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During the coronavirus pandemic, changes in the way science is done and shared occurred, which motivates meta‐research to help understand science communication in crises and improve its effectiveness. The objective is to study how many Spanish scientific papers on COVID‐19 published during 2020 share their research data. Qualitative and descriptive study applying nine attributes: (a) availability, (b) accessibility, (c) format, (d) licensing, (e) linkage, (f) funding, (g) editorial policy, (h) content, and (i) statistics. We analyzed 1,340 papers, 1,173 (87.5%) did not have research data. A total of 12.5% share their research data of which 2.1% share their data in repositories, 5% share their data through a simple request, 0.2% do not have permission to share their data, and 5.2% share their data as supplementary material. There is a small percentage that shares their research data; however, it demonstrates the researchers' poor knowledge on how to properly share their research data and their lack of knowledge on what is research data. [ABSTRACT FROM AUTHOR]

Introduction. This study examines the research methods and techniques used in Spanish journals of library and information science, the topics addressed by papers in these journals and their authorship affiliation. Method. The researchers selected 580 papers published in the top seven Spanish LIS journals indexed in Web of Science and Scopus and conducted a content analysis of 394 of these papers. In each case, the analysis considered: (1) type of paper (research/non-research); (2) authorship (country, sex, number of authors, academic versus professional profile); and (3) the research methods and techniques used and the topic addressed. Results. Sixty-eight per cent of the papers were identified as research papers. These papers used either a quantitative or qualitative approach to the topic and both were well represented, although rarely combined in the same paper (9.6%). The most frequently addressed topics were information sources, metric studies and technologies. Most of the authors were Spanish (78%). Forty-two per cent of the papers had just one author. Conclusions. In terms of the volume of publication and the research methods and techniques most commonly used, library and information science research in Spain does not generally lag behind research in the international sphere. However, there is still room for improvement in experimental research, of which there is very little, and in the internationalisation of authorship.

This article focuses on an investigation of English as a Foreign Language (EFL) teacher (de)motivation in Spain which underwent a methodological transformation from mixed methods to a qualitative approach. Unexpected statistical results from the questionnaire in the piloting phase led to the creation of interview prompts, a dynamic data collection instrument based on reliable items from the questionnaire which was disregarded from the main study at a later stage. The interview prompts provided a card-based data collection method which engaged participants in reflective and challenging tasks. This paper will discuss an unsettling challenge in the research process, how it was seized and the positive outcome which emerged from this unpredicted pitfall. A research breakdown welcomed a methodological turn enabled by the researcher's reflection on the research dilemma. Authors are encouraged to defy and embrace research obstacles while learning from them and sharing the solutions with the research community.

This paper builds on the history of Esbrina, an established research group in Spain with almost 20 years' experience and a deeply-rooted tradition of self-reflection and learning. We start by analysing the academic and social contexts in which the group was created and recognised. We make explicit team members' backgrounds, dispositions and positionalities, to provide insight into the tensions aroused in deciding research topics, methodological approaches and research methods. Then we focus on two specific projects and explore the learning processes of those engaged in them: the first involves micro-ethnography, for which we examine our apprenticeship process through interviews, observation, inferential analysis and visual documentation. The second involves collaborative ethnography, for which we give an analytical account of how we created different ways of learning through collaborating and narrating. Throughout the paper, we reflect on our determination to create a methods-learning environment in which we constantly challenge our comfort zone by trying to do research on topics involving authentic learning. The most innovative aspect of the process is that senior and junior researchers, including group directors, play both the role of teachers and learners.

Accessible Summary: What is known on the subject: Adult psychiatric services typically focus on the mental health needs of the client but they do not support his or her parenting role.Many authors highlight the importance of a non‐judgmental approach when providing support and care to clients with mental illness who are parents.Assessments frequently focus on the negative aspects while the strengths of these families were often overlooked.There is a lack of scientific literature exploring nurses' experiences when caring for parents with mental illness and their families. What this paper adds to existing knowledge: Trust is the basis that helps clients to be open to receiving care and answering parenting‐related questions. Therefore, without adequate professional‐client trust, some care and interventions addressed to parents with mental illness could be poorly received by the client.Tronto's phases of care facilitated the collection of data and exploration of mental health nurses' experiences of care. What are the implications for practice: Mental health nurses should be aware of the potential needs of these families, as described in the scientific literature, so they can include them in their assessments. They also should consider the need to individualize each care since each situation of a family with parental mental illness is unique.Mental health nurses must take the person's environment into account (family, social and political aspects and different forms of stigma) since all these factors may influence how parents with mental illness receive and provide care. Introduction: Many authors highlight the importance of a non‐judgmental approach when providing care to parents with mental illness. However, assessments frequently focus on the negative aspects while the strengths of such families were often overlooked. Aim: To explore the lived experiences of mental health nurses who care for clients who are parents. Method: We conducted a qualitative phenomenological study. The main data collection technique was in‐depth interviews. Data were analysed according to Colaizzi model, subsequently, the main categories that arised were compared and related to the five phases of Tronto's care. Results: The main categories identified from the analysis of the interviews were: (1) individualized care, (2) continuity of care, (3) psychoeducation and counselling, (4) trust and (5) context of the client. Discussion: Trust is the basis that helps parents with mental illness to be open to receiving care and answering parenting‐related questions. Without trust, some interventions could be poorly received by the client. Implications for Practice: Mental health nurses should be aware of the potential needs of these families, so they can include them in their assessments. They also should consider the need to individualize each care since each situation of a family with parental mental illness is unique. [ABSTRACT FROM AUTHOR]

Objective: To explore the experiences and emotions of individuals with depression and physical comorbidity within the context of psychoeducational group interventions led by primary care nurses in Catalunya (Spain). Method: A psychoeducational group intervention was conducted in the first semester of 2019 with 13 primary care teams (rural/urban) and 95 participants with depression and physical comorbidity. The qualitative research and phenomenological perspective were based on 13 field diaries and 7 semi‐structured interviews carried out with the observer nurses. The interviews were recorded and transcribed. Codes were identified by segmenting the text into citations/verbatim accounts and emerging categories/subcategories by regrouping the codes. The results were triangulated among the researchers to identify and compare similarities and differences. Results: Four major themes were found: (a) gender differences; (b) coping strategies and changes observed during the intervention; (c) functions of the group as a therapeutic element; and (d) the nurses' perceptions of the group experience. Gender differences were identified in relation to experiences and emotions. Conclusions: As some patients acquired skills/behaviours during the intervention that helped them initiate changes and the nurses were satisfied with the intervention, it is important to include this information when planning effective interventions for patients with this profile. Summary statement: What is already known about this topic? There are gender differences in the prevalence of depression. What this paper adds? This study describes the experiences and emotions of women with depression and physical comorbidity within the context of psychoeducational group intervention. The implications of this paper: The study provides information about the experiences and emotions of women with depression. It will be important to include this qualitative information when planning effective interventions directed at patients with this profile. [ABSTRACT FROM AUTHOR]

Aims: This study aimed to delineate the relationships between actors and contextual factors associated with the development of the advanced practice role in Catalonia. Methods: A complementary data analysis was conducted based on the social network analysis (SNA) method. The primary study design was qualitative, descriptive and explanatory. Participants from diverse perspectives of practice, organization and external environment were engaged to participate in semi‐structured focus groups. Data collection was conducted between March and May 2016 in Catalonia, Spain. Participants were asked to report on various dimensions of the role development context: understanding of the role, felt needs, perceived outcomes, barriers and facilitators. Results: Primary data analysis performed for 44 participants identified 71 related contextual factors associated with role development. Complementary network analysis revealed multiple relationships and agreements among participants and context‐related themes. Professional roles and disciplines clustered around topics show consensus and the significance of topics. Conclusion: Understanding the level of interactions and consensus among participants and contextual factors will ultimately allow better insight into how complex contexts influence the development of advanced practice nursing in healthcare organizations. Significant, consensual contextual factors should be used to influence further development and implementation of new roles that affect patient care and outcomes. Summary statement: What is already known about this topic? Comprehensive understanding of context at various levels should generate greater knowledge about what affects advanced practice role development locally and globally.What this paper adds? Findings could help organizations to make sense of the full dimension of context and to predict or act on development of advanced practice nursing roles.The implications of this paper: Significant, consensual contextual factors should be used to influence further development and implementation of new roles that affect patient care and outcomes. [ABSTRACT FROM AUTHOR]

Unwanted pregnancies are considered a public health problem that affects women's mental health and quality of life. The aim of this paper was to access university students' understanding and behaviours regarding unwanted pregnancies and identify their needs to prevent them. Qualitative descriptive design was used, and 13 semi-structured interviews were carried out. Women between 18 and 20 years old participated. They discussed a lack of training for themselves, their partners, and their families, their desire to have access to non-in-person health care resources, and their belief that contraception was expensive. Emotional aspects were relevant, affecting the way communication is established with those close to them and with health professionals. Despite the existence of access to sexual health resources, the findings show the existence of needs related to the prevention of unwanted pregnancies. The findings are presented grouping the main identified needs as "related to capability", "related to opportunity", and "related to motivation". Among the aspects to consider when designing interventions to prevent unwanted pregnancies are the feelings shown by these women, the inclusion of couples and family members in educational programs, and access to non-face-to-face health resources and less expensive contraceptive methods. Interventions for social support and understanding of women are necessary both to prevent unwanted pregnancies and to support adolescents with unwanted pregnancies by avoiding criminalization or blame. [ABSTRACT FROM AUTHOR]

Aims: We aimed to investigate the perspective of primary care nurses on their role with patients who have chronic cardiovascular disease and to identify cultural elements shared by nurses caring for people with chronic cardiovascular disease. In primary care, the role of the nurse is essential to promote self‐efficacy in cardiovascular self‐care. Individuals with chronic cardiovascular disease need to integrate the disease into their life, together with the health recommendations for management and follow‐up. Methods: A qualitative, focused ethnographic study was conducted. Purposeful sampling was used to include nurses who were working in primary care during the study. Data collection took place between 20 January and 20 May 2014 and consisted of semi‐structured interviews. A thematic analysis was applied using the data. Results: Eleven participants were included. Cardiovascular care forces nurses to reflect on their identity and role in primary care. The relationship between the nurse and people with chronic cardiovascular disease is a complex process, which may cause nurses to feel a sense of failure and monotony in their work. Conclusions: Our findings may help to understand the role of the nurse and the care provided in patients with chronic cardiovascular disease. Summary statement: What is already known about this topic? Primary care nursing is necessary for the improvement of cardiovascular risk factors.Chronic cardiovascular patients need training in self‐care.The organizational culture confers different forms of care to patients. What this paper adds? The vision of the socio‐cultural role of the family and community nurse is shown regarding cardiovascular prevention.Information is provided on the differentiating approach to chronic cardiovascular patients in primary care.Our study reflects the influence of routine care in nursing consultations, and what it entails to provide improved nursing care in cardiovascular patients. The implications of this paper: These findings can be used to understand the need to change the focus of nursing care in cardiovascular prevention.The implementation of a follow‐up protocol for the care of cardiovascular patients can improve patients' self‐care and reduce monotony in the nursing consultation.Further training and research is necessary regarding comprehensive chronic cardiovascular care within primary care services. [ABSTRACT FROM AUTHOR]

Initial needs assessment can be useful for obtaining information about the issues that should be addressed in newly launched intergenerational centers. However, there are few examples of how such studies should be conducted. This paper shares insights and lessons learned during a needs assessment study conducted nine months after the inauguration of an intergenerational shared site in Spain. In addition to presenting the needs identified, such as accurate and complete job descriptions, the paper offers methodological recommendations to practitioners embarking upon a similar needs study. The value of needs assessment as an educational endeavor is also highlighted. [ABSTRACT FROM AUTHOR]

Managing cultural diversity remains a challenge in secondary schools in Spain. In this paper, we approach cultural diversity from the standpoint of school counsellors, who are key professionals attending to immigrant pupils. Through the use of qualitative research techniques (semi-structured interviews and discussion groups), the strengths, weaknesses, opportunities, and threats are identified by counsellors. The findings show the need to implement pupil-focused responses sensitive to their cultural identity and based on the collaboration of all agents involved. Likewise, the school is defined as a privileged setting in which to celebrate cultural diversity and the pivotal role that counsellors play in this process is highlighted. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Coercive measures represent an ethical conflict because they limit the person's freedom, compromising their personal autonomy, self‐determination and fundamental rights.The reduction of the use of coercive measures implies not only regulations and mental health systems, but also cultural aspects, such as societal beliefs, attitudes, and values.There is evidence about the professionals' views on coercion in acute mental health care units and community settings, but they remain unexplored in inpatient rehabilitation units. What the paper adds to existing knowledge?: The knowledge about coercion varied from not knowing at all the meaning of the word, to a proper description of the phenomenon.Coercive measures are considered a necessary evil or normalized in mental health care and considered implicit to daily practice. What are the implications for practice?: The perceptions and attitudes towards coercion might be influenced by the knowledge about the phenomenon. Training of mental health nursing staff in non‐coercive practice could help professionals to detect, be conscious towards, and question coercive measures, thus orienting them to the effective implementation of interventions or programmes with evidenced effectiveness to reduce them. Introduction: Creating a therapeutic and safe milieu with the minimum coercive measures requires knowing professionals' perceptions and attitudes towards coercion, but they remain unexplored in medium and long‐stay inpatient psychiatric rehabilitation units. Aim: To explore the knowledge, perception and experience of coercion among nursing staff at a rehabilitation medium‐stay mental health unit (MSMHU) in Eastern Spain. Method: Qualitative phenomenological study including 28 face‐to‐face, semi‐structured interviews based on a script. Data were analysed using content analysis. Results: Two main themes were found: (1) therapeutic relationship and treatment in the MSMHU, which included three subthemes: qualities of the professionals for building the therapeutic relationship; perceptions about the persons admitted to the MSMHU; views of the therapeutic relationship and treatment in the MSMHU; (2) Coercion at the MSMHU, comprising five subthemes: professional knowledge; general aspects; emotional impact of coercion; opinions; alternatives. Discussion: Coercive measures are often normalized in mental health care and considered implicit to daily practice. A proportion of participants who did not know what coercion is. Implications for Practice: Knowledge about coercion might influence attitudes towards coercion. Mental health nursing staff could benefit from formal training in non‐coercive practice, facilitating the operative implementation of effective interventions or programmes. [ABSTRACT FROM AUTHOR]

This study sheds light on how to develop inclusive pedagogy in higher education, from the point of view of 42 inclusive faculty members from 6 Spanish universities. A qualitative methodology was used through semi-structured in-depth interviews. Data analysis was inductive, using a system of categories and topics. The results reveal that the faculty members which develop inclusive pedagogy in general have beliefs linked to the social model of disability and inclusive education approaches. They do not usually have specific training or knowledge about disability. They design their curricula in a flexible and open way to accommodate all students. They show a positive attitude toward students with disabilities and use diverse and participatory teaching methodologies, giving prominence to students. These data are consistent with those found in previous studies and offer keys to those faculty members who are interested in developing an inclusive pedagogy at the university. This paper examines in detail how faculty members of six faculties of educational sciences develop a theoretical framework comprising beliefs, knowledge, designs and actions. The research has found that faculty members hold beliefs about disability based on the social model of disability and inclusive approach. In general, inclusive faculty members' knowledge of disability and attention to diversity issues is scarce. The design of courses and teaching programmes led by inclusive university faculty is characterised by being open, flexible and providing clear and detailed information to students. Faculty who develop inclusive pedagogy use varied, participative and active methodologies, which are combined with a positive and approachable attitude towards students with disabilities. [ABSTRACT FROM AUTHOR]

Spanish legislation obliges the public administration to ensure equal opportunities and support for access to higher education for people with disabilities. This work has one central goal: to analyse and understand the causes for the potential inequality for people with disabilities in accessing higher education in Spain and the barriers they encounter during their academic life. This paper focuses on the differences in inclusive education between people with disabilities and people without disabilities by sex, age, and type of university. A mixed research design is used: qualitative research of two focus groups and fourteen interviews to sixteen students with disabilities; and statistical analysis of the Social Integration and Health Survey 2012, using two-way and multi-way cross-tables. There are significant differences between presence of disability and learning variables. Controlling by sex and age, almost every age-group is significant. Using sex as independent variable, and controlling by disability, there is no relationship with the variables relating to barriers to accessing education; therefore, the larger differences by sex are in the group of people without disabilities. [ABSTRACT FROM AUTHOR]

The WHO established that medication errors are the most common and preventable errors and represent an expenditure of 42 billion U.S. dollars annually. The risk of medication errors increases in transitions between levels of care, mainly from hospital care to primary healthcare after hospital discharge. In this context, communication is a key element in the safety of the medication reconciliation process. The aim of this paper was to describe the barriers to, and facilitators of, effective communication during the medication reconciliation process at hospital discharge in people over 65 years of age, from the perspective of primary healthcare professionals. A qualitative descriptive study was designed, and in-depth interviews were conducted with 21 individuals, of whom 13 were nurses and 8 were physicians. This study was carried out with healthcare professionals belonging to primary healthcare centres in Huelva (Spain). Following content analysis of the discourses we identified 19 categories, grouped into three areas: interlevel communication, communication between primary healthcare professionals, and communication between healthcare professionals and patients/caregivers. The barriers found mainly relate to the adequacy and use of technological tools, time available, workload and the level of collaboration of patients/caregivers. Facilitating elements for communication in medication reconciliation included technologies, such as computerized medical history, protocolization of clinical sessions, the presence of case management nurse and interdisciplinary teamwork. [ABSTRACT FROM AUTHOR]

Aim: The purpose of this study is to describe the experience of nursing care provided to the deceased organ donor by the nurse transplant coordinator. Methods: A qualitative exploratory study was conducted within the National Transplant Organization and the Regional Office for Transplant Coordination. A purposive sampling method was used. Data collection methods included semistructured interviews. Sampling and data collection were pursued until the researchers achieved information redundancy. A systematic text condensation analysis was performed. The Guba and Lincoln criteria for guaranteeing trustworthiness were followed. Results: A total of 16 participants were recruited, and three themes were identified regarding care of organ donors by the nurse transplant coordinator during the organ donation process: (a) fulfilling the desire and will of the donor patient; (b) the family as an extension of the donor; (c) coordinating the organ donation process. Conclusions: The donation process is both complex and delicate, and nursing care is an essential component. The care provided by the nurse transplant coordinator has the donor at the centre of the process, driven by respect for their decision. The family is seen as an extension of the donor. Nursing care should focus on continuous, honest communication, coordinating care with the intensive care unit, ensuring privacy and intimacy. SUMMARY STATEMENT: What is already known about this topic? Spain is the world leader in organ donation, with a rate of 48.0 donations per million population.The nurse transplant coordinator plays a significant role in the organ donation process, dealing with the difficulties of a tight schedule, in order to shorten ischemia times, while addressing grief, family decision making and donor care. What this paper adds? The hospital‐based nurse transplant coordinator is an essential role that links the donor's family and health professionals related to the donor hospital. Support within the nurse transplant coordinator team is key for organization and to prevent failure of the organ donation process.Donor care interventions are aimed at facilitating the donation process while maintaining the dignity of donors.The donor's family needs constant communication, based on reliable, empathetic and organized information. These results highlight family care as part of the donor care provided by nurse transplant coordinators, seen as an extension of the donor. The implications of this paper: This study captures the importance of the hospital‐based nurse transplant coordinator as the role able to provide donor centre care, ensuring the success of the organ donation process.Hospital structures and intensive care units (ICUs) must guarantee adequate spaces for communication with the family, respecting privacy and specific family needs.Maintenance and improvement of support among nurse transplant coordinators should be implemented to coordinate times and ensure the safety and success of the organ donation process. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Mechanical restraint is a common practice in mental healthcare settings in Spain, despite controversy.Mechanical restraint is perceived as a negative experience for nurses and service users.Mechanical restraint damages the nurse–patient therapeutic relationship, which is essential in providing quality care and promoting recovery. What the paper adds to existing knowledge?: The negative experiences of service users and mental health nurses arising from use of mechanical restraint affects both parties involved and results in trauma.Using mechanical restraint can provoke a moral injury in mental health nurses which can negatively impact on the establishment of trust within the therapeutic nurse–patient relationship. What are the implications for practice?: Nurses must be aware of the negative effects that mechanical restraint use has on both their practice and their day‐to‐day lives.Post‐mechanical restraint debriefing is required to repair the damage to the trust aspect of the nurse–patient relationship.Involving service users in co‐producing a debriefing framework may be a way to rebuild trust through constructive dialogue. Introduction: Mechanical restraint is an intervention that causes harm to service users and nurses, yet continues to be used in many countries, including Spain. However, there is a lack of research exploring Spanish mental health nurses' experiences of using mechanical restraint. Aim: To describe the experiences of mental health nurses who have used mechanical restraint in practice. Methods: A qualitative descriptive methodology was used and a purposive sample of 10 Spanish mental health nurses were interviewed about their experiences of using mechanical restraint. Thematic analysis was then employed to analyse interview data. Results: Participants' experiences of using mechanical restraint were mostly negative. Three main themes arose from the analysis of interview transcripts, (i) symmetrical trauma, (ii) moral injury and (iii) broken trust. Discussion: The use of restrictive practices, which can be perceived as counter‐therapeutic, exposes nurses to risks such as moral injury and service users to broken trust in the therapeutic nurse patient relationship. Avoiding empathy in order to use mechanical restraint is counterproductive, in the understanding that empathy is key to reducing this intervention. Implications for practice: Reducing or eliminating use of mechanical restraints should be a policy and practice priority due to the symmetrical harms it causes both nurses and service users. The trust aspect of the therapeutic nurse–patient relationship is a significant casualty when mechanical restraint is used, therefore involving service users in co‐production of post‐mechanical restraint debriefing can be an avenue for restoring this trust through dialogue. [ABSTRACT FROM AUTHOR]

This paper presents a study which aims to know what faculty members who develop inclusive pedagogy do to foster the inclusion of students with disability. Using a qualitative methodology, individual semi-structured interviews were conducted with 25 faculty members, who were recommended by their students with disabilities. The data were analyzed inductively through a categories and codes system. The results show the participants' experiences working with disabilities and the active and participatory methodological strategies used by the interviewees to ensure the participation of all the students, as well as some key elements to foster inclusion. Lastly, the participants offer some recommendations for other faculty members to move toward inclusion in the university. The conclusion section discusses the results of this work with those of previous studies, and offers some suggestions for further work in the scope of inclusive pedagogy and Higher Education. Faculty members need training and information on inclusive education to meet the needs of students with disabilities. Faculty members who develop inclusive pedagogy do not distinguish between students with and without disabilities, and treat all students in the same way. Active and participatory teaching methods are the most effective and beneficial for all students. Inclusive Faculty members recommend that other teachers become informed about disability, develop a good and close relationship with their students and value their abilities, not their limitations. [ABSTRACT FROM AUTHOR]

Grassroots social innovations are citizen-led initiatives that develop bottom-up solutions to societal challenges. Alternative food networks (AFNs) are innovations which propose alternative schemes for distribution and consumption of food—such as community-based agriculture or food cooperatives—which can improve the well-being of participants. Its potential for social work and social services has been recognised, but remains underexplored. This paper proposes a theoretical framework based on the capability approach in order to explore the impacts, drivers and factors at play in the expansion of well-being in participants in AFNs. This framework is applied to address seven cases of different kind of AFNs in Valencia (Spain) and to explore implications and strands of action so community social services can make use of AFNs. The study draws on information from thirteen interviews with participants of AFNs, local experts and policymakers; from secondary sources and from participant observation. It deductively uses the categories in the framework and inductively identifies specific capabilities, drivers and factors. The results show that AFNs expand well-being in several aspects of human experience. They are highly diverse, from more reformist to more radical, so they can mobilise different publics. Social services can benefit from this impact and diversity. [ABSTRACT FROM AUTHOR]

Purpose: Research findings provide the professional community with knowledge that enables to better understand healthcare interventions. Many authors point out that whilst these findings are valued, the findings are not always translated into healthcare practise. The purpose of the paper is to assess the applicability of the essential elements of an integrated palliative care system (IPCS) found in research into the practise of Osona Palliative Care System (OPCS). Design/methodology/approach: The study used a qualitative methodology with a case study design. In total, 24 health professionals were interviewed in Osona for the research, and the results were analysed using deductive content analysis. Findings: The study concludes that research findings can better be translated into specific contexts by incorporating the needs and characteristics of the system. The process could be a strategy for bridging the research–practise gap. Originality/value: Combining the findings from the study and the findings found in the literature reviewed led to the creation of the IPCS-elements-blended model of research and practise. Such a kind of mixed model could be used in other studies seeking to overcome the research and practice gap. [ABSTRACT FROM AUTHOR]

Purpose - The purpose of this paper is to analyze the relationship between Latin American migrants and the Spanish healthcare system, from the users' perspective, in order to examine the socio-cultural determinants for access and attention, as well as the possible difficulties faced when attending institutional facilities. Design/methodology/approach - This work is based on qualitative ethnographic research with the Latin American community established in the region of Castile and León, Spain. Analysis was established through a thematic approach and illustrated with the testimonies of participants involved, to inspect personal meanings and interpretations, as well as specific practices regarding healthcare. Findings - The encounter between foreigners and health services is frequently expressed with negative emotions, such as feelings of fear facing a system that is perceived as designed "for others." For many Latin American immigrants in Spain, institutional healthcare is not considered their first choice for treating illness. This has been related to economic, bureaucratic, ideological and emotional factors. Originality/value - Most of the existing literature about immigrant healthcare in Spain has focused on sanitary conditions or patterns of service use from an institutional perspective and a quantitative approach. This paper highlights the perceptions of users to enrich comprehension of the rapport betweenmigrants and medical care. [ABSTRACT FROM AUTHOR]

This paper aims at describing the eating experience of people diagnosed with and treated for laryngeal cancer. Going beyond the mere conceptualization of "after-effect" or the quantification of the disease's impact on the basis of standardized questionnaires, we present a qualitative analysis of the narratives of such experiences. Ethnographic study. Data is obtained from conversations, semi-structured interviews, participant observation, and written documents. A discourse analysis of the narrative information was conducted, with process coding and using the constant comparative method, inductive content analysis, category analysis, units of meaning associated with each other, and triangulation. The impact of cancer on eating processes is not limited to nutrition, but also affects the social and cultural value of food, which is put into question. The symbolic and social values which accompany the traditional way of eating are modified, which is connected with impaired quality of life. The impact on the eating process and its relationship with quality-of-life impairment are clear and connect with the importance of eating ways in culture and social organization. Greater attention should be paid to these contexts in clinical practice, which can affect even more than the impact on communicative processes. [ABSTRACT FROM AUTHOR]

Background: Accurate symptom monitoring is vital when managing pediatric asthma, providing an opportunity to improve control and relieve associated burden. The CHILDHOOD ASTHMA CONTROL TEST (C-ACT) has been validated for asthma control assessment in children; however, there are concerns that response option images used in the C-ACT are not culturally universal and could be misinterpreted. This cross-sectional, qualitative study developed and evaluated alternative response option images using interviews with children with asthma aged 4–11 years (and their parents/caregivers) in the United States, Spain, Poland, and Argentina. Interviews were conducted in two stages (with expert input) to evaluate the appropriateness, understanding and qualitative equivalence of the alternative images (both on paper and electronically). This included comparing the new images with the original C-ACT response scale, to provide context for equivalence results. Results: Alternative response option images included scale A (simple faces), scale B (circles of decreasing size), and scale C (squares of decreasing quantity). In Stage 1, most children logically ranked images using scales A, B and C (66.7%, 79.0% and 70.6%, respectively). However, some children ranked the images in scales B (26.7%) and C (58.3%) in reverse order. Slightly more children could interpret the images within the context of their asthma in scale B (68.4%) than A (55.6%) and C (47.5%). Based on Stage 1 results, experts recommended scales A (with slight modifications) and B be investigated further. In Stage 2, similar proportions of children logically ranked the images used in modified scales A (69.7%) and B (75.7%). However, a majority of children ranked the images in scale B in the reverse order (60.0%). Slightly more children were able to interpret the images in the context of their asthma using scale B (57.6%) than modified scale A (48.5%). Children and parents/caregivers preferred modified scale A over scale B (78.8% and 90.9%, respectively). Compared with the original C-ACT, most children selected the same response option on items using both scales, supporting equivalency. Following review of Stage 2 results, all five experts agreed modified scale A was the optimal response scale. Conclusions: This study developed alternative response option images for use in the C-ACT and provides qualitative evidence of the equivalency of these response options to the originals. Plain English summary: Accurate monitoring of the symptoms associated with pediatric asthma is important when managing the condition. The CHILDHOOD ASTHMA CONTROL TEST (C-ACT) is a questionnaire widely used to measure asthma severity in young children (aged 4–11 years). Each question answered by the child in the C-ACT has four possible answer choices. To help children answer, each choice is presented alongside an image of a male child's face ranging from sad to happy. However, there are concerns that the images used are not culturally universal and could be misinterpreted—due to difficulties translating to electronic formats and a lack of differentiation between the images used. Through interviewing children with asthma, we aimed to address these concerns by developing and testing new images. Alternative image options developed included simpler faces, circles of decreasing size and squares of decreasing quantity. Children aged 4–11 years old were interviewed to test whether they understood the response scale using the new images and if they answered in the same way as with the original images. Interviews were conducted in two stages, with expert guidance at key stages. Results showed that children can interpret and understand the newly developed images and that they answer the questions the same as they would using the original images. These new images have the advantages of being culturally neutral and easier to implement on an electronic device. [ABSTRACT FROM AUTHOR]

Background: The migratory flows in Spain have changed due to the arrival of a diverse migrant population. Among the new migrants the Latino collective predominate with more than half being women of childbearing age. There are no previous studies exploring breastfeeding experiences of migrants in a country where their mother tongue is spoken. This study aimed to explore Latina migrants' breastfeeding experiences in a Spanish-speaking country. Methods: A descriptive qualitative study was carried out in the main province in southern Andalusia between November 2019 and June 2020. The study used intentional sampling. The study participants were contacted by video calls and data were collected through a semi-structured in-depth interview (n = 19). The interviews were transcribed and analysed by thematic analysis. Results: The nineteen participants were aged between 22 and 43 years old and came from six different countries in Latin America. The two main categories that emerged were breastfeeding facilitators and barriers, divided into ten interrelated sub-categories: working conditions; precarious socioeconomic conditions; lack of support (health professionals, family and society); physiological changes, pain and fatigue; ignorance and wrong beliefs; support networks (partner, health professionals and family); host country versus home country; religious practices/worship; appropriate attitude, knowledge and experience; and breastfeeding support groups. Most of the study participants stated that their breastfeeding experiences were influenced by barriers such as work and by facilitators such as peer support. Conclusions: More support from caregivers and more sensitivity to cultural diversity were demanded by the women and well-trained professionals are needed to enable breastfeeding for a longer time. This paper provides caregivers, such as nurses, more knowledge about the care demanded by migrant women to ensure a longer breastfeeding experience. [ABSTRACT FROM AUTHOR]

This paper presents a research project carried out with participatory methodology in which the collaborative creation of an audiovisual has been the driving element of a complex process of inquiry about prison reality. The objective of the project is to describe, reveal and denounce how conjugal and family visits to inmates in prison take place. We have employed artistic co-creation and media literacy as facilitators of the participation of social groups without a voice. The project is structured as a qualitative case study. The participating group consists of six men in a Centre for Social Integration, the social worker and three researchers. The results discuss the possibilities offered by art as a viable social transformative practice. Likewise, the possibilities of art as social activism and as a facilitator of new forms of knowledge accessible to all are analysed. Finally, as a device of digital artivism, the audiovisual will be disseminated. [ABSTRACT FROM AUTHOR]

Background: In this paper, we illustrate the extent to which building an inclusive research team and the selection of a research topic, based on a collaborative group approach, constitute key elements of inclusive research. Method: The selection and analysis of activities and methodological strategies, extracted from the recordings of the research meetings, offer clues about the creation of collaborative and deliberative research spaces. Results: Some of the elements that reaffirm the inclusive nature of this research are as follows: contributions by all members of the research team receive equal recognition, the particular interests of all of those involved are taken into account and research strategies that are supported in different languages encourage the participation of all researchers. Conclusions: We need to review our practices in order to identify the added value of this type of work and move towards research training proposals that promote the research ownership of people with intellectual disabilities. [ABSTRACT FROM AUTHOR]

Aims and objectives: This study aimed to describe and understand the lived experiences and opinions of sub‐Saharan women living in Spain in relation to female genital mutilation. Background: Female genital mutilation is a bloody procedure with serious consequences for the health of women and girls. Understanding mutilated women's lived experiences plays a crucial role in the management of health consequences and could help healthcare professionals to provide assistance to these women. Design: A descriptive phenomenological study was carried out. The COREQ checklist was followed as guidance to write the manuscript. Methods: A total of 12 in‐depth interviews were conducted. Interviews were recorded, transcribed and analysed using ATLAS.ti 9.0. Results: Two themes with four subthemes were identified from the data analysis: 1) 'The traumatic experience of female circumcision' with the subthemes 'Female mutilation is a physical and psychological torture procedure' and 'recognising and coping with negative emotions'; 2) 'The fight for the eradication of female genital mutilation' which contains the subthemes 'the need for a real sociocultural change at the origin' and '"I want to be the last": Personal development leads to sociocultural change'. Conclusions: Female genital mutilation was experienced by women as a very aggressive and traumatic event. It causes considerable negative emotions that last over time. Although there is a tendency to reject the practice, in women's countries of origin, there is social pressure for girls to be mutilated. Relevance to clinical practice: Caring for women who have suffered from female genital mutilation requires awareness of the traumatic experience they underwent when they were girls. Healthcare professionals play a crucial role in eradicating female genital mutilation. Apart from education, preventive measures may include specific recommendations when girls are travelling to the country of origin and participatory action research. [ABSTRACT FROM AUTHOR]

Providing an inclusive education to students with intellectual disability in higher education is an emerging challenge. This paper presents the results of a research study that analyses the perceptions of graduates from the Promentor Programme (Universidad Autónoma de Madrid, Spain). The study follows a phenomenological design and employs qualitative research methodology. Two focus groups are conducted, with 14 participants in total. The participants' perspective is structured around the following categories: (a) Quality of life and training received; (b) barriers encountered; (c) supports received; and (d) lecturers' competences. In general, participants give their experience a positive assessment in relation to aspects such as social inclusion, professional and personal development or self-esteem. The study's conclusions highlight the convenience of an inclusive and qualitative research design that will serve to hear the voices of persons with intellectual disability, as well as their perception of the positive impact of university education on their lives. This article focuses on the perspective of Spanish university students with intellectual disability in order to understand their perceptions of their training experience in an inclusive higher education course. An inclusive research design is adopted which seeks to give voice to people with intellectual disability not only as participants, but also as members of the research team. The study confirms that, from the students' perspective, university environments can be suitable for the education of students with intellectual disability; therefore, the creation of inclusive higher education programmes should be encouraged. University lecturers should receive training in inclusive education. Higher education institutions must take into account the voices of vulnerable groups of students in order to effectively eliminate existing barriers. [ABSTRACT FROM AUTHOR]

This paper reviews the development of greenways/car-free trails as an alternative environmentally friendly communication system and assesses their strengths and weaknesses. It gives the results of a questionnaire survey of 1261 users along a 106-km greenway in Spain linking the Pyrenees with the Mediterranean Sea. Unlike previous studies, sampling was random and unequal probabilities of selection were properly accounted for. The results show a complex range of user profiles, tourist and non-tourist, their perceptions of the trail and some of the direct and indirect impacts of the greenway on the communities through which it passes. Management recommendations flowing from the survey are presented with the aim of increasing the use of accommodation services and businesses in the towns and villages near the greenway and helping create a more sustainable tourism system. The paper illustrates the potential importance of greenways in a future low-carbon tourism strategy adapting to climate change. [ABSTRACT FROM AUTHOR]

Background: Opioids are one of the most prescribed treatments for chronic pain (CP). However, their long‐term use (>3 months) has been surrounded by controversy, due to loss of beneficial effects. Objective: To explore the experiences of people with chronic non‐malignant low back pain in Spain undergoing long‐term treatment with opioids. Design: Qualitative study. Setting and participants: We conducted 15 semi‐structured interviews at the Pain Clinic with persons taking opioid treatment. Methods: The interviews were analysed by qualitative content analysis as described by Graneheim and Lundman, and developed categories and themes discussed in light of a biomedicalization framework. Main results: We developed one overarching theme—Living with opioids: dependence and autonomy while seeking relief—and three categories: The long pathway to opioids due to the invisibility of pain; Opioids: from blind date to a long‐term relationship; and What opioids cannot fix. Discussion: The long and difficult road to find effective treatments was a fundamental part of coping with pain, involving long‐term relationships with the health system. This study reflects the benefits, and drawbacks of opioids, along with struggles to maintain autonomy and make decisions while undergoing long‐term treatment with opioids. The paper also highlights the consequences of pain in the economy, family and social life of patients. Conclusions: Patients' experiences should be considered to a greater extent by health‐care professionals when giving information about opioids and setting treatment goals. Greater consideration of the social determinants of health that affect CP experiences might lead to more effective solutions to CP. [ABSTRACT FROM AUTHOR]

Accessible summary Relationships and sexuality are important for disabled people., Through the voices of 16 intellectually disabled adults, this paper shows what they consider to be important in areas such as education or personal relationships., Most of the people interviewed would like to have a partner and live together as a couple., Intellectually disabled people encounter many barriers to obtain certain basic rights., Summary This study starts from the premise that we are sexual beings, and therefore, sexuality is part of our lives and defines us as human beings. This is also true with regard to intellectually disabled people. Within the framework of broader qualitative research carried out in Spain, some partial results of an ongoing study aimed at finding out what a group of adults see as important in different areas of their lives are presented here. Through the personal narratives of 16 intellectually disabled people, this paper explores some of their ideas and demands about sexuality and their sexual lives. Most of the people interviewed expressed their desire to have a partner and to live as a couple. There is no doubt that many intellectually disabled people have greater control over their lives and the decisions that affect them, but as they tell us, the presence of old ideas can hinder them from securing their fundamental rights. [ABSTRACT FROM AUTHOR]

Chronic kidney disease (CKD) has considerable effects on the quality of life of female patients. Receiving the diagnosis and beginning renal replacement therapy (RRT) has a great personal impact on patients. The purpose of this study was to describe the experience of female patients with CKD at an ambulatory dialysis unit regarding diagnosis, life changes, and initiation of RRT. A qualitative exploratory study was conducted based on a social contructivism framework. Participants were recruited using purposeful sampling. In total, 18 women who received treatment for CKD with RRT were included. The women were attending the Ambulatory Dialysis Unit at a hospital belonging to the public health system of Madrid (Spain). Unstructured and semi-structured in-depth interviews, researchers' field notes, and women's personal letters were used. A systematic text condensation analysis was performed. The criteria used to control trustworthiness were credibility, transferability, dependability, and confirmability. Two themes emerged from the data: (a) A turning point in their lives, and (b) The emotional journey of beginning RRT. The diagnosis of CKD and the beginning of treatment implies changing routines and adapting to a new life with CKD. The first dialysis and puncture of the arteriovenous fistula is a major experience. Support from other CKD patients with more experience is perceived as a necessity and a tool to share their experiences and resolve doubts among peers. The diagnosis and initiation of RRT leads to numerous changes in the lives of women with CKD, which may influence the acceptance of treatment. [ABSTRACT FROM AUTHOR]

Nurse‐led digital transformation promotes nurses' participation and leadership in digital health. It also aims to improve the quality of care and patient satisfaction. The objective is to describe the priorities of nursing managers in the field of digital health and their beliefs related to the digital transformation led by nurses. The methodology used is a qualitative‐descriptive study. The data were collected by means of the implementation of playful‐reflective workshops. Open and/or closed questions were used, to which participants responded using their mobile phones, by capturing QR codes. A group of 32 nursing managers from the Spanish private hospital sector were invited to participate by means of purposive sampling. Data were analysed using the Braun and Clarke thematic analysis performed by two researchers independently. Of the 32 participants, 25 were women. The average age was 38 years. The main utility of the use of technology in health environments that they noted was innovation, followed by communication. Another utility mentioned repeatedly was that of visibility, considering digital media as a way to show the population the role of a nurse. They also noted time savings and error reduction. Moreover, as barriers to the implementation of technology, participants pointed out the lack of skills or equipment, institutional support, and the care burden. This study shows that nursing managers are aware of the need and benefits that nurse‐led digital transformation can bring about. These findings can pave the way for promoting a nurse‐led digital leadership culture. [ABSTRACT FROM AUTHOR]

Accessible summary: What is known on the subject?: Advance care planning (ACP) in mental health is a useful tool to avoid human rights violations in mental health settings. However, ACP is not yet a reality in the Spanish context.The advance healthcare directive (AHD) is a document reflecting healthcare preferences, drafted within the framework of the ACP process, to be applied in situations in which an individual's legal capacity may be questionable.No study has explored the viewpoint of Spanish mental healthcare professionals towards AHDs in the mental health field. Considering their extensive use, further study of providers' knowledge and attitudes is warranted. What does the paper add to existing knowledge?: The study adds knowledge about the viewpoint of Spanish mental healthcare professionals towards the implementation of AHDs in their clinical practices.This study illuminates the prevailing paternalistic provider–user relationship as the main barrier surrounding AHD management in terms of decision‐making.Our findings support the need for broader awareness, staff training regarding the documentation, the conversation process and communication skills, and personalized assistance in the mental health services to implement AHDs in everyday practice. What are the implications for practice?: Advance healthcare directives are a recovery tool that offers major information regarding mental health user preferences. Although they pose challenges for clinical practice, AHDs should be incorporated into interventional mental health care.Obtaining up‐to‐date perspectives held by mental healthcare professionals regarding AHDs allows the administration to determine the aspects requiring reinforcement.The implementation of AHDs in the Spanish mental health system requires macro‐ and micro‐changes, both ethically and structurally, so that mental healthcare professionals relinquish their paternalistic approach and embrace new ways of relating to users. Introduction: An advance healthcare directive (AHD) is a written document that contains a patient‐in‐care's will and preferences concerning the treatment options available to them, should they lack decision‐making capacity. AHDs are completed within a broader framework known as advance care planning. No study has explored the viewpoint of Spanish mental healthcare professionals towards AHDs. Aim: To explore the viewpoint of mental health professionals towards the implementation of AHDs in mental health. Method: A qualitative study was conducted using semi‐structured interviews that were thematically analysed. Findings: Three main themes were identified: care planning culture; barriers for the practical management of AHDs; and reasons to not honour patient‐in‐care AHDs. Discussion: Professionals find it pragmatically difficult to stop applying traditional paternalistic practices. To implement AHDs, improving the knowledge and awareness of AHDs and management of non‐technical skills through training is required. Such training should include users and families and allow for compliance with United Nations requirements. Implications for practice: Advance healthcare directives offer important information regarding user preferences, although they pose challenges for practices. Acquiring an up‐to‐date perspective on the attitudes of professionals towards AHDs allows organizations to attend to particular aspects that require reinforcement. Wider awareness, staff training and new ways of relating to users are necessary to implement AHDs in Spanish context. Relevance statement: A better understanding of the attitudes of Spanish mental health professionals towards AHDs was achieved. Despite the implementation of AHDs being an important and potentially beneficial initiative, mental health professionals find many pragmatic issues that need addressing before AHDs become a reality in their clinical practice. Wider awareness, staff training, personalized assistance and new ways of relating to users are required to implement AHDs in everyday practice. [ABSTRACT FROM AUTHOR]

Background: A prospective Population Risk Stratification (PRS) tool was first introduced in the public Basque Health Service in 2011, at the level of its several Primary Care (PC) practices. This paper aims at exploring the new tool's implementation process, as experienced by its potential adopters/users, ie. PC clinicians (doctors and nurses). Findings could help guide future PRS implementation strategies. Methods: Three focus groups exploring clinicians' opinions and experiences related to the PRS tool and its implementation in their daily practice were conducted. A purposive sample of 12 General Practitioners and 11 PC nurses participated in the groups. Discussions were digitally recorded, transcribed verbatim and analysed by two independent researchers using thematic analysis based on Graham et al.'s Knowledge Translation Theory. Results: Exploring PC clinicians' experience with the new PRS tool, allowed us to identify certain elements working as barriers and facilitators in its implementation process. This series of closely interrelated elements, which emerged as relevant in building up the complex implementation process of the new tool, as experienced by the clinicians, can be grouped into four domains: 1) clinicians' characteristics as potential adopters, 2) clinicians' perceptions of their practice settings where PRS is to implemented, 3) clinicians' perceptions of the tool, and 4) the implementation strategy used by the PRS promoter. Conclusions: Lessons from the implementation process under study point at the need to frame the implementation of a new PRS tool within a wider strategy encouraging PC clinicians to orientate their daily practice towards a population health approach. The PRS tool could also improve the perceived utility by its potential adopters, by bringing it closer to the clinicians' needs and practice, and allowing it to become context-sensitive. This would require clinicians being involved from the earliest phases of conceptualisation, design and implementation of the new tool, and mounting efforts to improve communication between clinicians and tool promoters. Graham et al.'s Knowledge Translation Theory proved a suitable framework to explore the implementation process of a new PRS tool in the public Basque Health Service's PC practice, and hence to identify implementation barriers and facilitators as experienced by the clinicians. [ABSTRACT FROM AUTHOR]

The COVID-19 has caused high morbidity and mortality in vulnerable people, such as those affected by chronic diseases, and case-management nurses (CMNs) are reference professionals for their health care and management. The objective of this study is to better understand the discourse, experiences, and feelings about the professional performance of CMNs during the pandemic. A qualitative study was conducted by conducting semi-structured interviews with CMNs (n = 31) from the province of Seville (Spain) and performing a narrative discourse analysis. The Atlas Ti 6.2 software program was used. Two categories were defined: 1. CMNs' competencies (76 verbatim testimonies); and 2. Consequences of the COVID-19 pandemic (61 verbatim testimonies). This study was granted due permission by the Research Ethics Committee belonging to the University of Seville, under protocol code: 1139-N-22. The pandemic caused an increase in CMNs' workload, and they had to assume their usual care tasks for vulnerable populations in addition to simultaneously prioritizing assistance in nursing homes. We can highlight CMNs' adaptation to the pandemic situation and to these new requirements in the context of their significant social commitment to the advanced practice of the profession, a commitment that is closely related to leadership. We should also indicate that interpersonal relationships were improved, and that there was technological progress. Some CMNs mentioned an increase in their workload and reported experiencing burnout syndrome. We conclude that CMNs' management of health care during the pandemic has been extraordinary, especially in regard to the most vulnerable populations of patients, including individuals with chronic diseases and institutionalized older adults, a fact that has been valued by the institutions and by society in general. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic imposed lockdown measures that affected caregiving. Understanding caregivers' context provides reveals their adaptive strategies to continue caring in this situation of uncertainty and isolation. Objective: To better understand the caregiving experiences of caregivers looking after dependent individuals living in the community during the pandemic. Design: Qualitative research, phenomenological approach. Setting: Primary healthcare centers in Madrid region (Spain). Participants: 21 family caregivers. Methods: Purposive and theoretical sampling was used to recruit caregivers across nurses from primary healthcare centers. Participants were interviewed using a semi-structured interview guide to explore the caring experience. Interview transcripts were evaluated using thematic analysis. Results: The findings were categorized into two themes: "Caregivers during lockdown—providing care in a time of adversity" and "Caregiving toward normality". The sub-themes identified were the re-structuring of before-care services and the introduction of new care approaches, managing the dependent person's health problems, looking after oneself, and dealing with adversity. To adapt to the new normal, strategies were put in place designed to recover confidence and trust, reincorporate assistance, and reconnect with others. Conclusions: Care intensified during the pandemic. Caregivers took on the task without assistance, focusing on preventing contagion and protecting themselves to be able to continue giving care. [ABSTRACT FROM AUTHOR]

This paper draws on findings from a European project, 'Rights through Alliances: Innovating and Networking Both Within Homes And Schools' (RAINBOW-HAS), conducted in 2013-15. It built collaboration between six EU countries to analyse and improve the rights of children and youth regarding sexual orientation and gender identity in educational settings. The main focus of discussion derives from a secondary discourse analysis following thematic analyses of the qualitative interviews undertaken with a range of different families, schools and community associations across these European countries, which provide a snapshot of contemporary practice. We discuss the relative silence of social work in challenging homophobic and transphobic bullying, given their potential in promoting family and young people's engagement. [ABSTRACT FROM AUTHOR]

Background: Effective communication with GPs (General Practitioners) enables higher rates of patient satisfaction and adherence to treatment plans. People with severe mental illness (SMI) and their caregivers present unique characteristics that present difficulties in the GP-carer-patient communication process. Aim: To explore the expectations of patients with SMI and their caregivers regarding GPs' communication skills in primary care consultations. Design & setting: Face-to-face interviews, using focus group methodology, which were undertaken in southern Spain. Method: Forty-two participants took part in 21 paired semi-structured interviews with an average duration of 19±7.2 minutes. Information was audio-recorded and transcribed verbatim. Qualitative content analysis was undertaken, obtaining a codification in categories by means of triangulation. Results: Four themes emerged from the analysis. Theme 1 was interviewer communication characteristics. The ability of GPs to use a language that was colloquial and adapted to each person was perceived as a determinant of the quality of care provided. An empathetic attitude, low reactivity, and efficient time management were the most valued communication skills. Theme 2 was telemedicine: telephone consultation and video consultation. The telephone consultation was perceived as a useful tool to care for people with SMI. Video consultation was valued as a requirement in isolated rural areas. Theme 3 was the role of the caregiver during the clinical interview. The caregiver was considered by the patients as an ally who improves the clinical interview. Theme 4 was the perceived barriers and facilitators during the clinical interview. The continuity of care, defined by a low turnover of GPs, determined the quality perceived by those who required care. Conclusion: Themes emerging from this study have suggested that people with SMI require an inclusive, collaborative, and personalised approach in the care they receive from the public health system. Improved communication between GPs and patients with SMI is an essential requirement for quality medical care. [ABSTRACT FROM AUTHOR]

Purpose: Long Covid syndrome is a multiorgan condition with multiple sequelae affecting quality of life, capacity to work and daily activities. The advantages that new technologies can offer are presented as an opportunity in the current healthcare framework. Objective: This research aimed to explore people with Long Covid's experiences with a digital physiotherapy practice intervention, during four weeks. Methods: Qualitative semistructured interviews were conducted by video call. Thirty‐two Long Covid participants were invited to join an in‐depth interview once the intervention was completed. Participants were queried on their intervention experiences and perceptions, as well as any lifestyle changes made, as a result of receiving digital physiotherapy practice. The interviews were transcribed and analysed using inductive qualitative content analysis. Results: In‐depth qualitative analysis has revealed four themes that reflect participants' perceptions of digital physiotherapy intervention. The helpfulness of the exercises, interaction with the physiotherapist, the domestic use of technology and the future of digital health practice were the topics highlighted by Long Covid participants. Some improvements have been suggested including video sounds and the need to introduce face‐to‐face sessions. Participants stated that interventions were helpful and superior to printed exercise sheets, mobile phone apps and usual care received. This intervention did not present major barriers, highlighting the importance of personalized care and continuity in the provision of health services. Conclusion: The digital physiotherapy practice is perceived by people with Long Covid as an appropriate method for the care of their health needs. Participants stated the need for this type of intervention in the public health system, where it would eliminate waiting lists, facilitate accessibility and improve existing care. Patient and Public Contribution: Participants contributed to the interpretation of the data acquired in the interview. Clinical Trial Registration: Trial registration NCT04742946. [ABSTRACT FROM AUTHOR]

Introduction: Fever stands out as the predominant clinical indicator in infancy. Pediatricians encounter fever routinely in their daily practice, playing a crucial role in their interactions with children and families. Objective: The aim is to examine pediatricians' viewpoints, understanding, and approaches regarding childhood fever in two healthcare settings: pediatric hospitalization (emergency and inpatient ward) and primary care. Methods: A qualitative study was conducted using an ethnomethodological approach. Pediatricians working in the specified pediatric settings participated in in-depth interviews where theoretical clinical cases were presented for analysis. Results: Following the examination of the discourses, the codes were organized into eight categories: Understanding of fever, Significance ascribed to fever, Therapeutic strategies, Engagement with the evidence, Family apprehensions regarding fever, Influence of the COVID-19 Pandemic, Inter- and intra-professional relationships, and Suggestions for change: Conclusions: Pediatricians acknowledge the importance of addressing discomfort in the treatment of fever, but express challenges in implementing these recommendations. Pediatricians in inpatient settings emphasize the need for enhanced parental education from primary care, while those in primary care recognize the potential for improvement. Inpatient pediatricians are open to implementing changes in their daily practices, particularly concerning the administration of antipyretics. [ABSTRACT FROM AUTHOR]

Suicide is a serious public health problem, with a global mortality rate of 1.4% of all deaths worldwide and the leading cause of unnatural death in Spain. Clinical simulation has proven to be a beneficial tool in training nursing students. Such experiences allow them to develop cognitive and affective skills that are fundamental for the detection of warning signs and the use of interventions in cases of people who want to take their own lives. Working in a mental health environment can be difficult for nursing students; therefore, the purpose of this study was to explore the perceptions of nursing students on the approach, management, and intervention of suicidal crisis through clinical mental health simulation. Methods: qualitative descriptive phenomenological study through focus groups and reflective narratives in a sample of 45 students. A thematic analysis was performed using ATLAS-ti. Results: After the analysis, three themes were obtained: (a) management and handling of emotions, (b) identification of suicide motives, and (c) intervention in suicidal crisis. Discussion: Clinical simulation in mental health allows students to exercise clinical judgment reasoning, detect warning signs for a better treatment approach, and provide tools for effective intervention and management of patient care. The results of this study indicate that nursing students face challenges in approaching mental health clinical simulation due to a lack of prior exposure. [ABSTRACT FROM AUTHOR]

Introduction. During the COVID-19 pandemic, there was a need to promote the most adequate behaviors. It is essential to know what aspects were implemented and what needs to be re-enforced. Objectives. (a) To identify the knowledge and behaviors related with preventive measures, lifestyle habits, sources of information, vaccination, and emotions generated and coping strategies and (b) to explore the personal experiences with respect to the knowledge, attitudes, and practices when facing COVID-19. Design. A convergent mixed method design. Setting and Participants. This study was conducted in the Segrià region (Catalonia, Spain) during the months of January and February 2022, with individuals 18 years old or older. Methods. Based on variables proposed by the WHO and a bibliographic review, an ad hoc electronic survey was utilized for the quantitative part, analyzed through frequency distribution or central tendency and dispersion measurements. For the qualitative part, two focus groups were analyzed through content analysis. Results. The participants (n QUAN = 1,559; n QUAL = 19) were aware about and applied the prevention measures, but when delving into it, deficiencies were detected especially when referring to hand-washing; lifestyles remained healthy; the population trusted the information from professionals (78.8%), but excess of information led to saturation; protection (75.3%) and herd immunity (47.2%) were recognized with vaccination; and the psychological impact (69.5%) was buffered with the activation of positive coping measures (99.1%), although it was maintained in more than half of them. Conclusions. This study showed that prevention measures must be re-enforced, especially hand-washing. Another revealing aspect was psychological impact, which, although coping measures were utilized, was maintained for another two years in most of them. This evidences the need for an intervention centered on this to guarantee the mental health of the population. Implications for Nursing Management. The detection of the current needs of the population provides the information necessary for the design of an adapted intervention and for promoting health education programs to address COVID-19 or other future health situations. [ABSTRACT FROM AUTHOR]

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Introduction: The COVID-19 pandemic caused an international health emergency situation where nursing took on a fundamental role. The high number of patients in hospital ICUs led to a shift in nurses' working conditions and workload. Objective: The objective of this study was to describe the experiences of nurses who worked in ICUs during the acute phase of the COVID-19 pandemic. Methodology: A qualitative, descriptive study was carried out, with the participation of 21 nurses who worked in the ICU during the pandemic. Data collection took place between May and July 2021 through 21 in-depth interviews. Results: Three main themes emerged: (1) COVID-19 in ICUs: nurses on the frontline. (2) United against adversity: teamwork. (3) New optics of critical care and the nursing profession. COVID-19 was perceived with harshness, and the lack of knowledge about the virus generated confusion, anxiety and fear due to the risk of transmission to family members and relatives. The pandemic marked a shift in the management of human, material and economic resources. Novice nurses learned critical care at an accelerated pace, with significant physical and psychological strain. Expert nurses carried the burden of training new nurses. Although there were tense situations, experiencing these adverse situations as a team led to feelings of increased belonging, togetherness and professional bonding for nurses. While the participants noted an increase in motivation to continue in their profession, they also had a feeling of not having been cared for as they deserve by healthcare institutions. [ABSTRACT FROM AUTHOR]

This research critically explores deficiencies in the palliative care system, focusing on evaluation and treatment aspects for both adult and paediatric patients. Using a qualitative methodology, the study engages healthcare professionals and family caregivers to uncover perspectives on the existing state of palliative care. Conducted through three focus groups and a semi-structured in-depth interview with participants recruited from Virgen de la Arrixaca University Clinical Hospital, this research illustrates critical issues, highlighting the insufficient healthcare workforce and resources to meet the comprehensive needs of patients and their families. Recommendations include holistic care addressing social, emotional, psychological, socio-familiar, and economic dimensions, supported by embedded support groups and the enforcement of relationships with palliative associations. This study also advocates for improved health institutional coordination, social worker support, and ongoing health professional satisfaction monitoring. In paediatric care, specific demands involve specialised units, medical team continuity, 24 h paediatrician care, and a more professional paediatric approach. Beyond problem identification, this study offers valuable insights for shaping health policies and tools, incorporating new indicators and introducing grief bereavement support in clinical reports, contributing to the advancement of patient evaluation in palliative care. [ABSTRACT FROM AUTHOR]

Introduction: Delirium in the pediatric population admitted to intensive care is a worrying reality due to its potential complications and the increase in associated costs. This study aims to explore the experiences of nursing staff of a Pediatric Intensive Care Unit after 15 months of starting a program to fight against childhood delirium in their unit. Methodology: A qualitative study was conducted through semi-structured interviews with Pediatric Intensive Care Unit (PICU) Key Informants. The Standards for Reporting Qualitative Research (SRQR) and the consolidated criteria for Reporting Qualitative Research (COREQ) were followed as quality measures for the study. Seven nurses (33% of the eligible population) from the PICU of a referral hospital were interviewed. Text transcripts were analyzed using the Interpretative Description and Qualitative Content Analysis method. Results: The interviewees indicated not identifying delirium as an important reality; with great deficiencies observed in what is related to the identification of delirium; identifying CAPD as an unreliable tool in their unit; and not sharing therapeutic objectives in this respect with the medical staff. Conclusions: The nursing staff presented a series of negative attitudes towards the phenomena of delirium in their unit, with gaps in training and in clinical management, and the diagnostic tool used, and did not see it as a priority objective of the unit, partly due to a resistance to change and a latent interprofessional communication conflict. A change at the formative, attitudinal, and relational levels is urgently needed for the success of the program and the well-being of the children in the unit. [ABSTRACT FROM AUTHOR]

Objective: To explore the perceptions and experiences of health professionals who participated in a multicomponent program for fibromyalgia (FM) patients based on health education, physical exercise and cognitive–behavioral therapy. Methods: In this qualitative, descriptive study that was based on a pragmatic and utilitarian approach, we conducted two focus groups (FGs) with 12 professionals (nurses and general practitioners) from the primary healthcare system of Spain who had been trained as FM experts. A thematic content analysis was carried out. Results: The findings were organized into four key domains, each with explanatory emerging themes. Overall, the professionals positively valued the program for the knowledge gain it offered, its integrated approach, the group effect and other benefits to patients. Work overload and peers' lack of acknowledgement of the program's value were identified as barriers. A reduction in the amount of content in each session, the creation of quality-of-care indicators and the promotion of the new professional role (FM expert) were proposed. Conclusions: The FM experts supported the program and recognized its usefulness. To implement the program within the primary healthcare system, the program needs to be adjusted to accommodate professionals' and patients' reality, and institutional health policies must be improved by providing training on FM to the healthcare community. [ABSTRACT FROM AUTHOR]

Older people are increasingly being cared for in the community across Europe. Dependent care in Spain largely remains a private issue involving family carers and migrant women from developing countries. Qualitative research on respite care has contributed to our understanding of respite as a subjective experience. Nonetheless, how care-givers relieve the burden of care is still not fully understood. Migrant care-givers are present in family life but their need for rest remains unseen. The aim of the study presented in this paper was to contrast family care-givers and migrant care-givers' strategies for relief from their caring role. Care-givers rest by thinking, doing and being but in a different manner from that of care-giving, that is: when they are a different person. To leave the life of care-giving is the general strategy that family care-givers use to rest from their care-giving selves while turning to one's own world describes the way migrant care-givers seek to relieve the burden of care. The comparative analysis shows that both strategies have in common the necessity to disconnect from the care-giving identity and that both migrant and family care-givers employ strategies that are false exits to a care-giving identity: they apparently relieve the burden of care. Respite goes beyond places, times and activities; as family care itself, it requires identity. [ABSTRACT FROM PUBLISHER]