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Doctoral Education in Nursing in Ibero‐America: An Analysis of Its Evolution and Perspectives for the Future

ABSTRACT

Aim

To provide an overview of doctoral programs in nursing offered in Ibero-American countries to inform regional collaboration and academic development.

Design

This study was a descriptive, document analysis.

Methods

A systematic mapping was conducted using data obtained from official university and program websites, national postgraduate databases, and academic documents. The variables analysed included country, institution, year of implementation, number of faculty and students, course duration, delivery modality, costs, scholarship availability, internationalisation activities, and research lines.

Results

A total of 94 active nursing doctoral programs were identified. Brazil emerged as the pioneer, launching the first doctoral program in 1982, and remains the regional leader, accounting for 43 programs. Most programs are offered by public institutions (76.6%), delivered primarily in face-to-face format (64.1%), and emphasise research (90.4%). There has been a consistent upward trend in the establishment of programs since 2000, with notable expansion between 2011 and 2025. Despite this progress, regional disparities persist, along with a lack of data standardisation and a limited presence of professional doctorates. While 69.1% of programs reported international activities, few offer joint or dual degrees. The most common thematic axis, “Health Care and Nursing,” proved to be broad and non-specific.

Conclusion

The study reveals the expanding landscape of nursing doctoral education in Ibero-America, while also exposing persistent challenges regarding access, curricular clarity and regional articulation.

Implications for the Profession and/or Patient Care

Doctoral programs are essential for developing research capacity, academic leadership and evidence-based care. Strengthening these programs could enhance nursing responses to local health needs and promote scientific progress in care delivery.

Impact

This study provides the first comprehensive mapping of nursing doctoral programs in Ibero-America, highlighting regional disparities and areas for academic collaboration, with potential impact on policy-making, curriculum development, and the strengthening of research capacity in nursing education.

Reporting Method

STROBE (Strengthening the Reporting of Observational Studies in Epidemiology).

Patient or Public Involvement

No patient or public contribution.

Understanding barriers and facilitators of inter-organizational dynamics in addressing substance use disorder among pregnant and parenting women

by Sugy Choi, Elizabeth Knopf, Megan A. O’Grady, Ivy Van Domselaar, Jessica Ortiz, Carla King, Charles J. Neighbors, Thomas D’Aunno

Background

Pregnant and parenting women with substance use disorders (SUDs) face complex and overlapping challenges, including substance use, legal issues, housing instability, and trauma. Effective interorganizational collaboration is critical but often hindered by fragmented care and resource limitations. This study explores the key barriers and facilitators that impact collaborative efforts among healthcare providers, government agencies, and community organizations in addressing SUD among pregnant and parenting women.

Methods

This qualitative study was conducted in New York State between April 2022 and April 2023. The study focused on organizations that provide services to pregnant and parenting women with SUDs, including government agencies, SUD treatment centers, healthcare settings, and community-based care organizations. Semi-structured, one-on-one interviews were conducted with staff to explore how their organizations coordinate care. Thematic analysis was used to identify patterns related to interorganizational collaboration. Primary data were collected through interviews with 30 staff members across multiple stakeholder groups: child welfare services (n = 8), criminal legal agencies (n = 5), health agencies (n = 3), healthcare service settings (n = 4), SUD treatment programs (n = 6), and community-based organizations (n = 4). Interviews lasted approximately one hour and focused on organizational roles, referral processes, and coordination efforts in serving the target population.

Results

Collaborative care was primarily facilitated through referral networks, case management teams, and the presence of embedded healthcare professionals. However, these systems were frequently limited by fragmented communication, stigmatizing attitudes, and insufficient resources. Organizational facilitators included co-located healthcare staff within child welfare services and formalized partnerships across sectors. Key barriers included staffing shortages, burnout, and misalignment of organizational goals. At the individual level, collaboration often depended on informal relationships and staff-driven initiatives, though interdisciplinary knowledge gaps remained a significant challenge.

Conclusions

Improving service coordination for pregnant and parenting women with SUDs will require stronger organizational infrastructure, investment in cross-sector communication strategies, and deliberate efforts to address stigma. Future research should explore models that support sustained, formalized interagency partnerships to enhance care integration.

Validation and cost-effectiveness of an mHealth tool for cognitive impairment detection in Peru: protocol for the IMPACT Salud observational study

Por: Cardenas · M. K. · Anza-Ramirez · C. · Bernabe-Ortiz · A. · Custodio · N. · Montesinos · R. · Miranda · J. J. · Da Re · M. · Belon-Hercilla · M. V. · Lazo-Porras · M. · Hawkins · J. · Diez-Canseco · F. · Moore · G. · Whiteley · W. · Calvo · R. A. · Cuba-Fuentes · M. S. · Landeiro · F.
Introduction

Dementia is a chronic and progressive neurological condition characterised by cognitive and functional impairment. It is often associated with multimorbidity and imposes a significant economic burden on healthcare systems and families, especially in low-income and middle-income countries. In Peru, where dementia cases are increasing rapidly, timely detection and referral for diagnosis is crucial. This protocol is part of the IMPACT Salud project in Peru. Here, we focus on a specific component aimed at validating an mHealth tool for the detection of cognitive and functional impairment and assessing its cost-effectiveness. We will also assess changes in cognitive and functional impairment as well as health economic outcomes over 1 year.

Methods and analysis

This observational study will be conducted in four geographically diverse regions of Peru. Community health workers are expected to contact approximately 32 000 participants (≥60 years) to apply an mHealth-enabled tool that includes cognitive and functional instruments: Ascertain Dementia 8, Peruvian version of Rowland Universal Dementia Assessment Scale and Pfeffer Functional Activities Questionnaire. From this large sample, we aim to find 3600 participants and their study partners to enrol and interview at baseline regarding sociodemographic characteristics, lifestyles, comorbidities and health economic data including resource use, costs and health-related quality of life (HR-QoL). Psychologists, blind to previous results, will assess dementia stage of the participants using an abbreviated Clinical Dementia Rating (CDR) scale. At 6-month follow-up, participants will complete a brief health economics questionnaire on resource use, costs and HR-QoL. To validate the accuracy of the detection tool, a subsample of 600 participants who completed the baseline will undergo a gold-standard clinical neuropsychological assessment. This subsample will participate in a 12-month follow-up, including health economics, cognitive and functional impairment tests and the CDR scale. Results will be analysed and presented by cognitive status, site, sex and multimorbidity profile. Finally, data from all stages and external sources will inform a decision model to implement a cost-effectiveness analysis of the detection tool at the national level.

Ethics and dissemination

The study received ethics approval in Peru (Universidad Peruana Cayetano Heredia: CONSTANCIA-CIEI-378-33-23) and in the UK (Imperial College London: ICREC/SETREC reference number 6647445). Informed consent will be obtained from participants and their study partners, considering the participant’s capacity to consent. For illiterate participants, consent will be obtained through a witnessed procedure involving study partners, with a fingerprint obtained instead of a signature. The results will be disseminated through conferences, published articles, public presentations (particularly to those involved in dementia care) and presentations or meetings with local health authorities.

Effectiveness of a home-based physical exercise intervention in patients with fragility fractures on functional independence and hospital readmissions: a protocol for a randomised controlled trial

Por: Segura-Ruiz · R. · Ruiz-Canete · M. · Munoz-Alonso · A. · Rivas-Cruces · C. · Serrano-Lazaro · P. · Armenteros-Ortiz · P. J. · Hidalgo-Lopezosa · P. · Lamberti · N. · Manfredini · F. · Lopez-Soto · P. J.
Introduction

Patients with fragility fractures are two times as likely to suffer future fractures as their peers who have not suffered a fracture. In addition, 40% of those who suffer fragility fractures do not recover their level of functioning in terms of activities of daily living after 1 year. The present study aims to verify the hypothesis that a semipersonalised home-based exercise intervention may improve patients’ independence and reduce the number of hospital admissions compared with usual care for a population that suffers fragility fractures.

Methods and analysis

This parallel-arm single-blinded randomised-controlled trial will take place at the University of Cordoba (Spain) between September 2022 and September 2024. Patients aged >50 years old who have undergone surgery for a fragility hip fracture and who were prefracture independent (Barthel index (BI)>60) will be invited to participate. Patients will be excluded if they present a different type of fracture, mild or greater cognitive impairment or contraindication to exercise training. Patients will then be randomised into exercise or usual care group. The former will receive a daily walking appointment (number of steps to be completed inside home, interspersed with sit-to-stand movements) with the total volume increasing weekly. The latter will receive the usual care. The outcomes, collected at baseline, at the end of training (3 months) and at follow-up (6 months) by blinded operators will include the BI and number of readmissions (primary outcomes) and quality of life, exercise capacity, strength, cognitive status, bone mineral density and laboratory biomarkers (secondary outcomes). Variables related to quality of life, cognitive status, laboratory markers and densitometry will also be analysed.

Ethics and dissemination

The research ethics committee of the province of Cordoba approved the project (number 326; date 28 July 2021). Patients who meet the eligibility criteria will receive a patient information document and the consent form and will be encouraged to ask any questions. The proposed research respects the fundamental principles of the Declaration of Helsinki, the Council of Europe Declaration on Human Rights and Biomedicine, the UNESCO Universal Declaration on the Human Genome and Human Rights, and the Oviedo Council on Human Rights and Biomedicine. The data obtained in this study will be confidential. They will be treated by the Organic Law 3/2018, of 5 December, on the Protection of Personal Data and Guarantee of Digital Rights, keeping it strictly confidential and not accessible to unauthorised third parties, and the Regulation (EU) 2016/679 of the European Parliament and of the Council of 27 April 2016 on Data Protection (RGPD). Written informed consent will be obtained from all the participants. The study’s results will be published in peer-reviewed journals and presented at scientific congresses worldwide. The results will also be disseminated through patient advocacy group newsletters and social media platforms. Patient partners will help select the appropriate channels and develop plain-language summaries tailored to their communities’ needs.

Trial registration number

ClinicalTrials.gov ID: NCT04934358 (registration date: 14 June 2021).

Safety culture in paediatric emergency departments: a cross-sectional study among healthcare professionals

Objectives

Safety culture is essential to improving healthcare quality. Paediatric emergency departments are high-risk environments where evaluating safety culture helps identify areas for improvement. This study aimed to analyse the safety culture among professionals in paediatric emergency departments, according to job category and gender.

Design

Multicentre cross-sectional study using the Hospital Survey on Patient Safety Culture (HSOPSC).

Setting

19 paediatric emergency departments, covering all levels of care.

Participants

1843 healthcare professionals were invited to participate; the response rate was 63.8%, and 33% of respondents were nurses. All clinical staff in paediatric emergency departments were eligible. Professionals from other specialties and non-clinical staff were excluded.

Outcome measures

The primary outcome was the assessment of patient safety culture using the HSOPSC, following the methodology of the Agency for Healthcare Research and Quality. Secondary outcomes included comparisons by job category and gender, and an exploratory cluster analysis.

Results

In terms of patient safety, the main strength was ‘teamwork within units’ (83.65% positive), while the main weakness was ‘staffing’ (61.92% negative). Patient safety was rated with an average score of 7.21 by the participants. Paediatricians rated ‘manager expectations’ significantly higher than nurses (p=0.023) and residents (p=0.026). Paediatricians gave more positive responses overall, with significant differences in ‘communication openness’, ‘feedback and communication’, ‘non-punitive response’ and ‘teamwork across units’, though none were classified as strengths. Cluster analysis showed that the group with more paediatricians identified more strengths and no weaknesses, while the group with more nurses and nursing assistants showed no strengths and significant weaknesses in ‘overall safety perception’, ‘staffing’ and ‘management support’.

Conclusions

Safety culture in paediatric emergency departments is acceptable, but still far from excellent, indicating ample room for improvement. Differences between professional categories, especially between paediatricians and nurses, highlight the need for targeted safety strategies and leadership involvement.

New regimens of benznidazole for the treatment of chronic Chagas disease in adult participants in indeterminate form or with mild cardiac progression (NuestroBen study): protocol for a phase III randomised, multicentre non-inferiority clinical trial

Por: Marques · T. · Forsyth · C. · Barreira · F. · Lombas · C. · Blum de Oliveira · B. · Laserna · M. · Molina · I. · Bangher · M. d. C. · Javier Fernandez · R. · Lloveras · S. · Fernandez · M. L. · Scapellato · P. · Patterson · P. · Garcia · W. · Ortiz · L. · Schijman · A. · Moreira · O. C.
Introduction

Chagas disease (CD) is one of the most neglected diseases in the world. In Latin America, CD is endemic in 21 countries, with an estimated 70 million people at risk of infection. Current treatments are limited to two nitroheterocyclic compounds: nifurtimox and benznidazole (BZN). Each has significant limitations, including long duration and safety concerns. However, data from recently completed studies suggest that reduced-duration regimens may be equally effective while enhancing safety.

Methods and analysis

NuestroBen is a phase III, randomised, multicentre clinical trial designed to assess whether shorter (2- and 4-week) regimens of BZN are non-inferior to the standard 8-week treatment. A total of 540 adult participants with no evidence of organ damage (the indeterminate form) or with mild cardiac progression (mild electrocardiographic alterations and without systolic dysfunction or symptoms), all in the chronic phase of CD, will be recruited at six study sites in Argentina and two study sites in Bolivia. Participants will be randomised to receive one of the two shortened regimens of BZN (300 mg per day for 2 or 4 weeks) or standard treatment (300 mg per day for 8 weeks). The primary endpoint is sustained elimination of parasitaemia from the end of treatment through 12 months of follow-up. Secondary endpoints will assess sustained clearance of parasitaemia at 1, 4, 6 and 8 months of follow-up from the end of treatment, drug tolerability and adherence to treatment. NuestroBen will also evaluate whether two shortened regimens of BZN improve drug tolerability and treatment adherence compared with the current standard treatment while maintaining efficacy in participants with the indeterminate form of CD or with mild cardiac involvement.

Ethics and dissemination

In Argentina, this study was approved by Fundación de Estudios Farmacológicos y Medicamentos ‘Luis M. Zieher’ for its conduct at the Instituto de Cardiología de Corrientes ‘Juana Francisca Cabral’ (reference: NuestroBen-2020/2021) and the Instituto Nacional de Parasitología ‘Dr. Mario Fatala Chaben’ (reference: NuestroBen-2020/2021) by Comité Institucional de Ética de Investigación en Salud for the Centro de Chagas y Patología Regional de Santiago del Estero (reference: NuestroBen-2020-088/2021), by Comité de Ética en Investigación for the Hospital de Infecciosas F.J. Muñiz (reference: NuestroBen-2020–4037) and the Hospital General de Agudos D.F. Santojanni (reference: NuestroBen-2020–4039) and by Comité de Bioética for the Fundación Huésped (reference: NuestroBen-2020/2021). In Bolivia, it was approved by Comité de Ética en Investigación en Salud from the Universidad Autónoma Juan Misael Saracho (reference: NuestroBen-2020/2025). All participants are asked to provide written informed consent to participate. Recruitment processes started in July 2023, and as of 15 June 2025, 140 participants have been recruited. Findings will be shared with Argentinian and Bolivian public health officials and with the Chagas and tropical medicine communities via international conferences. Findings will also be published in medical journals.

Trial registration number

NCT04897516.

Effects of manual therapy on oral opening, swallow function and upper quarter mobility in Chilean survivors of head and neck cancer: a study protocol for a controlled, randomised study (MAnual ThErapy for Oral Opening (MATEO) study)

Introduction

Head and neck cancer (HNC) accounts for over 4% of global cancer incidence, yet the oncological treatment induces several sequelae such as oral dysfunction, cervical and shoulder impairments or pain that are not well addressed. Thus, survivors of HNC (sHNC) perceive a decrease in their quality of life (QoL). This study protocol aims to investigate the effects of manual therapy (MT) to determine the effectiveness and safety on oral opening, swallow function and upper quarter mobility, cervical muscle strength, pain, functionality and QoL of sHNC.

Methods and analysis

A randomised controlled trial will include 70 sHNC over 18 years of age and will be divided into two groups. Intervention will last for 6 weeks with a total of 18 sessions, including MT targeting mastication and head and neck muscles. The control group will receive motor control exercises. The main outcomes will be oral opening and swallow function. An intention-to-treat analysis will be performed to evaluate the effectiveness of the intervention, which will be further determined with the calculation of effect sizes expressed in Cohen’s d.

Ethics and dissemination

The study was approved by the Ethics Committee of the Universidad de La Frontera (File 001_24) according to the Helsinki Declaration for Biomedical Research. All participants will provide informed consent. Study results will be published in open access peer-reviewed journals and may be shared at relevant meetings and research meetings.

Trial registration number

This trial was registered with ClinicalTrials.gov on 28 November 2023 (code: NCT06148077).

Role of the exposome in mental disorders: a scoping review protocol

Por: Gutierrez-Ortiz · C. · Hossain · B. · Dessenne · C. · Aguayo · G. A. · Ruiz-Castell · M.
Introduction

The development of mental disorders is multifactorial across the lifespan. The introduction of the exposome concept has enhanced the understanding of life-course environmental factors by encompassing the totality of environmental exposures. While most studies on chronic diseases have applied a single-exposure approach, the exposome approach remains underutilised in mental disorder research. There is a need to better recognise the environmental factors considered in exposome analysis of mental disorders, the methodologies used and the gaps reported. This scoping review aims to map the evidence on the relationship between the exposome and mental disorders across the lifespan, identifying and describing the methodologies used and highlighting the gaps reported.

Methods and analysis

This scoping review will follow PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines and the Population-Concept-Context approach. It will include observational and interventional studies involving populations of all ages in the community or healthcare settings. The search strategy will contain indexed terms in MEDLINE and will be adapted for CINAHL (EBSCO), Scopus, Embase and PsycINFO without restrictions on language or date of publication. For the selection of articles, two independent researchers will screen articles by title and abstract, followed by a full-text assessment. Afterwards, the extracted data will be summarised using a narrative and descriptive analysis.

Ethics and dissemination

Ethics approval is not required for this scoping review. Dissemination activities will include peer-reviewed publications and academic presentations.

Diseño de una intervención psicoeducativa basada en modelo de promoción de la salud

Objetivo: diseño de una intervención psicoeducativa de enfermería para el control del peso gestacional en mujeres embarazadas mexicanas basado en Modelo de Promoción de la Salud. Método: Uso de teorías en el diseño de intervenciones. Resultados: Los determinantes que se utilizaron para el diseño de la intervención, fue la autoeficacia, barreras percibidas e intenciones de implementación. Se diseñaron dos manuales, uno para el facilitador y otro para el participante. Conclusiones: El modelo de promoción de la salud es útil para guiar intervenciones psicoeducativas.

Percepción del personal de enfermería frente al cuidado durante la pandemia COVID-19

RESUMEN

Objetivo: describir la percepción del personal de enfermería que brinda cuidado durante la pandemia por Covid-19. Metodología: estudio cualitativo descriptivo con análisis de contenido temático e inductivo, la selección de participantes fue por muestreo no probabilístico e intencionado, 50 enfermeros que laboran en la unidad de cuidado intensivo adulto y hospitalización. Se aplicó entrevista para la recolección de datos, que partió de una pregunta central, el análisis se realizó según planteamientos propuestos por Tinto. Resultados: emergieron tres temas con sus unidades de significado. Cuidado de enfermería durante la pandemia: mezcla de emociones. Separación familiar como medida de cuidado. Trabajo en equipo una estrategia de afrontamiento. Conclusión: Los desafíos a los cuales el personal de enfermería se ha enfrentado en esta pandemia ha llevado a la presencia de un sin número de manifestaciones emocionales que deben ser tenidas en cuenta para el manejo psicoemocional y prevención de secuelas a largo plazo.

Empoderando comunidades: investigación-acción-participativa en gestión de riesgos y desastres en Tausa, Colombia

Colombia enfrenta constantes desafíos en la gestión del riesgo de emergencias y desastres, demandando la participación activa de todos los actores del territorio nacional. Reconociendo el papel esencial de la disciplina enfermera en el cuidado de individuos y comunidades en situaciones de riesgo, se llevó a cabo una investigación-acción-participativa con el objetivo de promover la participación de una comunidad en la gestión del riesgo de emergencias y desastres de su municipio. La investigación se estructuro en 4 etapas en las cuales se recogieron datos mediante entrevistas, video-paseos y talleres comunitarios, que fueron procesados en el software Atlas.Ti mediante análisis de contenido. Se logró un proceso de co-creación en el cual la comunidad identificó los riesgos locales, asumió un rol activo en la prevención y mitigación de los mismos y aportó en la construcción de una herramienta innovadora que utiliza la tecnología para involucrar a la comunidad en la gestión del riesgo. Se concluyó que la inclusión de la comunidad en la gestión del riesgo posibilita la comprensión contextualizada del riesgo y fomenta un cambio social liderado por la comunidad, reflejado en la generación de estrategias adaptadas a sus necesidades particulares.

Evaluación crítica de la teoría de rango medio de la Autotrascendencia de Pamela Reed en el contexto de las drogas

Introducción: La teoría de rango medio de la Autotrascendencia de Pamela Reed se fundamenta en la naturaleza del desarrollo de las personas en la adolescencia, la edad adulta, el envejecimiento y el final de la vida, en el contexto de experiencias difíciles relacionadas con la salud, enfocada al mantenimiento del bienestar a través de la autotrascendencia durante el proceso de envejecimiento. Objetivo: Evaluación crítica de la Teoría de la Autotrascendencia de Pamela Reed para su uso en el contexto de las drogas. Metodología: A través de los criterios propuestos por Fawcett (2009) en el que se evalúa la significancia, la consistencia interna, parsimonia y la capacidad de prueba de la teoría y una revisión integrativa de la literatura de la teoría en su aplicación al fenómeno de las drogas. Resultados: La teoría mostró significancia, parsimonia y sus conceptos y proposiciones son explícitos, claros y entendibles, han logrado ser medidos, utilizando la Escala de Autotrascendencia de Reed. Conclusiones: La Teoría de la Autotrascendencia aplicada en el contexto de las drogas es útil para dar respuesta a los diferentes problemas que se presentan en la sociedad con respecto a las drogas y es aplicable en cualquier etapa de la vida.

Cuidados en el hogar al niño hospitalizado con infecciones respiratorias agudas desde un enfoque cultural

Introducción: Las prácticas culturales que tienen las madres para tratar las infecciones respiratorias en sus niños pueden tener efectos positivos o negativos para su recuperación. Objetivo: Describir los cuidados en el hogar al niño hospitalizado con infecciones respiratorias agudas desde un enfoque cultural. Método: Estudio cualitativo descriptivo. La muestra estuvo representada por 12 madres de niños menores de cinco años con infecciones respiratorias agudas hospitalizados. Los datos se recolectaron a través de la entrevista semiestructurada y fueron procesados mediante análisis de contenido. Resultados: Se establecen tres categorías: a) Uso de la medicina tradicional como práctica ancestral para tratar las infecciones respiratorias agudas, b) Hábitos en la alimentación durante las infecciones respiratorias agudas, c) Costumbres en el abrigo y la higiene frente a las infecciones respiratorias agudas. Conclusiones: Las madres tratan las infecciones respiratorias con plantas medicinales que son oriundas de su comunidad. Existen aspectos positivos que se deben preservar como brindar lactancia materna durante la enfermedad, pero se debe negociar el baño diario, y reestructurar el sobreabrigar al niño. Asimismo, el personal de enfermería debe tener conocimientos sobre la medicina tradicional y sus efectos, con la finalidad de brindar una educación sanitaria intercultural.

Resiliencia en niños de padres con consumo dependiente de alcohol: propuesta de teoría de situación específica

La resiliencia como parte del proceso evolutivo se promueve desde la infancia, los hijos de padres con consumo dependiente de alcohol tienden a mostrar resultados negativos mientras crecen, como depresión, ansiedad, ideación suicida y consumo de sustancias a temprana edad. Se ha encontrado evidencia de intervenciones que favorecen la resiliencia, sin embargo, no durante la infancia. Las teorías y modelos de enfermería han sido utilizados para guiar intervenciones, particularmente las teorías de situaciones específicas (TSE) que mejoran la práctica al responder a preguntas más concretas. Se presenta la propuesta de TSE de Resiliencia en niños de padres con consumo dependiente de alcohol, desarrollada con la metodología de substracción teórica de Fawcett y sustento en la Teoría de Resiliencia de Polk; su objetivo es favorecer la resiliencia, resultado de la acción de patrones que la conforman, como estructura de protección para superar los desafíos de su contexto. Esta propuesta es una oportunidad de poner en práctica estas construcciones teóricas en la investigación y en el diseño de intervenciones que promuevan la resiliencia y prevenir el riesgo de consumo de alcohol en los hijos de padres que consumen esta sustancia.

Artificial Intelligence and the National Violent Death Reporting System: A Rapid Review

imageAs the awareness on violent deaths from guns, drugs, and suicides emerges as a public health crisis in the United States, attempts to prevent injury and mortality through nursing research are critical. The National Violent Death Reporting System provides public health surveillance of US violent deaths; however, understanding the National Violent Death Reporting System's research utility is limited. The purpose of our rapid review of the 2019-2023 literature was to understand to what extent artificial intelligence methods are being used with the National Violent Death Reporting System. We identified 16 National Violent Death Reporting System artificial intelligence studies, with more than half published after 2020. The text-rich content of National Violent Death Reporting System enabled researchers to center their artificial intelligence approaches mostly on natural language processing (50%) or natural language processing and machine learning (37%). Significant heterogeneity in approaches, techniques, and processes was noted across the studies, with critical methods information often lacking. The aims and focus of National Violent Death Reporting System studies were homogeneous and mostly examined suicide among nurses and older adults. Our findings suggested that artificial intelligence is a promising approach to the National Violent Death Reporting System data with significant untapped potential in its use. Artificial intelligence may prove to be a powerful tool enabling nursing scholars and practitioners to reduce the number of preventable, violent deaths.

Prototyping Process and Usability Testing of a Serious Game for Brazilian Children With Type 1 Diabetes

imageThis study aims to describe the prototype development and testing of a serious game designed for Brazilian children with diabetes. Following an approach of user-centered design, the researchers assessed game's preferences and diabetes learning needs to develop a Paper Prototype. The gameplay strategies included diabetes pathophysiology, self-care tasks, glycemic management, and food group learning. Diabetes and technology experts (n = 12) tested the prototype during audio-recorded sessions. Next, they answered a survey to evaluate the content, organization, presentation, and educational game aspects. The prototype showed a high content validity ratio (0.80), with three items not achieving the critical values (0.66). Experts recommended improving the game content and food illustrations. This evaluation contributed to the medium-fidelity prototype version, which after testing with diabetes experts (n = 12) achieved high content validity values (0.88). One item did not meet the critical values. Experts suggested increasing the options of outdoor activities and meals. Researchers also observed and video-recorded children with diabetes (n = 5) playing the game with satisfactory interaction. They considered the game enjoyable. The interdisciplinary team plays an important role guiding the designers in the use of theories and real needs of children. Prototypes are a low-cost usability and a successful method for evaluating games.

The paradoxical position of nurses regarding euthanasia and its legalisation: A descriptive quantitative study

Abstract

Aims and Objectives

To learn about the attitudes of nurses working in the Andalusian Public Health System regarding euthanasia and its legalisation.

Background

Euthanasia often finds itself in the crosshairs of ethical and political debate on an international scale. Currently, the Spanish Organic Law 3/2021 of 24 March, 2021, recognises euthanasia as a fundamental right in Spain. It is of particular interest to know about the views, attitudes and stances that Andalusian nurses have of euthanasia as they are key players within the framework of euthanasia and administration of life-ending drugs. They play a central role in guiding patients through the euthanasia application process.

Design

Observational descriptive study.

Methods

A study of Andalusian Public Health System nurses was carried out using non-probability convenience sampling. 518 nurses with an average age of 44.75 years answered in a questionnaire that was distributed on an online platform. Socio-demographic and occupational variables were assessed, together with the Death Anxiety Scale and the Euthanasia Attitude Scale. A bivariate analysis and a multivariate linear regression model were performed. The STROBE checklist was used.

Results

The mean score obtained on the Euthanasia Attitude Scale was 75.95 (SD = 16.53). The mean score obtained on the Death Anxiety Scale was 7.56 (SD = 3.05). The variables age and work experience were negatively correlated with the total scores of the Euthanasia Attitude Scale and the categories ‘Ethical considerations’, ‘Practical considerations’ and ‘Treasuring life’. On the other hand, there was a significant positive correlation between age and work experience and ‘Spiritual beliefs’ category.

Conclusions

The current situation shows a worrying paradox. There is a stark difference between positive professional attitudes towards euthanasia and the desire to participate in its application.

Relevance to Clinical Practice

It is vital that educational and healthcare institutions make the necessary efforts to ensure that nurses develop sound moral judgement, displaying the moral conscience and ethical commitment required of this established profession.

Patient or Public Contribution

No patient or public contribution.

El concepto del estrés de aculturación desde la mirada del inmigrante hispano en los Estados Unidos

Objetivo principal: Clarificar el significado de estrés de aculturación del inmigrante hispano, además de conocer cada una de las dimensiones y características propias del concepto, con la finalidad de comprender mejor las necesidades de la persona inmigrante que vive en los Estados Unidos. Metodología: El análisis de concepto se hizo a través de los ocho pasos propuestos por Walker y Avant. Resultados principales: Se identificaron tres dimensiones del concepto estrés de aculturación: (1) estresores personales, (2) estresores del entorno y (3) estresores sociales. Como antecedentes del concepto se identificó el arrepentimiento, la culpa y negación. En general, las consecuencias se reflejan en la salud mental del inmigrante hispano. Además, se reconoció los instrumentos de medi-ción que evalúan el estrés de aculturación. Conclusión principal: Se obtuvo una definición clara del concepto estrés de aculturación desde la perspectiva del inmigrante hispano, que ayudará a estimar la validez de constructo de las mediciones de este concepto. Las dimensiones reportadas con mayor frecuencia son consideradas en el inventario de estrés en hispanos, sin embargo, se recomienda analizar la validez de constructo del concepto. Sería importante considerar las consecuencias derivadas del estrés de aculturación en la prevención y tratamiento de la salud mental.

Perspectivas de enfermería en atención primaria y promoción de salud en los adolescentes durante la pandemia

Sr. Director: A inicios de la pandemia por la enfermedad de coronavi-rus (Covid‑19), producida por el virus SARS-CoV-2, las autoridades en salud emitieron recomendaciones a todos los países a fin de salva-guardar la integridad física de la población [Fragmento de texto].

Monitorización con Índice biespectral para reducción de complicaciones asociadas a sobresedación en adultos: revisión sistemática

Objetivo: Demostrar mediante la monitorización con el índice biespectral la reducción de complicaciones asociadas a sobresedación en paciente con ventilación mecánica. Metodología: Enfermería basada en evidencia. Traducción a lenguaje científico DeCS y MeSH. Fuentes documentales: Epistemonikos, PUBMED, ELSEVIER, DOAJ y Google académico. Operador booleano AND, OR y NOT. Lectura critica mediante FLC 3.0. Jerarquización con Scottish Intercollegiate Guidelines Network (SIGN). Resultados: Ocho de 10 artículos demuestran reducción de eventos adversos, 5 de 10 artículos indican reducción de dosis empleadas y administradas de sedantes, también una fuerte evidencia de la precisión para valorar el nivel de sedación y reducción de la incidencia de la sedación. Se necesitan más estudios. Conclusión: La monitorización con índice Biespectral tiene un índice de especificidad más objetivo que escalas de sedación comúnmente usadas y demostró que reduce complicaciones asociadas a la sobresedación. Se requieren más estudios.

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