Introducción: La Inseguridad Alimentaria (IA), vinculada a la pobreza, favorece el consumo de alimentos poco nutritivos y aumenta el riesgo de enfermedades crónicas. Su comprensión es clave en enfermería comunitaria y escolar para fomentar hábitos saludables desde edades tempranas. Objetivo: Analizar la relación entre el Nivel Socioeconómico (NSE) e IA en Estudiantes de Una Universidad Pública del Norte de Sinaloa, México. Metodología: Estudio cuantitativo, descriptivo, correlacional y transversal en estudiantes de 18 a 25 años inscritos en un programa de Licenciatura. Los participantes fueron seleccionados a partir de un muestreo aleatorio simple. La muestra fue de 311 estudiantes. Se aplicó una cédula de datos sociodemográficos, el cuestionario AMAI y la Escala Latinoamericana y Caribeña de Inseguridad Alimentaria. Resultados: En los hogares sin presencia de menores, la IA severa presenta mayor prevalencia en NSE medio (29,6%) y alto (32,5%). Se observó una correlación positiva y significativa entre el NSE y la IA, tanto en hogares sin integrantes menores de edad (rs = 0,263, p < 0,01), como en aquellos con menores (rs = 0,231, p < 0,01). Conclusiones: En esta población de estudiantes universitarios, se observó que a medida que aumenta el NSE, también lo hace la IA, lo que sugiere que esta no es exclusiva de los sectores socioeconómicos bajos, sino que también afecta de forma considerable a los niveles medio y alto. La persistencia de esta problemática en todos los niveles sugiere que factores estructurales, más allá del ingreso, como el acceso a alimentos nutritivos, educación alimentaria y estabilidad laboral, podrían influir significativamente.
ABSTRACT
Introduction: Food insecurity (FI), linked to poverty, promotes the consumption of unhealthy foods and increases the risk of chronic diseases. Understanding it is key in community and school nursing to foster healthy habits from an early age. Objective: To analyze the relationship between socioeconomic status (SES) and FI in students at a public university in Northern Sinaloa, Mexico. Methodology: A quantitative, descriptive, correlational, and cross-sectional study was conducted with students aged 18 to 25 years enrolled in an undergraduate program. Participants were selected using simple random sampling. The sample consisted of 311 students. A sociodemographic data form, the AMAI questionnaire, and the Latin American and Caribbean Food Insecurity Scale were administered. Results: In households without children, severe FI was more prevalent in middle (29.6%) and high (32.5%) SES groups. A positive and significant correlation was observed between socioeconomic status (SES) and food insecurity (FI), both in households without minor members (rs = 0.263, p < 0.01) and in those with minors (rs = 0.231, p < 0.01). Conclusions: In this population of university students, it was observed that as SES increases, so does FI, suggesting that it is not exclusive to low socioeconomic sectors, but also significantly affects middle and high levels. The persistence of this problem at all levels suggests that structural factors, beyond income, such as access to nutritious food, nutrition education, and job stability, could have a significant influence.
Haemophilia is a rare inherited bleeding disorder with complex support and costly treatment. Comprehensive care for people with haemophilia (PwH) must take place in structured and continuously evaluated treatment centres. The aim of the Public Assistance for People with Haemophilia in Brazil Project (PATCH Project) is to assess the infrastructure, human resources and healthcare delivery processes of Brazilian Blood Centres (BC) involved in the provision of haemophilia care.
This is a nationwide cross-sectional study involving 98 BC across Brazil’s 26 states and the Federal District, focusing on the care provided to PwH. A self-administered structured questionnaire was prepared, based on national and international recommendations for management, treatment and outcomes assessment in PwH. The criteria of the World Federation of Haemophilia and the European Association for Haemophilia and Allied Disorders will be used to define standards of quality.
Ethical approval for this study was granted by the Human Research Ethics Committee of the Federal University of Goiás, the coordinating centre (protocol CAAE 53863221.8.0000.5078), and subsequently by all participating institutions. Written informed consent is obtained from all participants prior to enrolment. Study findings will be disseminated through publication in peer-reviewed journals and presentation at international scientific conferences. Research data will be managed in accordance with ethical and legal standards and will be made available on reasonable request to support future investigations.
Not applicable
by Ariene Silva do Carmo, Paulo César Pereira de Castro Júnior, Thais Cristina Marquezine Caldeira, Daniela Silva Canella, Rafael Moreira Claro, Luiza Delazari Borges, Larissa Loures Mendes
The present study analyzed the prices of food sold in canteens of Brazilian private schools and described price-based marketing strategies, according to the NOVA food classification system. This is a mixed methods study combining a cross-sectional component and time series analysis, with data from 2,241 canteens in private elementary and secondary schools in the 26 capitals of Brazil and the Federal District, collected between June 2022 and June 2024. Price data collected for unprocessed, minimally processed, or processed foods and culinary preparations based on these foods (UMPCP), and ultra-processed foods and culinary preparations based on these foods (UpCP) sold in school canteens and from the National System of Consumer Price Indices (SNIPC), were used to create a data set containing deflated monthly prices for food and beverages sold between August 2022 and July 2024. Calculations were made for adjusted prices (R$/100 g or ml) and absolute prices (R$ per portion), and frequency of use of strategies such as combos and promotions. UMPCP showed lower adjusted price, but higher absolute price than UpCP, especially for solid foods. About 27% of the study canteens implemented pricing strategies for both food groups. Most of these strategies did not exclusively favor healthy foods, indicating that promotions and combos were used without distinction. The affordability of healthy foods is disadvantaged in school canteens when considering the price per portion, which may negatively influence students’ food choices. The findings show that current prices for food sold in most canteens discourage the purchase of healthy items, but favor the purchase of unhealthy ones. These results reinforce the importance of interventions for promoting healthy foods and making them more affordable.by Jorman H. Tejada-Perdomo, Valentina Gutierrez-Perdomo, Juana V. Agudelo-Castro, Jorge A. Pérez-Gamboa, Alejandro Weinstein, Sebastián San Martín, Rodrigo Salas, Jorge A. Ramos-Castaneda
The use of devices that facilitate rapid airway isolation is essential when managing critical patients in emergencies. In recent years, additive manufacturing has emerged as an innovative, versatile, and accessible technology for developing medical devices. This study presents the design, development, and validation of an extraglottic medical device created using computer-aided design tools and stereolithographic 3D printing to facilitate blind intubation by first responders. The device was iteratively modeled and fabricated with biocompatible materials; validation in airway simulators and human cadaveric specimens assessed dimensions, friction, intubation technique, and learning curve, and ease of use was rated with a Likert scale. Ten iterations led to a final design with low friction and minimal cervical manipulation; ramp angle, cup geometry, and distal tip were optimized for tube passage, and BioMed Flex 80A showed high strength and anatomical compatibility. The final version is a safe, reusable, and functional alternative for airway management and blind orotracheal intubation, particularly in emergencies and resource-limited settings; clinical validation in live patients is still needed.Patient safety culture plays a crucial role in reducing clinical errors. By improving healthcare professionals’ and patients’ understanding of human fallibility and error attribution, patient care can be enhanced, fostering greater engagement from both groups. A Just Culture approach, which balances accountability and learning from errors, is a key factor in fostering this safety culture. The DECIDE Project aims to: (1) examine the conceptualisation of human fallibility within and beyond healthcare, (2) identify barriers and facilitators to Just Culture adoption, (3) assess the impact of psychoeducational interventions on professionals’ and social leaders’ attitudes toward clinical errors and (4) develop a roadmap for Just Culture implementation in healthcare.
A 36-month mixed-methods study including qualitative research, a survey of 1255 healthcare professionals, an experimental study with 180 participants (60 per arm) testing interventions based on cognitive dissonance and reasoned action theories and a consensus conference to develop a Just Culture roadmap. Participants include professionals from hospitals, primary care, long-term care, nursing homes and social leaders in Spain. The qualitative data collected during stages 1 and 4 will be analysed using MAXQDA software. In identifying factors related to the implementation of Just Culture during stage 2, ANOVA, t-tests and multiple linear regression will be conducted. To examine the effects of the interventions in phase 3, a linear mixed-effects model for repeated measures will be employed.
This study has received ethical approval from three institutional review boards. Findings will be disseminated through peer-reviewed publications, conference presentations and policy recommendations aimed at integrating Just Culture into national and international patient safety strategies. By promoting a constructive approach to errors, the project could enhance incident reporting, strengthen professional engagement in safety policies and foster a culture of learning and accountability. Its findings will guide policy recommendations for integrating Just Culture into national and international patient safety strategies, with potential applications beyond Spain.
Optimal selection of vascular access devices is based on multiple factors and is the first strategy to reduce vascular access device-related complications. This process is dependent on behavioural and human factors. The COM-B (Capability, Opportunity, Motivation, Behaviour) model was used as a theoretical framework to organize the findings of this systematic review.
To synthesize the evidence on determinants shaping the optimal selection of vascular access devices, using the COM-B behavioural model as the theoretical framework.
Systematic review of studies which explore decision-making at the time of selecting vascular access devices.
The Medline, Web of Science, Scopus and EbscoHost databases were interrogated to extract manuscripts published up to 31 December 2021, in English or Spanish.
Among 16 studies included in the review, 8/16 (50%) focused on physical capability, 8/16 (50%) psychological capability, 15/16 (94%) physical opportunity, 12/16 (75%) social opportunity, 1/16 (6%) reflective motivation and 0/16 (0%) automatic motivation. This distribution represents a large gap in terms of interpersonal and motivational influences and cultural and social environments. Specialist teams (teams created for the insertion or maintenance of vascular access devices) are core for the optimal selection of vascular access devices (75% physical capability, 62% psychological capability, 80% physical opportunity and 100% social opportunity).
Specialist teams predominantly lead all actions undertaken towards the optimal selection of vascular access devices. These actions primarily centre on assessing opportunity and capability, often overlooking motivational influences and social environments.
A more implementation-focused professional approach could decrease inequity among patients and complications associated with vascular access devices.
Optimal selection of vascular access devices is the primary strategy in mitigating complications associated with these devices. There is a significant disparity between interpersonal and motivational influences and the cultural and social environments. Furthermore, specialized teams play a pivotal role in facilitating the optimal selection of vascular access devices. The study can benefit institutions concerned about vascular access devices and their complications.
This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
No Patient or Public Contribution.
Optimal selection of vascular devices remains a growing yet unresolved issue with costly clinical and patient experience impact. Interventions to improve the optimal selection of vascular devices have focused on training, education, algorithms and implementation of specialist vascular teams; alas, these approaches do not seem to have substantially addressed the problem. Specialist vascular teams should evolve and pivot towards leading the implementation of quality improvement interventions, optimizing resource use and enhancing their role.
Aunque algunas tecnologías con inteligencia existen desde hace más de 50 años, la irrupción de la inteligencia artificial (IA) en situaciones cotidianas de nuestras vidas es aún reciente. Su uso por parte de la población general nos abre un mundo de posibilidades, pero también nos sitúa ante nuevos retos y problemas que deben ser abordados para evitar, entre otras cuestiones, que la IA perpetúe sesgos que permanecen en nuestra sociedad.
ABSTRACT
Although some intelligent technologies have existed for more than 50 years, the widespread of artificial intelligence (AI) in our daily living is still recent. Its use by the general population opens up a world of possibilities, but it also bringsnew challenges and problems that must be solved to prevent, among other issues, AI perpetuating biases that remains in our society."
by Claudia Castro, Jacquelyn Badillo, Melissa Tumen-Velasquez, Adam M. Guss, Thomas S. Collins, Frank Harmon, Devin Coleman-Derr
Recent wildfires near vineyards in the Pacific United States have caused devastating financial losses due to smoke taint in wine. When wine grapes (Vitis vinifera) are exposed to wildfire smoke, their berries absorb volatile phenols derived from the lignin of burning plant material. Volatile phenols are released during the winemaking process giving the finished wine an unpleasant, smokey, and ashy taste known as smoke taint. Bacteria are capable of undergoing a wide variety of metabolic processes and therefore present great potential for bioremediation applications in many industries. In this study, we identify two strains of the same species that colonize the grape phyllosphere and are able to degrade guaiacol, a main volatile phenol responsible for smoke taint in wine. We identify the suite of genes that enable guaiacol degradation in Gordonia alkanivorans via RNAseq of cells growing on guaiacol as a sole carbon source. Additionally, we knockout guaA, a cytochrome P450 gene involved in the conversion of guaiacol to catechol; ΔguaA cells cannot catabolize guaiacol in vitro, providing evidence that GuaA is necessary for this process. Furthermore, we analyze the microbiome of berries and leaves exposed to smoke in the vineyard to investigate the impact of smoke on the grape microbial community. We found smoke has a significant but small effect on the microbial community, leading to an enrichment of several genera belonging to the Bacilli class. Collectively, this research shows that studying microbes and their enzymes has the potential to identify novel tools for alleviating smoke taint.Aunque algunas tecnologías con inteligencia existen desde hace más de 50 años, la irrupción de la inteligencia artificial (IA) en situaciones cotidianas de nuestras vidas es aún reciente. Su uso por parte de la población general nos abre un mundo de posibilidades, pero también nos sitúa ante nuevos retos y problemas que deben ser abordados para evitar, entre otras cuestiones, que la IA perpetúe sesgos que permanecen en nuestra sociedad.
ABSTRACT
Although some intelligent technologies have existed for more than 50 years, the widespread of artificial intelligence (AI) in our daily living is still recent. Its use by the general population opens up a world of possibilities, but it also bringsnew challenges and problems that must be solved to prevent, among other issues, AI perpetuating biases that remains in our society."
Randomized controlled trials (RCTs) are essential for evidence-based nursing care. However, the quality of reporting and adherence to methodological standards in Latin American nursing journals remains unclear. This study evaluates the characteristics, reporting quality, and potential risk of bias of RCTs published in Latin American nursing journals.
To assess the reporting compliance and risk of bias of RCTs published in Latin American nursing journals.
Meta-research study.
A comprehensive handsearch of 29 Latin American nursing journals was performed covering publications from 2000 to 2024. Identified RCTs were assessed for adherence to CONSORT reporting guidelines and evaluated for risk of bias. Outcomes were classified using the COMET taxonomy. A descriptive analysis was performed.
A total of 6377 references were screened, identifying 34 eligible RCTs, most published after 2018. The median CONSORT compliance was 19 reported items (IQR 16–22). High compliance (> 90%) was observed in abstract reporting items, study objectives, and participant selection criteria. However, critical methodological features such as randomization procedures, blinding, and protocol registration showed low adherence (< 40%). Risk of bias was mostly rated as having “some concerns”, largely due to insufficient reporting. According to the COMET taxonomy, the most frequently reported outcome domains were “Delivery of care” and “Physical functioning”.
Reporting compliance and risk of bias of RCTs published in Latin American nursing journals presents significant gaps, particularly in key methodological domains. These shortcomings hinder transparency, reproducibility, and integration into evidence synthesis. Strengthening editorial policies and enforcing reporting standards could enhance the quality and reliability of published research in Latin American nursing journals.
To understand the social representations of bedside milk expression (BME) among mothers of preterm newborns in neonatal intensive care units (NICUs).
Qualitative descriptive study.
The study was conducted from July to August 2024 in two NICUs of a referral maternity hospital in Fortaleza, Brazil. Nineteen mothers of hospitalised premature newborns participated. Semi-structured interviews were conducted and subjected to thematic content analysis.
Mothers perceived BME as a meaningful act of protection and bonding, though some were unfamiliar with the practice. Emotional ambivalence was common, shaped by prior breastfeeding experiences and the context of prematurity. Discomfort related to privacy and shared spaces was noted. Support from healthcare professionals was essential to promote understanding and adherence.
Social representations of BME are shaped by emotional, social and institutional experiences. Anchored in prior breastfeeding experiences and cultural meanings of maternal care, the practice is objectified through both gestures of affection and tangible barriers.
Healthcare professionals, particularly nurses, should receive training to support mothers in BME. Structural improvements, privacy and emotional support are essential for fostering maternal autonomy and confidence.
This study highlights the barriers to BME, emphasising the role of healthcare support and the need for better infrastructure, privacy and training to enhance maternal confidence and breastfeeding.
The study followed the Consolidated Criteria for Reporting Qualitative Research checklist.
None.
This paper highlights the pivotal role of healthcare professional support in overcoming barriers to BME and promoting breastfeeding practices.
Fresh breast milk is considered the gold standard for reducing complications and improving survival in preterm infants. BME is recommended as an effective strategy to ensure the availability of fresh breast milk. Mothers' social representations of this practice remain underexplored within the neonatal intensive care context.
Explores mothers' social representations of BME in NICUs, addressing a significant gap in qualitative research. Reveals how emotional, social and institutional factors shape mothers' perceptions, motivations and challenges related to BME. Highlights the need for targeted professional support, improved infrastructure and privacy to enhance maternal autonomy and adherence to milk expression practices.
Healthcare professionals, particularly nurses, should receive specialised training to provide technical guidance and emotional support, enhancing mothers' confidence and autonomy in BME. Improving infrastructure and ensuring privacy in NICUs are crucial to creating supportive environments that facilitate milk expression and strengthen maternal–infant bonding. Institutional policies should integrate maternal-centred strategies to support breastfeeding continuity and promote humanised neonatal care.
Mobile diagnostic imaging services provided at home increase accessibility and convenience, particularly for older adults, people with disabilities and other vulnerable groups. These services can reduce the need for patient travel and support the routine monitoring of chronic conditions. However, current guidelines often overlook user acceptance and environmental considerations within the home setting.
To map studies that identify the models, barriers and facilitators for performing home-based diagnostic imaging/graph according to end users.
A scoping review was conducted following the methodological framework of the Joanna Briggs Institute and reported according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews checklist.
Studies that addressed mobile or portable diagnostic imaging or graph examinations conducted in the home for individuals of any age or health status were included. Studies were eligible if they reported on barriers, facilitators or user experiences. Studies that focused on wearable technologies were excluded.
The search strategy was developed using terms related to home-based diagnostic imaging/graph, portability, home setting and user perceptions. Searches were conducted in PubMed, Web of Science, Scopus, Embase, The ACM Guide to Computing Literature and LILACS, without restrictions on publication date or language. Additional grey literature was identified through Google Scholar.
Two reviewers independently extracted data using a standardised form that captured study characteristics, types of procedures, target populations and reported barriers and facilitators. Quantitative data were summarised using absolute and relative frequencies. Qualitative findings were synthesised through basic content analysis to identify and categorise recurring themes.
Data were charted in tables to organise and visually map study contexts, methodological features and thematic patterns related to implementation and user experience.
Twenty-six studies published between 1998 and 2023 across 15 countries were included. The diagnostic examinations included mostly polysomnography, X-ray imaging and ultrasonography. Seven categories of barriers were identified, such as physical discomfort, equipment-related challenges and procedural limitations. Seven facilitators were also reported, including perceived comfort, patient satisfaction and equipment usability.
This review identifies key factors affecting the delivery and user experience of mobile diagnostic imaging at home, including logistical, technical and environmental aspects. It reveals gaps in the literature and provides a basis for future research to inform more inclusive and effective public health policies and service design.
Open Science Framework (DOI 10.17605/OSF.IO/7UV5D).
Novel diagnostics, particularly point-of-care (POC) tests, play a crucial role in the early detection and management of infectious diseases, especially in resource-limited settings. Ensuring test performance and quality while minimising the risk of human error becomes more relevant when shifting testing tasks from highly controlled settings like centralised laboratories to people with minimal training. Applying usability and human factors engineering principles can reduce the challenges related to human errors. Despite existing frameworks and tools, the practical application of usability guidelines remains variable across different settings.
This scoping review protocol outlines a systematic investigation of current practices in assessing the usability of novel diagnostics, particularly POC tests for infectious diseases intended for use in low-income and middle-income countries. The review will analyse original research studies of all designs and product dossiers that report on the usability evaluation or validation of a diagnostic test for an infectious disease. A qualitative synthesis of the data extracted from the articles will be conducted. We will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols and the Joanna Briggs Institute guidelines for this scoping review.
No ethical approval is required because individual patient data will not be included. The findings will be disseminated through publication in a peer-reviewed journal.
Puede ser que una de las posibles razones por las que la significación estadística esté siendo cuestionada durante décadas sea la errónea interpretación del p-valor como una medida suficiente para la toma de decisiones clínicas. Es importante reconocer que, aunque la significación clínica puede ser entendida como una condición sine qua non para con considerar la implementación de una intervención sanitaria, aunque sea una condición indispensable, esto no implica que sea suficiente. La significación estadística por sí sola no puede servir como la única fuente de información para la toma de decisiones clínicas basadas en la evidencia. La toma de decisiones clínicas basadas en evidencias requieren la estimación de medidas que evalúan y cuantifican la magnitud del efecto, se (como aquellas que se exponen en este editorial), ya que estas proporcionan información orientada a la relevancia clínica. No obstante, este tipo de medidas no pueden prescindir de la significación estadística que debe acompañar cualquier estimación puntual. Además, para la toma de decisiones clínicas, basadas en evidencia, debemos ser conocedores de las falacias, limitaciones, e imprecisiones inherentes a cualquier estimación estadística. Asimismo, más allá de este conocimiento metodológico, debemos considerar el juicio clínico y la habilidad de los profesionales clínicos para evaluar aspectos más amplios de la relevancia clínica (como la severidad, la vulnerabilidad, la morbimortalidad del problema, su coste y prevalencia) ya que estos factores van más allá de los relacionados con la magnitud del efecto.
ABSTRACT
It might be that one possible reason why statistical significance has been questioned for decades might lie in the misinterpretation of p-value as a sufficient measure for clinical decision-making. It is essential to recognize that, although statistical significance can be considered a sine qua non condition for contemplating the implementation of a healthcare intervention, being an essential requirement does not imply that it is sufficient, Statistical significance alone cannot serve as the sole source of information for evidence-based clinical decisions. Evidence-based clinical decision-making requires measures that assess and quantify the magnitude of the effect (such as those discussed in this editorial), as they provide information focused on clinical relevance. Nevertheless, these types of measures cannot disregard statistical significance, which should accompany any point estimation. Besides, evidence-based clinical decision-making requires us to be aware of the fallacies, limitations, and inaccuracies inherent to any statistical estimation. Furthermore, beyond these methodological knowledge we must consider clinical judgment and the clinician’s ability to assess broader aspects of clinical relevance (such as severity, vulnerability, morbimortality, cost, and prevalence) as these factors extend beyond data related to magnitude effects.
To explore the experience of primary healthcare (PHC) professionals in their professional role during the pandemic and to describe collective coping strategies.
We conducted a qualitative study using interviews, focus groups and photovoice techniques from February to September 2021. The qualitative data were transcribed, aggregated and analysed, from a hermeneutic perspective, using applied thematic analysis and ethnographic approaches.
Primary Care Health Madrid region (Spain).
Convenience sampling was used to select 71 multidisciplinary primary care professionals who were working in 12 PHCs representing diverse socioeconomic, social vulnerability and COVID impact levels in the Madrid region (Spain).
Findings from this study show how lack of protection in the early days, uncertainty about how the disease would evolve and the daily challenges they faced have had an impact on the participants’ perceptions of their professional role. Nuanced differences in impact were found between men and women, age groups, professional roles and territories. The questioning of the basic foundations of primary care and the lack of prospects led to a feeling of demotivation. They perceive a wide gap between their levels of involvement and commitment, the recognition they receive and the attention to resources they need to do their work to a high standard. The support of their colleagues was seen as the most valuable resource for coping with the crisis.
The practitioners’ discourses offer knowledge that could help to face new global health threats; they also identify an urgent need to restore the role and motivation of PHC professionals as part of a wider regeneration of health systems.
The interaction between dementia and changes in health status accelerates the progression of dementia and health deterioration. Although health indicators exist for older adults, comprehensive ones for dementia are lacking.
To (1) establish core health indicators for older adults with dementia, (2) develop an integrated health assessment toolkit for older adults with dementia, and (3) test the feasibility and applicability of the integrated health assessment toolkit.
This study involved two phases. In the first phase, using the Delphi method, opinions from 10 experts were synthesized to establish core health indicators for older adults with dementia. In the second phase, with a descriptive research approach, an integrated health assessment toolkit was developed, evaluated by 10 daycare case managers for feasibility, and then pilot tested with 50 older adults with dementia across three daycare centers.
The core health indicators for older adults with dementia covered 18 indicators in five domains: (1) cognitive and behavioral impairment, (2) sensory and perceptual impairment, (3) disease and dysfunction, (4) functional fitness deterioration, and (5) social isolation. After two rounds of assessments, experts rated the criteria's importance and clarity at 0.94 and 0.89 on the scale-level content validity index/universal agreement (S-CVI/UA), respectively. In the second phase, the integrated health assessment toolkit was developed, which integrated five observational assessment scales and six physical function measures. The average applicability scores ranged from 7.80 to 9.90 out of 10. In the pilot test, the assessment process proceeded smoothly without any adverse events. However, 10 participants did not comply with wearing the actigraphy device.
The core health indicators and the corresponding health assessment toolkit are feasible to assess the health of older adults with dementia that could provide valuable insights and guide future interventions to enhance their well-being.
Si hay alguna expresión que impregna los artículos originales de los estudios enmarcados en el paradigma positivista es la de “estadísticamente significativo”. La significación estadística se mide mediante el valor de p (p-valor) y, en Ciencias de la Salud se ha consensuado, de forma arbitraria, que la probabilidad de cometer un error al afirmar que existe una diferencia estadísticamente significativa debe ser menor del 5% (el consabido p< 0,05), pero: ¿obtener una p< 0,05 es una garantía de calidad de los resultados?,
Approximately 25% of the Brazilian population suffers from mental disorders, a prevalence exacerbated by systemic and cultural factors such as socioeconomic inequalities, underfunded mental health services, regional disparities, and persistent stigma. These conditions significantly impact hospital care. Nurses, due to their direct contact with these patients, face challenges ranging from managing physical conditions to handling verbal aggression and psychiatric crises. This study aimed to assess the scientific evidence regarding nursing care for hospitalized patients with psychiatric disorders.
A systematic review with a mixed-methods approach was conducted, registered in PROSPERO (#CRD42022359288) and guided by PRISMA standards. Databases, such as MEDLINE, LILACS, PubMed, Web of Science, Scopus, and BDEnf, were searched using keywords like “Mental disorder,” “Psychiatric health,” “Nursing care,” and “Hospital.” Methodological quality was assessed using JBI and SQUIRE tools. The integration of quantitative and qualitative components occurred through meta-aggregation of qualitative data and frequency-based coding of quantitative themes, allowing thematic convergence across study designs.
Six studies were included. Meta-aggregation revealed frequent terms, such as “Nurse,” “Emergency,” “Screening,” “Patient,” and “Care.” Similarity analysis linked “Nurse” with “perception” and “experience” and “Emergency” with “Screening” and “Mental health,” highlighting the importance of experience and training. Five categories emerged: (1) professional experience (19.05%, showing skill gaps despite experience); (2) caring process (19.05%, stressing efficient screening); (3) barriers and challenges (19.05%, revealing difficulty with comorbidities); (4) training process (19.05%, identifying training deficiencies); and (5) therapeutic interventions (23.81%, discussing restraint use). These percentages refer to the proportional frequency of themes identified across the total number of studies analyzed. For thematic classification, only statistically significant chi-square values (p < 0.05) were considered in the grouping of content.
Nursing care for psychiatric patients in hospitals faces challenges like insufficient training and difficulty managing psychiatric comorbidities. Recommendations include incorporating structured mental health content into nursing curricula and hospital-based continuing education programs. These strategies may guide future healthcare policies in Brazil by improving patient safety, reducing hospital readmissions, and promoting more humane, evidence-based therapeutic interventions.
The findings emphasize the urgent need for targeted education and training to improve nursing care for psychiatric patients in hospital settings.