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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.
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.
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.
This trial was registered with ClinicalTrials.gov on 28 November 2023 (code: NCT06148077).
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.
Differentiated thyroid cancer (DTC) is the most common endocrine malignancy, with a high 5-year survival rate of approximately 98%. Despite advances in diagnosis and treatment, up to 20% of patients experience recurrence, adversely affecting their quality of life. Predictive models have been developed to assess recurrence risk and guide clinical decision-making, but these models often face limitations such as retrospective design, lack of diversity in study populations and absence of external validation. The primary aim is to externally validate existing predictive models for DTC recurrence using prospective data from a diverse Latin American cohort. The secondary aim is to explore opportunities for model recalibration to improve their performance in our population.
The CaTaLiNA study is a multicentre prospective observational study conducted across 10 hospitals in five Latin American countries, including Ecuador, Peru, Uruguay and Mexico. Patients aged 18 years or older receiving treatment for DTC, such as the first thyroid surgery, active surveillance or radiofrequency ablation will be included. Recruitment will occur from November 2023 to June 2025, with follow-up extending until June 2028. Data collection will include baseline clinical, surgical and histological characteristics, treatment details and follow-up outcomes. Statistical analysis will follow the Transparent Reporting of a multivariable prediction model for Individual Prognosis or Diagnosis guidelines, using imputation strategies for missing data and evaluating calibration and discrimination of the prediction models. Calibration measures include the ratio of expected and observed events, calibration slope and calibration plot, while discrimination will be assessed using the C-index and area under the receiver operating characteristic curve.
This study protocol was approved by Comité de Ética de Investigación en Seres Humanos de la Universidad San Francisco de Quito USFQ ‘CEISH-USFQ’ APO-010–2023-CEIHS-USFQ Oficio No. 161-2023-CA-23030M-CEISH-USFQ. Results will be disseminated via peer-reviewed publications.
A significant number of critically ill patients who survive their illness will experience new sequelae or a worsening of their baseline health status following their discharge from the hospital. These consequences may be physical, cognitive and/or psychological and have been labelled postintensive care syndrome (PICS). Prior research has demonstrated that spiritual care aligned with a specific creed during hospitalisation in the intensive care unit (ICU), as part of a comprehensive care plan, may be an effective strategy for preventing psychological sequelae in surviving critically ill patients. However, there is a gap in clinical literature regarding the effectiveness of generalist spiritual care in preventing psychological sequelae associated with PICS. This pilot study aims to explore the feasibility of implementing a generalist spiritual care strategy in the ICU and to evaluate its preliminary effectiveness in preventing anxiety and depression symptoms and post-traumatic stress disorder in critically ill patients.
This is a single-site, feasibility randomised controlled pilot trial of a generalist spiritual care intervention compared with the current standard of care. A total of 30 adults who are critically ill and have undergone invasive mechanical ventilation for a minimum of 72 hours without alterations in consciousness will be randomly assigned to either the spiritual care group or the usual care group at a ratio of 1:1. The primary outcome will be the feasibility and acceptability of the spiritual care strategy in critically ill patients. Secondary aims include evaluating the differences in anxiety and depression symptoms and post-traumatic stress disorder between the spiritual care group and the usual care control group at 3 months after ICU discharge. Subjects will be followed up until 3 months post-ICU discharge.
The Ethics Committee for Medical Sciences of Pontificia Universidad Católica de Chile (#220111005) and the Ethics Committee of Servicio de Salud Metropolitano Sur Oriente approved the study. Pontificia Universidad Católica de Chile funded the study (project number 105699/DPCC2021). The findings will be widely disseminated through peer-reviewed publications, academic conferences, local community-based presentations, partner organisations and the Chilean Intensive Care Society.
Introducción: En la atención del parto es primordial brindar cuidado humanizado a la madre, garantizando de esta forma el respeto a su dignidad, bienestar y cultura. Objetivo: Describir la atención y cuidados que brinda el personal de enfermería durante el parto a mujeres hablantes de lengua náhuatl y comparla con la percepción de las y los enfermeros. Materiales y método: Investigación cualitativa, con ocho mujeres hablantes de la lengua náhuatl de Uxtuapan, a quienes se les realizó una entrevista semiestructurada mediante grupo focal y una segunda entrevista individualizada en domicilio. También se entrevistaron a 11 profesionales de enfermería con grabadora de voz. Se transcribieron las entrevistas, se identificaron unidades de significado, se recategorizó y se describieron los resultados a través de la conformación de categorías: Cuidado, Entorno, Cultura, Relación ayuda-confianza. Se respetó la confidencialidad de los datos. Resultados: La falta de comunicación, tiempo e interacción en la relación enfermera-paciente favorece una percepción errónea de las pacientes ante su cuidado, denotando maltrato, soledad, falta de empatía. Conclusión: Para asegurar el cuidado humanizado en la atención del parto, se requiere mantener una conexión con las mujeres y cuidadores, donde se respeta su cultura y se favorece la seguridad de la vida humana.
Objetivo. Plantear el proceso de adaptación cultural de la intervención educativa en salud Un EVS utilizando la metodología ADAPT-ITT. Se consideran los determinantes sociales y culturales de la población adulta de la comunidad González Ortega en Mexicali, México para asistir a la población en la reducción de riesgo de Diabetes Mellitus tipo 2 (DMT2). Metodología. Se utiliza el marco ADAPT-ITT que consta de ocho fases divididas en dos etapas. La primera etapa comprende las fases de 1) evaluación, 2) decisión, 3) adaptación, 4) producción, 5) expertos temáticos e 6) integración de fases previas. La segunda etapa comprende la 7) capacitación y 8) ejecución de la intervención. Se plantea el uso de grupos focales y encuestas semiestructuradas con respuestas abiertas y cerradas para el análisis de los aportes de la población participante y expertos involucrados. La evaluación de la aceptabilidad y factibilidad de la intervención educativa se realiza utilizando encuestas adaptadas al contexto. Relevancia. México presenta un incremento en la incidencia y prevalencia de DMT2. Se estima que los casos asciendan un 46% para el 2045 (1). Intervenciones educativas en salud han demostrado que la mejora en la nutrición y actividad física (AF) pueden reducir la incidencia de DMT2 (2). No obstante, la implementación de una intervención puede ser truncada si no existe la aceptación social. Por lo tanto, realizar la adaptación cultural resulta crucial para abordar de manera más precisa los determinantes sociales y culturales de salud y así atender de manera más favorable a una población específica.
ABSTRACT
Objective. Present an approach to perform the cultural adaptation of the educational health intervention “Un EVS” using the ADAPT-ITT methodology. The social and cultural determinants from the adult population in the Gonzalez Ortega community in Mexicali, Mexico, are considered to assist in the risk reduction of DMT2. Methodology. The ADAPT-ITT framework that consists of eight stages is used and divided in two steps. The first step comprises the stages 1) assessment, 2) decision, 3) adaptation, 4) production, 5) subject matter experts, and 6) integration of the previous stages. The second stage covers 7) training and 8) implementation. The use of focus groups and semi-structured surveys with open and closed questions is considered to study the contributions of both experts and participants. Additionally, the feasibility and acceptance of the intervention are evaluated through surveys adapted to the specific context. Relevance. The incidence and prevalence of DMT2 is exacerbated within the Mexican population. It is estimated that DMT2 will grow to 46% by 2045 (1). Educational health interventions that improve nutrition and physical activity within the population have proved to reduce the incidence of DMT2 (2). However, poor social acceptance can prevent its positive impact. Therefore, implementing a cultural adaption is essential to deal with the social and cultural determinants and address more favorably the specific population.
To explore adverse event reporting in the surgical department through the nurses' experiences and perspectives.
An exploratory, descriptive qualitative study was conducted with a theoretical-methodological orientation of phenomenology.
In-depth interviews were conducted with 15 nurses, followed by an inductive thematic analysis.
Themes include motives for reporting incidents, consequences, feelings and motivational factors. Key facilitators of adverse event reporting were effective communication, knowledge sharing, a non-punitive culture and superior feedback.
The study underscores the importance of supportive organisational culture for reporting, communication and feedback mechanisms, and highlights education and training in enhancing patient safety.
It suggests the need for strategies that foster incident reporting, enhance patient safety and cultivate a supportive organisational culture.
This study provides critical insights into adverse event reporting in surgical departments from nurses' lived experience, leading to two primary impacts: It offers specific solutions to improve adverse event reporting, which is crucial for surgical departments to develop more effective and tailored reporting strategies. The research underscores the importance of an open, supportive culture in healthcare, which is vital for transparent communication and effective reporting, ultimately advancing patient safety.
The study followed the Standards for Reporting Qualitative Research and the Consolidated Criteria for Reporting Qualitative Research guidelines.
No patients or public contribution.
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 principal: Diseñar y validar el instrumento SEG-MED para identificar el cumplimiento de los principios correctos y riesgos en la administración de medicamentos. Metodología: Estudio metodológico. Fase inicial de revisión de literatura para establecer bases conceptuales y propuesta de ítems. Se continua con validez de contenido y validez facial por expertos y finalmente se realiza confiabilidad con la participación de 210 profesionales de enfermería. Resultados principales: instrumento Inicial de 46 ítems, que luego del proceso se reduce a 43. Se compone de dos dimensiones: cumplimiento de principios correctos (22 ítems) y riesgos en la administración de medicamentos (21 ítems). Con un promedio de aceptabilidad de los ítems en un 87%, concordancia global de 0.72 y alfa de Cron Bach 0,9. Conclusión principal: se obtiene una herramienta para medir la percepción del cumplimiento de los principios correctos e identificar condiciones de riesgo para para la ocurrencia de eventos adversos en la administración de medicamentos por enfermería válida y fiable para el constructo.
Objetivo principal: describir el efecto de una dosis de ejercicio cardiovascular sobre los afectos del adolescente con sobrepeso y obesidad (SOB). Metodología: ensayo clínico controlado, paralelo y simple ciego. Población: Adolescentes de 15-19 años, Grupo Experimental (GE=10) y Grupo Control (GC= 8). La intervención de ejercicio para el GE fue 5 veces por semana, 20-40 minutos, durante 8 semanas; mientras que para el GC fue menor dosis. Resultados principales: al comparar test vs. re-test, los afectos en general no tuvieron diferencia significativa (p>.05). Al analizar los afectos de manera específica, se observó diferencia significativa (p<.05) en motivado (test=3.10±.73 vs. re-test=3.90±1.44), activo (test=3.10±.56 vs. re-test=3.70±.82), entusiasmado (test=2.90±.87 vs. re-test=3.50±1.17) y estimulado (test=3±1.05 vs. re-test=3.80±1.03). Conclusión principal: la dosis propuesta de ejercicio en adolescentes con SOB, no representó cambios de manera general sobre los afectos, únicamente refleja significancia estadística en algunos de ellos por separado en el GE.
Objetivo principal: Analizar la efectividad del tratamiento de la pediculosis capitis con aceite de coco versus la permetrina o ivermectina para la reducción de la infestación en niños escolares. Metodología: Revisión sistemática con análisis interpretativo. Se consultaron bases de datos como PubMed, ScienceDirect, Epistemonikos, entre otros. Se incluyeron documentos publicados entre 2011 y 2021 derivados de la cadena de búsqueda: aceite de coco AND pediculosis capitis AND efectividad en español e inglés. Resultados principales: Después de aplicar criterios de exclusión y eliminación, se analizaron 10 documentos, que incluían ensayos comunitarios, estudios preclínicos de laboratorio y revisiones sistemáticas, los cuales proponen el aceite de coco como un tratamiento alternativo eficaz contra la pediculosis. Conclusión principal: Aunado a los reportes de alta efectividad de tratamiento, no se reportan efectos adversos y se sugiere el uso de gorra de baño así como un peinado vigoroso con una lendrera para aumentar la efectividad.
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