, and enhance the quality of patient care during and after health crises.
This study fills a gap in post-pandemic research by identifying predictors of burnout in nursing professionals. It supports the development of policies and interventions to protect mental health and improve working conditions in Brazilian hospitals.
STROBE guidelines for cohort studies.
Participants contributed only through data collection.
To assess human papillomavirus (HPV) vaccine awareness and uptake among caregivers in rural Indigenous communities in Guatemala and to identify sociodemographic predictors of vaccine unawareness and non-uptake.
This cross-sectional survey was conducted across 12 rural Indigenous communities in Guatemala’s Central Highlands. Using a community-engaged research approach, trained multilingual health workers administered surveys in Spanish, Kaqchikel or K’iche’. Eligible participants were adults who served as primary caregivers to children. The survey assessed HPV vaccine awareness, vaccine attitudes and uptake among those with daughters aged 8 or older. Logistic regression was used to examine predictors of vaccine unawareness and bivariate analysis explored differences in vaccine uptake.
Among 602 participants (92.5% identified as Indigenous), 95% expressed willingness to vaccinate a child against cervical cancer, yet only 56% had heard of the HPV vaccine. Of the 175 participants with eligible daughters, only 33.7% reported vaccination. Indigenous identity, older age and illiteracy were significantly associated with HPV vaccine unawareness. Speaking an Indigenous language at home was associated with greater awareness. Departmental differences were significant: participants from Sololá were more likely to be unaware of the vaccine, while those from Sacatepéquez had higher awareness and uptake. Community partners noted that access to information, geographic connectivity and social desirability may influence both awareness and response accuracy.
Despite strong willingness to vaccinate, significant knowledge gaps persist among Indigenous caregivers. Tailored, community-informed education strategies—delivered through trusted channels and adapted linguistically and culturally—are urgently needed to increase awareness and uptake of the HPV vaccine in underserved Guatemalan communities.
To explore the perceptions of primary care nurses regarding their skills and the challenges they face in managing paediatric obesity.
Qualitative descriptive study.
Data were collected between May 2022 and March 2024 from focus groups with primary care nurses (n = 25) and analysed using thematic analysis.
Four themes emerged from the data. ‘Nurses’ beliefs, skills and tools to manage pediatric obesity’ highlights the skills and limitations nurses encounter in their practice, their views on the causes of this condition, and how they assess families' motivation. The second theme, ‘Nurse-family-child communication’ describes the communication strategies nurses employ when interacting with motivated and unmotivated families. The third theme, ‘The impact of nursing interventions on family behavior’ highlights the limited results behavioural changes observed in families following interventions. The fourth theme, ‘Nurses' reactions to the treatment of pediatric obesity’ reflects the negative feelings nurses experience in managing paediatric obesity.
This study identifies significant challenges for nurses in addressing paediatric obesity, particularly in communication and engagement with unmotivated families, which might stem from a lack of tools. Furthermore, it recognises the emotional responses of nurses when tackling obesity.
This study highlights the needs related to nurses' communication skills. It is recommended to implement training courses focused on this topic.
Adherence to COREQ guidelines was maintained.
There was 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.The aim of review was to describe and synthesise the evidence on the use of tourniquets to control haemorrhages, summarising both civilian and military use.
Trauma-related haemorrhage constitutes one of the most preventable deaths among injured patients, particularly in multi-casualty incidents and disasters. In this context, safe instruments such as tourniquets are essential to help healthcare professionals to minimise loss of life and maximise patient recovery.
An integrative review was conducted in Medline, Nursing & Allied Health Premium, and Health & Medical Collection, using published data until March 2021 and following the PRISMA guidelines.
A total of 25 articles were included. Evidence has been synthesised to understand the use of different types of tourniquets, environment of application, indication for their placement and potential complications associated with tourniquet placement.
Commercial tourniquets such as Combat Application Tourniquet or Emergency Tourniquet models are a valuable and safe instrument for haemorrhage control in both military and civilian out-of-hospital care settings. Nurses, as part of emergency teams, and other professionals should be aware that there is a possibility of adverse complications, but they are directly proportional to the time of tourniquet placement and generally temporary. In addition, national and international guidelines ensure the need for all civilian emergency services to be equipped with these devices, as well as for the training of healthcare professionals and first responders in their use.
Despite the lack of complications in the use of tourniquets in these cases, their use has been a matter of debate for decades. In this sense, this review yields up-to-date guidelines in the use of tourniquets, their recommendations and their significance among professionals to manage complicated situations.
Low-income adults with disabilities experience disproportionately high rates of food insecurity and preventable healthcare utilisation. The Supplemental Nutrition Assistance Program (SNAP) can reduce food insecurity and improve health, but there are accessibility gaps in the SNAP enrolment process. Existing outreach and enrolment assistance programmes have been shown to boost SNAP enrolment, but their health effects are understudied. This study estimates the effects of a SNAP outreach and enrolment assistance programme on health outcomes among low-income adults with disabilities.
The study pragmatically evaluates a programme that provided outreach and SNAP enrolment assistance for low-income households. The study leverages a random process that selected households for one of two types of outreach, including an information-only arm and an information plus enrolment assistance arm, which formed a control group by default. The study will estimate the effect of this programme among low-income adults with disabilities using Medicaid and SNAP administrative data. Study outcomes include emergency department, hospital and long-term nursing home utilisation. SNAP enrolment and benefit amounts are secondary study outcomes and will be tested as a mediating mechanism of action. The study will test effect heterogeneity based on race, ethnicity, age and chronic conditions.
The study, which relies on deidentified data, was determined to be exempt as human subjects research by the Institutional Review Boards at Johns Hopkins Medicine and the Michigan Department of Health and Human Services. The study is being conducted in ongoing consultation with an Advisory Group of experts in food advocacy and disability advocacy. In addition to disseminating findings in peer-reviewed publications, findings will be disseminated to state decision-makers and the community in partnership with an advisory group.
Cohort studies of ageing and cognitive decline typically do not begin fielding comprehensive cognitive assessments until older adulthood. However, for identifying preventable dementia risk factors, there is strong value in beginning at earlier ages. The case is especially compelling in sub-Saharan Africa, where the number of older individuals is expected to triple in the next three decades, and where risk factors may operate more intensively at earlier ages. This study reports on the adaptation and validity of the Harmonised Cognitive Assessment Protocol (HCAP) approach in the Kenya Life Panel Survey (KLPS), collected among middle-aged respondents.
To evaluate the validity of the HCAP approach in Kenya, this study assesses model fit statistics from confirmatory factor analyses (CFA) and tests measurement invariance by respondent characteristics.
Both rural and urban areas in Kenya.
A sample of n=5878 individuals from the KLPS, who have been surveyed regularly since they were schoolchildren in the 1990s. The HCAP assessment was administered in 2023 at an average age of 37 years (10–90 range 34 to 41).
For each individual, the CFA generates a general cognitive performance score, and cognitive performance scores for five distinct domains, including memory, executive functioning, language, orientation to time and place, and visuospatial functioning.
Fit of the models to the data was adequate for general cognitive performance (root mean squared error of approximation (RMSEA)=0.03; comparative fit index (CFI)=0.94; standardised root mean residual (SRMR)=0.05), language (RMSEA=0.02; CFI=0.95; SRMR=0.05) and good for memory (RMSEA=0.05; CFI=0.99; SRMR=0.02) and executive functioning (RMSEA=0.03; CFI=0.98; SRMR=0.03). The CFA indicate that the factor structure is consistent with findings from other countries and that reliability for the general cognitive performance score was high. Statistical models also suggest invariance at the scalar level for leading demographic (gender, age) and socioeconomic (education, occupational complexity) characteristics.
This study demonstrates that the cognitive functioning of mid-age Kenyans appears to be well captured by the adapted protocol. While there is a moderate decline in cognitive performance among older individuals, this relationship appears to be mediated by education, indicating that this KLPS HCAP provides a valuable baseline for studying future cognitive decline.
Introducción: en el mundo contemporáneo donde cada vez se dan más oleadas de migraciones de un país a otro, se hace más necesaria una enfermería competente culturalmente. La mujer en su embarazo, en su maternidad y en la lactancia materna necesita ser apoyada con sensibilidad cultural por parte del profesional sanitario. Objetivo: revisar y reflexionar sobre la importancia y justificación que tiene la competencia cultural para enfermería en lactancia materna a través de estudios de metodología cualitativa. Material y método: se plantea una revisión narrativa en castellano e inglés en los recursos bibliográficos Pubmed, Scopus, Dialnet y Scielo teniendo en cuenta el objetivo de la revisión y los objetivos de inclusión. Los trabajos han de ser de metodología cualitativa y tener como temática de estudio la maternidad y/o la lactancia materna teniendo en cuenta la competencia cultural. Resultados: finalmente son seleccionados 6 artículos por cumplir los criterios de inclusión. En síntesis, en todos los estudios seleccionados se muestra la justificación e importancia que tiene la competencia cultural en todo lo concerniente a la maternidad y a la lactancia materna a nivel internacional entre grupos de mujeres diversamente culturales. Conclusiones y reflexiones finales: continúan existiendo márgenes de mejora en cuanto a la formación enfermera en competencia cultural en el cuidado de la mujer en el embarazo, en el puerperio y en lo que respecta a la lactancia materna internacionalmente.
Introducción. Las intervenciones de música en directo pueden ayudar a mejorar el bienestar tanto psicológico como físico, emocional y espiritual. El presente proyecto nace de un trabajo colaborativo e interdisciplinar entre dos titulaciones de grado: Enfermería e Interpretación Musical. Objetivos. Analizar la efectividad de una intervención musical en directo en el bienestar de pacientes oncológicos. Metodología. Se plantea un estudio de diseño mixto. Un estudio cuasiexperimental sin aleatorización para evaluar el efecto de la intervención con grupo un control (N=33) y experimental (N=33) durante la administración del tratamiento en un hospital de día oncológico. Se recogerán variables sociodemográficas y clínicas (nivel de ansiedad, afectividad y signos vitales). También se analizarán los niveles de ansiedad y variación en los signos vitales en los intérpretes (estudiantes de música) antes y después de los ensayos y de la intervención. Se diseña un estudio cualitativo fenomenológico-hermenéutico para conocer las experiencias de los pacientes y los intérpretes tras la intervención musical. Aplicabilidad práctica. En este proyecto se destaca la importancia de la colaboración entre estudiantes de dos disciplinas complementarias en contextos sanitarios reales.
ABSTRACT
Introduction. Live music interventions can help enhance psychological, physical, emotional, and spiritual well-being. This research project stems from a collaborative and interdisciplinary effort between two undergraduate programs: Nursing and Musical Performance. Objectives. To analyze the effectiveness of a live music intervention on the well-being of oncology patients. Methodology. A mixed-methods study design is proposed. A quasi-experimental study without randomization will evaluate the effect of the intervention with a control group (N=33) and an experimental group (N=33) during chemotherapy treatment administration in a day hospital. Sociodemographic and clinical variables (anxiety levels, affectivity, and vital signs) will be collected. The levels of anxiety and changes in vital signs in the performers (music students) will be analyzed before and after rehearsals and the intervention. A phenomenological-hermeneutic qualitative study is designed to understand the experiences of the patients and performers after the musical intervention. Practical Applicability. This project emphasizes the importance of collaboration between students from two complementary disciplines in real healthcare settings, starting from their formative stages.
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.
La elevada rotación del personal de enfermería que se produce en todos los centros sanitarios públicos y privados de nuestro país es una realidad muy habitual de nuestros días. La formación inicial de las nuevas compañeras plantea una dificultad añadida a la sobrecarga de trabajo que se da en muchos destinos. Con las nuevas tecnologías, tenemos en las formaciones online una gran oportunidad para diseñar planes de inmersión con un formato virtual.
El objetivo principal es analizar de qué manera el Modelo Tidal favorece la reconstrucción de significados en el duelo como continuidad de vínculos. El duelo es un proceso complejo que tiene componentes naturales y construidos, en ocasiones, las personas dolientes validan la continuidad de vínculos con la persona fallecida por medio de la organización de las autonarrativas. El manejo de este fenómeno es interdisciplinario donde destaca la Enfermería de Salud Mental orientada por el Modelo Tidal el cual se apoya en la historia personal para la reconstrucción de los significados tras la muerte de un ser querido favoreciendo la adaptación a través del cuidado. Conclusión principal: El abordaje de la continuidad de vínculos desde el Modelo Tidal favorece la adaptación al duelo centrado en la persona y su historia al afianzar la reconstrucción de significados que mejoren la calidad de vida por medio del cuidado enfocado en las necesidades actuales.
Objetivo: Describir la relación de la Inteligencia Emocional de rasgo con el Riesgo Suicida en los estudiantes de Enfermería luego del retorno estudiantil a la presencialidad en una universidad pública de Chile. Metodología: Enfoque cuantitativo, correlacional, transversal, no experimental. Resultados principales: Se presentó una prevalencia de 19,3% de la muestra con riesgo suicida, y ambas variables se correlacionaron negativamente a nivel estadísticamente significativo (r= -,502; p<,000). Conclusión principal: Existe una relación fuerte y de dirección negativa entre la inteligencia emocional de rasgo y el riesgo suicida en estudiantes de enfermería luego del retorno a la presencialidad. Se observa un aumento del riesgo suicida en comparación con la referencia prepandémica. Además, los estudiantes de primeros años presentaron niveles más altos de riesgo suicida. La inteligencia emocional se considera un factor protector, por lo que las universidades deben ser fuente de formación en la gestión emocional, dado que el riesgo suicida suele estar presente en este estudiantado.