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Gender differences exist in mental and physical health in schizophrenia, and healthcare education is part of the associated clinical approach. The main goal of the present paper is to describe a women's clinic for schizophrenia and carry out a narrative review about innovative healthcare and learning strategies in the context of women who suffer from schizophrenia, and to discuss innovative strategies for both healthcare and learning projects to be applied in this context. Observing the development of our unit, four clear innovation phases can be distinguished: the generation of new ideas (clinical and social needs), strategic planning (five observatories), the execution of these strategies (observatories/teams/interventions) and feedback, iteration and scaling. We found that the observatory for morbi-mortality adopted a retroactive proactive approach, and the observatory for hyperprolactinemia was proactive and deliberate. We describe the innovation aspects, both clinical and educational, as incremental. There was one exception, the introduction of a social exclusion and discrimination observatory, that from our perspective, was not gradual, but transformative. Future learning projects should include the role of social sciences and humanities and new technologies. Our pilot project gave us the opportunity to apply new learning methods to a relatively neglected field of care. [ABSTRACT FROM AUTHOR]

The Philippines is a source of labor for many countries. Roughly 10 million overseas Filipinos are working and living outside of the Philippines. This paper examines the association between sociodemographic characteristics (sex, age, educational level, and income) and self-rated physical and mental health, access to healthcare, and health habits among immigrant Filipinos living in Santa Cruz de Tenerife, Spain. Through convenience sampling, Filipino migrants (n = 103) aged 18 years and above participated in the online survey between October 2022 and March 2023. The data were analyzed using descriptive statistical analysis and chi-square. Almost all respondents self-rated their health as excellent and very good. Female respondents are more affected by mental health. Most are enrolled in the Universal Health System of Spain (public insurance). There is more utilization of private health insurance among respondents aged 60 years and above and high-wage earners. Cigarette smoking and alcohol drinking are associated with males. More than half of the respondents perform weekly exercise occasionally or never. These findings suggest a potential need for targeted interventions with an emphasis on the practice of preventive health and the promotion of healthy lifestyles, especially among financially disadvantaged migrants with lesser health access. [ABSTRACT FROM AUTHOR]

Pressure ulcers carry a significant risk in clinical practice. This paper proposes a practical and interpretable approach to estimate the risk levels of pressure ulcers using decision tree models. In order to address the common problem of imbalanced learning in nursing classification datasets, various oversampling configurations are analyzed to improve the data quality prior to modeling. The decision trees built are based on three easily identifiable and clinically relevant pressure ulcer risk indicators: mobility, activity, and skin moisture. Additionally, this research introduces a novel tabular visualization method to enhance the usability of the decision trees in clinical practice. Thus, the primary aim of this approach is to provide nursing professionals with valuable insights for assessing the potential risk levels of pressure ulcers, which could support their decision-making and allow, for example, the application of suitable preventive measures tailored to each patient's requirements. The interpretability of the models proposed and their performance, evaluated through stratified cross-validation, make them a helpful tool for nursing care in estimating the pressure ulcer risk level. [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]

Background/Objectives: The main outcomes of the COVID-19 pandemic can be used to assess the capability and sustainability of public healthcare and Long-Term Care (LTC) systems. This study aims to identify the population's demographic and socio-economic characteristics, as well as other national resources associated with the incidence and mortality of COVID-19, by comparing three European countries during the first pandemic period (Italy, Spain, and Germany). The results will identify possible strengths and weaknesses that could be considered as hints of the need for health and social intervention. Methods: Variables describing the countries' core demographics, socio-economic characteristics, and national resources were collected from 2001–2021 from well-established international databases. COVID-19 incidence and death figures from 1 March 2020 to 31 March 2021 were extracted from national health databases. Analysis focused on bivariate and weighted multivariable linear regressions between incidence, mortality, and socio-economic covariates. Results: Findings show that both care models and socio-demographic characteristics influenced the capability of the first year's response to the COVID-19 emergency. Formal public care appears to represent the most effective strategy against incidence and mortality regarding COVID-19, especially for older people, because it mitigates the adverse effects of socio-economic characteristics. Conclusions: Current strategies oriented towards privatizing care should, therefore, be considered critically, since they may result in weaker protection of vulnerable groups, such as frail older people, due to the unequal position of individuals with different socio-economic conditions in purchasing services from the care market. [ABSTRACT FROM AUTHOR]

Background: Developed countries report specific issues regarding the declining midwifery workforce, and their shortage could have serious consequences for women's sexual and reproductive health. The aim was to understand the perception of autonomy among midwives working in Spain, as well as factors related to their intention to leave the profession and their work environment. Method: A descriptive and cross-sectional study using an online questionnaire. Population: midwives working in Spain in any field (clinical, research, teaching, or management). Results: A sample of 1060 midwives was obtained. Of these, 53.7% (n = 569) feel autonomous in their work, 92.4% (n = 978) perceive that their profession frequently suffers from external interference, 46.6% (n = 494) have experienced sexist behaviors at work, and 53% (n = 561) have considered leaving the profession in the last year. Midwives with less than 10 years of experience (57.7%), those aged 31–45 years (59.8%), those with temporary contracts (38.3%), and those working in hospital care (71.9%) show a higher rate of considering leaving the profession (p < 0.001). Conclusions: Considering the current midwifery workforce crisis in Spain, it seems urgent to improve the working conditions of midwives to ensure the continuity and quality of women's sexual and reproductive healthcare. [ABSTRACT FROM AUTHOR]

Background/Objectives: The use of eHealth as a monitoring system in people with heart failure (HF) has been shown to be effective in promoting self-care and reducing re-admissions and mortality. The present study develops and evaluates the accessibility and usability of the web app iCardioMonitor HF monitoring system. Methods: This study consisted of two stages. The first stage (co-design) comprised two phases: (1) analysis of the scientific literature and expert opinions and (2) co-design of the iCardioMonitor (web app plus a knowledge-base algorithm) and definition of alert criteria. The second stage (cross-sectional descriptive study) analyzed system accessibility (% of people using the iCardioMonitor and % of parameters recorded) and usability, employing the Spanish version of the System Usability Scale for the Assessment of Electronic Tools. Results: The iCardioMonitor was configured by a web app and an algorithm with the capacity to detect decompensated HF automatically. A total of 45 patients with an average age of 55.8 years (standard deviation [SD] = 10.582) and an average time since diagnosis of 7.1 years (SD = 7.471) participated in the second stage. The percentage of iCardioMonitor use was 83.2%. The average usability score was 77.2 points (SD = 21.828), higher in women than men (89.2; SD = 1.443–76.0; SD = 1.443) (p = 0.004). The usability score was higher the shorter the time since diagnosis (r = 0.402; p = 0.025) and the higher the number of responses (r = 0.377; p = 0.031). Conclusions: The results obtained show that iCardioMonitor is a tool accepted by patients and has obtained a remarkable score on the usability scale. iCardioMonitor was configured by a web app and an algorithm with the capacity to detect decompensated HF automatically. [ABSTRACT FROM AUTHOR]

Background/Objectives. A notable decline in physical activity from late adolescence to early adulthood affects young women especially. This study aimed to investigate adherence to an unsupervised virtual-guided high-intensity interval training (HIIT) exercise program among young women in Spain. Methods. A total of 106 participants were recruited and randomized to the Women's Involvement in Steady Exercise (WISE) trial exercise program, administered remotely via a mobile app, and a control group. The primary outcome was adherence measured through daily steps. Secondary variables were patient-reported outcomes of physical activity, quality of sleep, and quality of life, assessed with the International Physical Activity Questionnaire (IPAQ), the Pittsburgh Sleep Quality Index (PSQI), and the Health Lifestyle and Personal Control Questionnaire (HLPCQ), respectively. The assessments were performed over 6 months, before the intervention (T0), at the halfway of the program (T1), and at the end (T2). Results. Daily steps revealed a decrease from baseline to final assessment in both groups. Secondary outcomes indicated a shift in physical activity levels, showing a transition from low to moderate and high activity perception. While sleep quality deteriorated post-intervention, quality of life showed no changes. Conclusions. The WISE trial highlights the potential and challenges of an unsupervised virtual-guided HIIT program for young women. While an improvement in physical activity levels was noticed, it also led to a decrease in daily steps and poorer sleep quality. These findings suggest a complex relationship between exercise and lifestyle factors, which could potentially have the greatest impact. [ABSTRACT FROM AUTHOR]

Background: Patients with advanced cancer often endure a heavy burden of symptoms, both in quantity and intensity. Complementary therapies offer potential relief in this challenging scenario. Increasing the number of randomized controlled trials provides a unique opportunity to generate rigorous data, which can be used to establish causal relationships and evaluate interventions; hence, nurses can strengthen evidence-based practices, leading to better patient outcomes and quality of care. Our study aimed to evaluate the impact of a 7-day pre-recorded music intervention on cancer symptoms and satisfaction in advanced-stage cancer patients receiving palliative care at home. Methods: This multicenter, double-blind, randomized, controlled clinical trial involved 80 Spanish cancer patients receiving palliative care at home, and was conducted from July 2020 to November 2021. The intervention group (n = 40) received self-selected pre-recorded music for 30 min daily over 7 days. The control group (n = 40) received pre-recorded basic health education sessions of equal duration and frequency. Symptoms and patient satisfaction were assessed before and after the intervention using the Edmonton Symptom Assessment System and the Client Satisfaction Questionnaire, respectively. Results: Comparing the intervention with the control group, significant improvements were observed in various symptoms: total symptom burden (p < 0.001), pain (p = 0.001), fatigue (p = 0.007), depression (p = 0.001), anxiety (p = 0.005), drowsiness (p = 0.006), appetite (p = 0.047), well-being (p ≤ 0.001), and sleep (p < 0.001); additionally, patient satisfaction was higher in the intervention group (p < 0.001). Conclusions: The 7-day pre-recorded music intervention reduced both physical and psychological symptoms in advanced-stage cancer patients receiving home-based palliative care, demonstrating significant alleviation of overall symptom burden and increased satisfaction with healthcare. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study is to describe and compare the levels of physical activity, preferences for leisure-time physical activity, and the frequency of non-sedentary behaviors of Portuguese, Italian, and Spanish students attending higher education. Methods: A total of 1354 students (21.2 ± 2.9 years) participated in the study, with data collected through an online questionnaire for 6 months. Results: The highest levels of sedentary behavior are found among Spanish students, followed by the Portuguese, and lastly the Italians. In relation to physical activity levels, Spanish students perform more low and moderate physical activity, while Italian students perform more vigorous activities and naturally have a lower level of sedentary behavior. Conclusions: However, it is worth highlighting that students from all three countries reach the minimum levels of physical activity recommended by the WHO. [ABSTRACT FROM AUTHOR]

Background: Health care is not exempt from harboring social inequalities, including in those countries with a universal public system. The objective was to ascertain whether the population's assessment of primary care (PC) changed between 2006 and 2016, the decade that included the economic crisis of 2008, and also if it exhibited patterns of social inequality in Barcelona (Spain). Methods: This was a cross-sectional study using Barcelona Health Surveys 2006 and 2016. Samples (4027 and 3082 respectively) comprised residents in Barcelona, over 15 years old. Dependent variable: Primary Care (PC) index. Independent variables: age, social class, and birthplace. Analyses included means and percentiles of PC index, and Somers' D test to compare the distribution of the groups. Results: Comparing 2016 with 2006, the distribution of the PC index remained in women (median of 73.3) and improved in men (from 70 to 73.3). By social class, the pattern of inequality observed in 2006 in men with perceived poor health status disappeared in 2016. Inequalities according to birthplace persisted in women, regardless of perceived health status, but disappeared in men. Conclusions: In the 10 years between which the global economic crisis occurred, the assessment of PC did not worsen, and it did improve for men, but the study points to the need for more focus on people born abroad. [ABSTRACT FROM AUTHOR]

Nurses play a critical role in caring for elderly patients; however, the emphasis on aging care in undergraduate programs may be insufficient. The present study aims at identifying the relevance given to theoretical and/or practical gerontological and geriatric contents in undergraduate study plans in Portugal and Spain. Presenting a two-part investigation, an integrative review approach examines nursing education on a global scale and a comparative analysis, using Bereday's comparative method, to assess the nursing curricula between Portugal and Spain. The search found 117 documents, with 16 being included. Studies covered diverse educational practices in geriatric and gerontological nursing, emphasizing curriculum development, faculty expertise, practical training, attitudes towards elderly care, and future directions. The comparative analysis of nursing curricula revealed that Portugal places a priority on building foundational theoretical knowledge in the first year and then gradually integrating practical training. In contrast, Spain emphasizes an extensive and integrated approach with a strong focus on practical skills and comprehensive assessments. Our research emphasizes the need to incorporate aging-focused education into nursing curricula and update the curriculum, providing hands-on training with early exposure to these environments. Additionally, simulation classes can enhance critical thinking by allowing students to experience aging effects firsthand. [ABSTRACT FROM AUTHOR]

Frailty is a common condition in older adults that negatively impacts health and quality of life. This study evaluated a comprehensive, personalised, and coordinated intervention under the value-based care approach to address frailty's multidimensional nature in older people in the primary care setting. It employed a pre–post randomised controlled design involving 242 frail individuals aged over 65 years living in the community in Valencia (Spain) between 2021 and 2023. Assessments were conducted at baseline, 12 months (immediately post-intervention), and 18 months. The intervention included a personalised care plan supported by technology, with monthly motivational follow-ups and plan updates by health professionals and participants. Outcomes were measured using an assessment questionnaire that included the International Consortium for Health Outcomes Measurement dataset for the older population: physical health, physical functioning, general mental health, satisfaction with social activities and relationships, ability to carry out usual social roles and activities, pain, general quality of life, loneliness, physical frailty, psychological frailty, and social frailty. The study found significant improvements in physical frailty, quality of life, reduced health resource use and hospitalisations and lower levels of pain and depression/anxiety compared to baseline. The findings suggest further research into value-based care approaches, emphasizing the development and activation of personalised, comprehensive programs for older individuals with frailty. [ABSTRACT FROM AUTHOR]

Background: New technologies have gained popularity, especially the use of mobile phone applications, in neurorehabilitation. The aim of this paper was (1) to develop a free mobile application (NeurorehAPP) that provides information about and helps to select the appropriate mobile application related to a list of neurological disorders (cognitive impairment, Alzheimer's disease, Parkinson's disease, multiple sclerosis, traumatic brain injury, stroke, cerebral palsy, muscular dystrophy, spina bifida, and facial paralysis), based on different objectives such as healthy habits, information, assessment, and treatment; and (2) to assess the feasibility, acceptability, and degree of satisfaction by physiotherapists after using NeurorehAPP for a minimum of three months. Methods: A free application was created to work with the Android® operating system. The degree of satisfaction and acceptance with the application was assessed with an adaptation of the Customer Satisfaction Questionnaire through a survey via email applied to physiotherapists from hospitals and neurological rehabilitation centers in Spain after using the application. Results: NeurorehAPP includes a total of 131 apps. A total of 121 physiotherapists completed a satisfaction survey. The total sample showed 85.41% satisfaction with the service provided by the app and 86.41% overall satisfaction with NeurorehAPP. Conclusions: NeurorehAPP is a free, intuitive, and friendly app used with the Android® operating system that allows the selection of the most appropriate app according to the type of user, neurological disorder, objective, and FDA criteria. Physiotherapists showed a high degree of satisfaction and acceptance with NeurorehAPP. [ABSTRACT FROM AUTHOR]

The aim of this study was to quantify the multivariate relationships between clinical, cognitive performance, executive functioning, and psychological outcomes in women with fibromyalgia (FMS) using network analyses. Demographic (age, height, weight), clinical (pain history, pain intensity, and related disability), neurocognitive (D2 Attention test, Rey-Osterrieth Complex Figure for visual perception, "Digits D/R/I" tests of the WAIS-IV battery for working memory, the 5-Digit Test for mental inhibition, the Symbol Search for processing speed and the Zoo Test for planning/decision making) and psychological (depressive symptoms, anxiety levels, sleep quality, pain hypervigilance) variables were collected in 129 women with FMS and 111 healthy women. Network analyses were conducted separately for each group to quantify the adjusted correlations between the modeled variables and to assess their centrality indices (i.e., connectivity with other symptoms in the network and their importance in the network). The network identified 74 associations in FMS women and 46 associations in controls with small differences. The strongest correlations in both groups were found between different attention variables: d2_CON with d2_C, d2_O with d_2TR, and d2_CON with d2_TA. The most central variables were d2_TA, d2_C, and d2_CON (highest strength centrality in both groups) and anxiety levels and pain hypervigilance (highest harmonic centrality in FMS women). The strength centrality of the network was stable for women with FMS (CScor0.7: 0.68) but not for healthy women (CScor0.7: 0.28). This study found that attention variables are most relevant within a neurocognitive network and that psychological variables are most important for the treatment of women with FMS. The clinical implications of the current findings, such as the development of treatments targeting these variables, are discussed. [ABSTRACT FROM AUTHOR]

Background: Cancer is a leading cause of morbidity and mortality globally. Dyspnea, affecting up to 60% of cancer patients, exacerbates physical and psychological distress, reducing quality of life. This study aims to explore the relationship between dyspnea and factors such as age, sex, clinical diagnosis, and treatment lines in cancer patients, with the goal of improving understanding and management of this debilitating symptom to enhance patient care and quality of life. Methods: This study employed an observational, cross-sectional, and descriptive approach to investigate patients with oncological disease at the University Hospital of Salamanca between March 2021 and April 2024. A convenience sample was selected, including patients over 18 years old with a pathological diagnosis of cancer, experiencing any degree of dyspnea, and who consented to participate by signing the informed consent. Exclusion criteria included lack of consent and clinical conditions that prevented an interview. The studied variables encompass sociodemographic (age, gender, diagnosis, tumor stage, number of treatment lines) and clinical aspects (daily activities, degree of dyspnea, functional capacity, physical performance), evaluated using the Barthel Index, the mMRC Dyspnea Scale, the ECOG Scale, and the Short Physical Performance Battery (SPPB). Data were collected through semistructured interviews and medical records, and analyzed using specialized software. This research has ethical approval CEiM Code 2023 12 1472, Reference 2024/01. Results: The mean age was 66.82 years. Lung cancer was predominant (60.2%), with most patients in stage 3 (65.7%) and receiving three treatment lines (68.7%). Higher age, advanced disease stage, and more treatment lines correlated with lower Barthel and SPPB scores, and higher ECOG and mMRC scores, indicating worse functionality, physical performance, and greater dyspnea. No significant correlations were found between gender or pathological diagnosis and the studied variables. Conclusions: Advanced age, higher disease stage, and more treatment lines are associated with decreased functionality, poorer physical performance, and increased dyspnea in cancer patients. Gender and specific cancer diagnosis do not significantly affect these relationships. Addressing dyspnea is crucial to improving the quality of life and physical performance in this population. Future studies should explore additional factors like treatment types and nutritional status. [ABSTRACT FROM AUTHOR]

In the healthcare field, the effective implementation of clinical protocols is crucial to ensuring patient safety and well-being. In this context, this study evaluates nurses' adherence to the maintenance and replacement protocol of peripheral venous catheters (PVCs) in a university hospital in Spain, examining the impact of compliance with the protocol on the loss of PVCs and on patient safety in addition to analyzing the related costs. A retrospective observational study was conducted with 590 patients who were admitted in 2018 and 2019. The chi-square test or Fisher's exact test, as appropriate, was used to see the association between the study variables; with the dependent variable being the loss of PVCs (including, as a dependent variable, the loss of PVCs before 48 h). The patients' electronic and physical medical records were reviewed to analyze nursing interventions related to the management of PVCs. A total of 24% of patients experienced PVC loss within the first 24 h after insertion. Failure to comply with the protocol resulted in 80% more catheter loss and increased the cost of cannulation by 46.84%. Low compliance with PVC care protocols significantly increases the risk of catheter loss, suggesting the need for increased training and strict protocol implementation. The findings emphasize the critical role of nursing in ensuring patient safety through adherence to evidence-based protocols. Continuing education and diligent protocol implementation are essential to reducing healthcare costs and improving patient outcomes. [ABSTRACT FROM AUTHOR]

A cross-sectional study was conducted with three aims: (1) to determine the degree of compliance with physical activity recommendations among adolescents according to sex and place of residence, (2) to determine the perceived support of family and friends for physical activity among adolescents according to sex and place of residence, and (3) to analyse the influence of family and friends support on compliance with physical activity recommendations among adolescents according to sex and place of residence. A total of 694 adolescents from an inland area of Spain (14.06 ± 1.27 years) participated. Four one-day physical activity questionnaires were administered to assess physical activity and the Parental Support Scale and Peer Support to measure perceived support from family and friends regarding physical activity. Chi-square, Crammer's V and Student's tests were calculated to identify differences between variables according to sex and municipality of residence. Moreover, the initial binary logistic regression model was constructed to predict the physical activity compliance. Differences in adherence to physical activity recommendations were found according to the sex of the students (rural area: x2 = 4.192, p < 0.05; V = 0.106, p < 0.05; urban area: x2 = 8.999, p < 0.05; V = 0.167, p < 0.01). There were also sex differences in rural areas on items related to families providing transport (t = 3.878, p ≤ 0.001; d = 0.40) and doing physical activity together (t = 4.974, p ≤ 0.001; d = 0.50). It is concluded that most adolescents do not comply with physical activity recommendations. In addition, 30.4% of urban girls' compliance was predicted by the perception that their family members saw them doing physical activity and doing it with friends. [ABSTRACT FROM AUTHOR]

(1) Background: To analyze the prevalence of physical activity (PA) according to the presence of overweight or obesity and other sociodemographic factors in the Spanish adult population. (2) Methods: Cross-sectional study using the European Health Interview Surveys for Spain from 2014 and 2020. (3) Results: In overweight and obese people, the percentage of those who reported not performing any type of PA remained constant between 2014 and 2020, while a statistically significant increase was observed in the percentage of people who walked for 10 min a day and exercised at least 2 days a week. The probability of being obese with respect to normal weight was higher in individuals who reported not engaging in PA during leisure time (OR 1.42; 95% CI 1.31–1.53), those who did not walk 10 min a day at least 2 days a week (OR 1.25; 95% CI 1.15–1.35), and those who did not exercise at least 2 days a week (OR 1.42; 95% CI 1.32–1.53). The probability of being overweight was higher in individuals who reported not performing PA during leisure time (OR 1.07; 95% CI 1.02–1.15) and in those who did not exercise at least 2 days per week (OR 1.15; 95% CI 1.09–1.22). (4) Conclusions: Small increases in PA have been observed in both overweight and obese individuals from 2014 to 2020. [ABSTRACT FROM AUTHOR]

The initial APEAS study, conducted in June 2007, examined adverse events (AEs) in Spanish Primary Healthcare (PHC). Since then, significant changes have occurred in healthcare systems. To evaluate these changes, a study was conducted in the Camp de Tarragona PHC region (CTPHC) in June 2019. This cross-sectional study aimed to identify AEs in 20 PHC centres in Camp de Tarragona. Data collection used an online questionnaire adapted from APEAS–2007, and a comparative statistical analysis between APEAS–2007 and CTPHC–2019 was performed. The results revealed an increase in nursing notifications and a decrease in notifications from family doctors. Furthermore, fewer AEs were reported overall, particularly in medication-related incidents and healthcare-associated infections, with an increase noted in no-harm incidents. However, AEs related to worsened clinical outcomes, communication issues, care management, and administrative errors increased. Concerning severity, there was a decrease in severe AEs, coupled with an increase in moderate AEs. Despite family doctors perceiving a reduction in medication-related incidents, the overall preventability of AEs remained unchanged. In conclusion, the reporting patterns, nature, and causal factors of AEs in Spanish PHC have evolved over time. While there has been a decrease in medication-related incidents and severe AEs, challenges persist in communication, care management, and clinical outcomes. Although professionals reported reduced severity, the perception of preventability remains an area that requires attention. [ABSTRACT FROM AUTHOR]

(1) Background: This paper aims to assess temporal trends (2016–2020) in incidence, patient's characteristics, complications, length of hospital stay (LOHS) and in-hospital mortality (IHM) among patients with and without idiopathic pulmonary fibrosis (IPF) undergoing lung transplantation (LTx). We also analyse the effect of the COVID-19 pandemic on LTx in these populations. (2) Methods: A retrospective, population-based observational study was conducted using the Spanish National Hospital Discharge Database. Multivariable adjustment was conducted with logistic regression to analyse the IHM. (3) Results: We identified 1777 admissions for LTx during the study period, of which 573 (32.2%) were performed in patients with IPF. The number of hospital admissions for LTx rose from 2016 to 2020, both in patients with and without IPF, but a marked reduction was observed from year 2019 to year 2020. Over time, the proportion of single LTx decreased and bilateral LTx increased significantly in both groups. The incidence of LTx complications increased significantly over time along with the increase in the incidence of IPF. No significant differences in the incidence of complications or in the IHM between patients with and without IPF were found. Suffering any complication of the LTx and pulmonary hypertension were conditions positively associated with IHM in patients with and without IPF. The IHM remained stable from 2016 to 2020 in both study populations and was not affected by the COVID pandemic. (4) Conclusions: Patients with IPF account for almost a third of all lung transplants. The number of LTx increased over time in patients with and without IPF, but a marked reduction was observed from 2019 to 2020. Although the proportion of LTx complications increased significantly over time in both groups, the IHM did not change. IPF was not associated with increased complications or IHM after LTx. [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]

Like other forms of domestic violence, child-to-parent violence (CPV) is a social and health-related problem. The identification of risk factors has preventive and therapeutic implications. This paper analyzes the risk profiles and gender differences of 206 CPV cases between 12 and 28 years of age (58% males) from clinical and judicial contexts in Spain, assessed using the Child to Parent Violence Risk (CPVR) Assessment tool. Two profiles were compared according to the extent of their violence: those using only CPV (specialist, 64.1%) and those also using other types of violence (generalist, 35.9%), as coded by professionals working with the cases. Generalist perpetrators had a significantly higher prevalence in terms of the bidirectionality of the violence (being victims at home), bullying victimization, empathy problems, anger management issues, attitudes justifying violence, antisocial behavior, failure of previous interventions, violence between parents, cohabitation problems other than CPV, problematic education style, and inversion of the hierarchy. Females were less likely to be generalists, and, in the case of female specialists, violence from parents and issues in the family context may have been among the main explanations for their violence. The results suggest differences between groups, which is consistent with previous research, but also the need for more accurate typological classification methods. [ABSTRACT FROM AUTHOR]

Combined oral contraceptives (COC) are a very popular form of birth control. Incorrect use and lack of adherence to treatment reduce the effectiveness of this method. Having a standard tool to identify poor-adherence profiles quickly and objectively can be helpful for midwives and potentially for COC users. The MMAS-4 adherence scale has been used in various medical fields, but there is little evidence of its potential in contraceptive consultation. This paper presents a piece of multicenter observational research based on a sample of 327 women who had attended contraceptive counselling in Spain and were COC users or had informed the midwife that they want to start to use this method. Two interviews were conducted: at the time of consultation and after one year. In our research, the MMAS-4 identified high-risk behaviors: during the 1-year follow-up period, COC users classified as poorly adherent had a significantly higher risk of missed contraceptive pills, more incidents and problems related to the method of contraception, as well as a lower degree of satisfaction with the contraceptive method. One case of unplanned pregnancy and two cases of emergency contraception were identified, all of them corresponding to poorly adherent women. The use of MMAS-4 in consultation can improve midwives' contraceptive counselling. [ABSTRACT FROM AUTHOR]

Although scales that evaluate postpartum stress exist, they lack specificity in maternal postpartum stress. The MPSS was created because there was a need to assess maternal stress during the postpartum stage. The introduction of the MPSS has enriched the evaluation tools for postpartum stress and has helped understand maternal stress at various postpartum time points and identify women at high risk for postpartum stress during this period. The aim was to translate the MPSS into Spanish and study its psychometric properties. Postpartum women (N = 167) with a mean age of 34.26 (SD = 4.71) were involved in this study. In addition to the MPSS, a battery of instruments was administered: a demographic sheet, the Birth Satisfaction Scale-Revised (BSS-R) and the Edinburgh Postnatal Depression Scale (EPDS). The MPSS data were analyzed, checking item communality first. As a result, three items showed unsatisfactory communality values (h2 < 0.40). Confirmatory Factor Analysis was conducted, comparing factor models using the full pool of MPSS items or the version without items with unacceptable communality. As a result, the original three-factor structure was endorsed on the Spanish MPSS, with better fit indices when removing items with low communality (RMSEA = 0.067, CFI = 0.99, TLI = 0.99). The reliability of this version was satisfactory (ω = 0.93). Finally, group comparisons for some perinatal variables were performed, showing no significant differences between groups of interest (p = 0.05 and above). To conclude, the MPSS will contribute to the existing literature, having a wider capacity to assess perinatal mental health difficulties in Spanish-speaking populations. [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]

The Chronic Disease Self-Management Program (CDSMP) focuses on a health promotion perspective with a salutogenic approach, reinforcing the pillars of self-efficacy. The aim of this study was to assess the impact of the CDSMP on Self-perceived Health (SPH) in disadvantaged areas of Asturias, España. The study included vulnerable adults with experience of chronic diseases for over six months, along with their caregivers. The intervention consisted of a six-session workshop led by two trained peers. SPH was evaluated by administering the initial item of the SF-12 questionnaire at both baseline and six months post-intervention. To evaluate the variable "Change in SPH" [improvement; remained well; worsening/no improvement (reference category)], global and disaggregated by sex multivariate multinomial logistic regression models were applied. There were 332 participants (mean = 60.5 years; 33.6% were at risk of social vulnerability; 66.8% had low incomes). Among the participants, 22.9% reported an improvement in their SPH, without statistically significant sex-based differences, while 38.9% remained in good health. The global model showed age was linked to decreased "improvement" probability (RRRa = 0.96), and the "remaining well" likelihood drops with social risk (RRRa = 0.42). In men, the probability of "remaining well" decreased by having secondary/higher education (RRRa = 0.25) and increased by cohabitation (RRRa = 5.11). Women at social risk were less likely to report "remaining well" (RRRa = 0.36). In conclusion, six months after the intervention, 22.9% of the participants had improved SPH. Age consistently decreased the improvement in the different models. [ABSTRACT FROM AUTHOR]

(1) Background: This systematic review presents an overview of psychological interventions in suicide published between 2013 and 2023 in Spain and Japan, sparked by Spain's alarming recent increase in suicide rates and the potential exemplar of Japan's reduction efforts. (2) Methods: Following the PRISMA checklist, the databases Web of Science, Scopus, PubMed, and PsycInfo were searched using the terms [("suicide" OR "suicidal behavior" OR "suicidal attempt" OR "suicidal thought" OR "suicidal intention") AND ("prevention" OR "intervention" OR "psychosocial treatment" OR "Dialectical Behavior Therapy" OR "Cognitive Therapy" OR "psychotherap*")] AND [("Spain" OR "Spanish") OR ("Japan" OR "Japanese")]. We included articles published in peer-reviewed academic journals, written in English, Spanish, and Japanese between 2013 and 2023 that presented, designed, implemented, or assessed psychological interventions focused on suicidal behavior. (3) Results: 46 studies were included, concerning prevention, treatment, and training interventions. The risk of bias was low in both Spanish and Japanese studies, despite the lack of randomization of the samples. We identified common characteristics, such as psychoeducation and coping skills. Assertive case management was only highlighted in Japan, making an emphasis on active patient involvement in his/her care plan. (4) Conclusions: The findings will help professionals to incorporate into their interventions broader, more comprehensive approaches to consider more interpersonal components. [ABSTRACT FROM AUTHOR]

(1) Background: The role of the nurse case manager is unknown to the population. The main objective is to analyze the existing differences within the national territory in order to make known the situation in Spain with a view to the recognition of its functions and the creation of the professional profile in an equal manner. (2) Methods: A scoping review was conducted in order to achieve the main aim. Selected articles were subjected to a critical reading, and the levels of evidence and grades of recommendation of the Joanna Briggs Institute were verified. The search field was limited to the last ten years. (3) Results: Case management models are heterogeneous in different autonomous communities in Spain. Case nurse management is qualified for high-complexity patients, follow up on chronic patients, and coordinate health assistance. (4) Conclusions: It concludes that nursing's role is crucial in the field of case management, being required in the follow-up of chronic patients of high complexity. Despite the proven health benefits, efficacy, and efficiency of case management, there are many heterogeneous models that coexist in Spain. This involves a restriction in the development of a nursing career because of the lack of a definition of its functions and competences. [ABSTRACT FROM AUTHOR]

Pelvic floor dysfunction comprises various disorders, including urinary incontinence, fecal incontinence, pelvic organ prolapse, and chronic pelvic pain. This study aimed to evaluate health-related quality of life (HRQoL), anxiety, depression, sleep disturbance, and sexual functioning in women with pelvic floor dysfunction of colorectal etiology compared with control women. Patients were recruited from a specialized colorectal unit and controls were selected from among the patients' friends and relatives. Sociodemographic and clinical data were collected. Pelvic floor dysfunction distress and impact, HRQoL, depression, anxiety, insomnia, and sexual functioning were assessed using the following validated questionnaires: Short-Form Pelvic Floor Distress Inventory (PFDI-20), Short Form Pelvic Floor Impact Questionnaire (PFIQ-7), 36-Item Short-Form Health Survey (SF-36), Beck Depression Inventory II (BDI-II), Beck Anxiety Inventory (BAI), Insomnia Severity Index (ISI), and Changes in Sexual Functioning Scale (CSFQ). Statistical analyses included Welch's t-test, Fisher's exact test, and Spearman's correlation coefficients. Eighty-four patients and 57 controls were included. Compared with controls, patients were more likely to be obese or overweight, have had higher numbers of deliveries, more vaginal deliveries, more frequent use of forceps, and have had more associated comorbidities, mainly in the urinary, neurological, and psychiatric domains. As expected, patients scored significantly higher than controls on both the PFDI-20 and PFIQ-7 and their respective sub-scales, with the highest mean values in the patient group on the sub-scales related to the colorectal–anal domain. QoL, depression, anxiety, insomnia, and sexual functioning were significantly worse in patients than in controls (p < 0.0001 in every case). In patients, PFIQ-7 scores correlated significantly with HRQoL (p < 0.001 for the physical component and p < 0.01 for the mental component), depression (p < 0.001), anxiety (p < 0.001), insomnia (p < 0.05), and sexual functioning scores (p < 0.05). Colorectal pelvic floor dysfunction had a markedly deleterious impact on the HRQoL, depression, anxiety, sleep disturbance, and sexual functioning of patients. It is concluded that colorectal pelvic floor dysfunction exerts a considerable burden on patients' lives. Addressing these issues in clinical settings could significantly improve patients' well-being. [ABSTRACT FROM AUTHOR]

(1) Background: Healthy aging is the process of developing and maintaining functional capacity and optimizing involvement in order to improve one's quality of life as people age. This study aimed to encourage healthy aging in people with cognitive impairment, as well as a control group, via the use of the Nintendo Switch combined with occupational therapy sessions, aiming to improve gross and fine motor skills, functionality, quality of life, and cognitive status. (2) Methods: A randomized clinical trial was undertaken. The sample was randomized using the OxMar software program Attribution 4.0 International, facilitating the division into a control group (CG), who received conventional occupational therapy sessions, and an experimental group (EG), who received therapy incorporating the Nintendo Switch, in addition to conventional occupational therapy sessions. The intervention period with the Nintendo Switch lasted for 8 weeks. (3) Results: Thirty-two participants were included in the study. Significant differences were found in the vast majority of the variables analyzed, which shows an improvement following the intervention; these improvements were mainly observed in measures of skill and the perception of quality of life. (4) Conclusions: An eight-week intervention with the Nintendo Switch alongside conventional occupational therapy helps to maintain cognitive status and functional independence. Following 8 weeks of intervention with the Nintendo Switch, improvements in gross motor dexterity, fine motor dexterity, and quality of life were observed in older people with cognitive impairment. [ABSTRACT FROM AUTHOR]

The well-being of people is a key aspect of the field of psychology. Hence, it is important to analyse the variables that are related to life satisfaction and happiness as perceived by individuals and that, therefore, increase their overall well-being. The main objective of this study was to analyse the predictive capacity of emotional intelligence and perceived social support on both the level of life satisfaction and perceived happiness. A total of 380 psychology students completed the Trait Meta Mood Scale, the Multidimensional Scale of Perceived Social Support, the Satisfaction with Life Scale, and the Subjective Happiness Scale. The results show that both emotional intelligence and social support are related to and predictive of subjective happiness and life satisfaction. The importance of developing the components of emotional intelligence and promoting an adequate social network in young people is highlighted. [ABSTRACT FROM AUTHOR]

The experience of menstruation is often associated with negative connotations and gender stereotypes, which results in making it invisible. This research aimed to explore the perceptions, beliefs, and knowledge of young Spanish women regarding the menstrual cycle and menstruation and their impact on their lives. The study delves into their understanding, menstrual management practices, the types of menstrual products employed, and their experiences related to menstrual health. Qualitative methodology was used with discussion groups as a data collection technique. The participants comprised 45 young Spanish women, aged between 18 and 23, hailing from both rural and urban areas. The majority were university students, with some engaged in part-time work, and one participant working full-time. While many experienced menstrual pain ranging from mild to debilitating, a normalization of this pain often led them to forego seeking specialist assistance. Disposable menstrual products (DMPs) are the most used by participants, despite limited awareness of their absorption capacity. Regarding reusable menstrual products (RMPs), menstrual cup users emphasized comfort but expressed a need for proper training. Negative menstruation experiences could evoke fear and difficulties, underscoring the importance of providing comprehensive menstrual health education encompassing both theoretical and practical components. [ABSTRACT FROM AUTHOR]

This document analyzes a survey conducted in three geographical areas in Spain, focusing on centers for individuals with cerebral palsy (CP). The study aims to determine the adherence rate to recommended physical activity guidelines, assess if there is a decline in interest in physical activity over time, identify the stage at which this decline occurs, and explore potential mechanisms, tools, or strategies to sustain long-term engagement in regular physical activity for this population. The 36-item questionnaire comprises multiple-choice, open-ended, and Likert scale-type questions. Data were collected on physical activity frequency and duration, daily living activities, and demographics. Statistical analysis identified patterns and relationships between variables. Findings reveal that only a 17.6% meets the World Health Organization (WHO) recommendations regarding regular physical activity (RPA), decreasing in frequency or number of days a week, (3.7 d/w to 2.9 d/w; p < 0.01) and duration (50.5 min/d to 45.2 min/d; p < 0.001) with age, especially for those with higher Gross Motor Function Classification System (GMFCS) mobility levels. Obesity slightly correlates with session duration (ρ = −0.207; p < 0.05), not mobility limitations. Gender has no significant impact on mobility, communication, or physical activity, while age affects variables such as body mass index (BMI) and engagement (p < 0.01). A substantial proportion follows regular physical activities based on health professionals' advice, with interest decreasing with age. To improve adherence, focusing on sports-oriented goals, group sessions, and games is recommended. These findings emphasize the importance of personalized programs, particularly for older individuals and those with greater mobility limitations. [ABSTRACT FROM AUTHOR]

This study aims to describe a local community expert's perspective on the identification of and access to children's health assets and to gather proposals to promote children's health and well-being within their community. The health asset approach is essential for health promotion, and there is evidence of its benefits to individuals' or communities' health when this approach is observed. Children's health assets are gaining increasing interest, but the literature that captures the perception of professionals working with children is scarce. Qualitative research designed with Delphi methodology was carried out with the participation of 25 professionals working in a neighbourhood with children and families. The participants stated that this neighbourhood was a good environment for the healthy and happy growth of children but pointed out that there were inequities. They emphasised the importance of economic and physical security and feeling loved. The absolute best aspects of the neighbourhood according to these experts were its support networks, mutual help, educational and health services, and green spaces, and the most deficient aspects were the possibility of a hopeful future and emotional support within the family unit. Poverty and/or the scarcity of economic resources were identified as the main barriers to accessing health assets. Special difficulties in access to health for migrant and Roma children were also identified. The panel of experts made concrete action proposals. It was recommended to support resources and services that already exist in their community. The experts prioritised work with families, education, working in conjunction with vulnerable groups, community participation, and networking. [ABSTRACT FROM AUTHOR]

Background: The widespread adoption of mobile devices by adolescents underscores the potential to harness these tools to instill healthy habits into their daily lives. An exemplary manifestation of this initiative is the Healthy Jeart app, crafted with the explicit goal of fostering well-being. Methodology: This study, framed within an applied investigation, adopts an exploratory and descriptive approach, specifically delving into the realm of user experience analysis. The focus of this research is a preliminary examination aimed at understanding users' perceived usability of the application. To glean insights, a comprehensive questionnaire was administered to 101 teenagers, seeking their evaluations on various usability attributes. The study took place during 2022. Results: The findings reveal a considerable consensus among users regarding the evaluated usability aspects. However, the areas for improvement predominantly revolve around managing the information density, particularly for a subset of end users grappling with overwhelming content. Additionally, recommendations are put forth to streamline the confirmation process for user suggestions and comments. Conclusion: This analysis illuminates both the strengths of the app and areas ripe for refinement, paving the way for a more user-centric and efficacious Healthy Jeart application. [ABSTRACT FROM AUTHOR]

This was a prospective observational study based on clinical simulation courses taught in 2017 at the IDEhA Simulation Center of Alcorcón Foundation University Hospital. Two courses in metabolic emergencies (MEs) and respiratory emergencies (REs) were offered to primary care physicians all over Spain. The main objective was to teach nontechnical skills (crisis resource management). Using a modified five-level Kirkpatrick–Phillips education evaluation model, level I (reaction, K1), level II (learning, K2) and level III (behavioral change, K3) changes were evaluated through surveys at the end of the courses and one year later. Thirty courses were held (15 ME courses and 15 RE courses) with 283 primary care physicians. The overall satisfaction (K1) was high: ME courses, 9.5/10; RE courses, 9.6/10. More than 80% of the participants rated the organization, resources, content, debriefing and scenarios as excellent, with no significant differences between the two courses. After one year (156 responses), the respondents for both courses reported that they would repeat the training annually (K2), encourage debriefing with colleagues (K3) and have modified some aspects of their workplace (K3), citing improvements in procedures and in the organization of the health team as the most important. After the ME course, few participants, i.e., 5 (6%), reported providing improved care to patients; after the RE course, 15 (19%) participants reported providing improved care; the difference between groups was significant (p < 0.05). Compared with the ME course, the RE course imparted greater knowledge about patient safety (K2) (38 (49%) vs. 24 (31%) (p < 0.05)) and more useful tools for daily clinical practice (K3) (67% vs. 56.4%) and resulted in participants paying more attention to personal performance and to colleagues when working as a team (K2) (64% vs. 50%). Clinical simulation courses are highly valued and potentially effective for training primary care physicians in patient safety and CRM tools. Future studies with objective measures of long-term impact, behavior in the workplace (K3) and benefits to patients (K4) are needed. Based on the results of our study, the areas that are important are those aimed at improving procedures and the organization of health teams. [ABSTRACT FROM AUTHOR]

Introduction: The psychometric properties of the Satisfaction With Life Scale (SWLS) have been evaluated across numerous languages and population groups, primarily from a factor analysis perspective. In some studies, inconsistencies in structural invariance have been identified. Objective: This study aims to analyze the properties and gender invariance of the SWLS from a network analysis perspective. Method: A total of 857 Spanish university students were obtained through a stratified random cluster sampling method in a cross-sectional survey design study. Descriptive analysis of the items, partial-correlation network, Bayesian network model estimation, and invariance analysis by gender were conducted. Results: The instrument did not exhibit any floor or ceiling effects. Each item can be considered univariately normally distributed, and all items clustered in a single and stable community. The partial-correlation network model and centrality measures were stable in the full sample and invariant across genders. Item 3 emerged as the most central node in the network with the highest predictability. The Bayesian network indicated that items 2 and 4 initiate the process, while item 5 acts as the sink, and items 1 and 3 act as mediators. Conclusions: The SWLS can be used as a unidimensional measure, and the total score and relationships among items are stable and reliable. Any potential differences among genders cannot be associated with the functioning of the instrument. The predictability of every item was high, and the Bayesian network clearly identified different roles among the items. [ABSTRACT FROM AUTHOR]

The Interpersonal Exchange Model of Sexual Satisfaction proposes that sexual satisfaction can be explained by the balance of sexual rewards or costs exchange. The Interpersonal Exchange Model of Sexual Satisfaction Questionnaire (IEMSSQ) was developed from this model. The IEMSSQ includes the Reward/Costs Checklist (RCC). The RCC assesses different sexual exchanges that are categorized into sexual rewards and/or costs. Analyses and comparisons of sexual rewards and costs in the Hispanic cisgender population based on gender (man or woman) and sexual orientation (heterosexual and homosexual) with this measure have not been conducted. The main goal was to analyze and rank the sexual rewards, costs, and both, indicated by a sample of 1996 Hispanic partnered participants (heterosexual men, gay men, heterosexual women, and lesbians). The predominant sexual exchanges that were reported involved emotional aspects, both as rewards and costs. When participants indicated that the exchange was both a reward and a cost, they were referring to aspects specifically related to the sexual relationship itself. Heterosexual men and women had greater rewards and higher costs, respectively. Gay men obtained a greater number of items reported as rewards and costs. The results provide further insight into sexual satisfaction related to gender and sexual orientation. [ABSTRACT FROM AUTHOR]

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]

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]

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]

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]

Background: The display of compassionate care by palliative care professionals is of the utmost importance to the patients, their families, and even to their own professional well-being. Lately and, especially due to the emergence of the COVID-19 pandemic, palliative care professionals have been subjected to greater pressures stemming from their work environment, organizational standpoint, and emotional sense of view. Not only have these factors made it harder for professionals to deliver compassionate care to their patients, but they have also decreased their overall well-being. The aim is to study how sociodemographics, workplace characteristics, internal resources, and the COVID-19 pandemic-derived pressures have affected the professionals' capacity to perform compassionate care and their well-being while at the same time exploring the relationship between compassionate care and well-being. Methods: This study used a cross-sectional design with data gathered from Spanish palliative care professionals. The final sample was formed by 241 participants. They were surveyed about compassion, professional quality of life, well-being, sociodemographic data, working conditions, self-care, and coping with death competence, and the impact of the COVID-19 pandemic. The analyses used were descriptive statistics, bivariate tests, and the construction of a structural equation model. Results: Compassion was predicted by the ability to control their workload and the ability to cope with death. Burnout was predicted by age, workload, workload control, self-care, material resources, and changes in teamwork. Moreover, compassion, age, workload control, and changes in teamwork and self-care were shown to significantly predict compassion satisfaction. When it comes to compassion fatigue, different variables were shown to predict it, those being compassion, control over the workload, social self-care, and the ability to cope with death. Conclusions: Having a healthy lifestyle and an adequate social support system is key to maintaining professional well-being in the case of palliative care professionals. Inner resources such as the ability to perform self-care and the capacity to cope with death are of vital importance to taking care of these professionals. Thus, it would be beneficial to establish training programs focused on these aspects in the myriad of sanitary centers that perform these tasks, as these abilities are necessary to withstand the work-related pressures and, at the same time, be able to provide compassionate care for patients. [ABSTRACT FROM AUTHOR]

Dating violence constitutes a serious social and health problem. This study aims to increase knowledge on dating violence in emerging adulthood by analysing the relevance of gender and of having or not having a current partner in the victimization and perpetration of such violence. It also analyses the association between dating violence and mental health, as well as the relevance of traditional gender role attitudes and the internalization of feminine/expressive and masculine/instrumental traits in the victimization and perpetration of such types of violence. The participants were 930 Spanish emerging adults who were assessed by six self-report questionnaires and scales. Men reported more psychological and physical violence victimization and physical violence perpetration than women, and women and men without a current partner reported more psychological and sexual violence than women and men with a current partner. Dating violence victimization was associated with more mental symptomatology, less life satisfaction, and lower self-esteem in men with a current partner and in women without a current partner. The main predictor of dating violence victimization was dating violence perpetration, and the main predictor of dating violence perpetration was victimization by such violence. More traditional gender role attitudes also predicted greater victimization and perpetration of dating violence, except among women without a current partner. [ABSTRACT FROM AUTHOR]

The objectives of this review were to identify the population groups most frequently studied, to determine the methods and techniques most commonly used to show health inequities, and to identify the most frequent socioeconomic and health indicators used in the studies on health inequities due to socioeconomic inequalities that have been carried out on the Spanish healthcare system. A scoping review was carried out of the studies conducted in the Spanish State and published in literature since 2004, after the publication of the Law of Cohesion and Quality of the National Health System. The PRISMA extension for scoping reviews was followed. The methodological quality of the studies was assessed using the critical reading guides of the Joanna Briggs Institute and an adaptation of the STROBE guide for ecological studies. A total of 58 articles out of 811 articles were included. Most of the articles were (77.59%, n = 45) cross-sectional studies, followed by ecological studies (13.8%, n = 8). The population group used was uneven, while the main geographical area under investigation was the whole state (51.7%, n = 30) compared to other territorial distributions (48.3%, n = 28). The studies used a multitude of health and socioeconomic indicators, highlighting self-perception of health (31.03%, n = 19) and social class (50%, n = 29). The relationship between better health and better socioeconomic status is evident. However, there is variability in the populations, methods, and indicators used to study health equity in Spain. Future health research and policies require greater systematization by public institutions and greater cooperation among researchers from disciplines such as sociology, economics, and health. [ABSTRACT FROM AUTHOR]

(1) Background: Anaphylaxis is a rapid-onset, life-threatening hypersensitivity reaction. This study explores the epidemiological trends and clinical outcomes of adult patients with and without asthma hospitalized for anaphylaxis in Spain from 2016 to 2021. (2) Methods: Data from the Spanish National Hospital Discharge Database (RAE-CMBD) were analyzed. We stratified patients with anaphylaxis based on their asthma diagnosis and evaluated various comorbidities and clinical outcomes. Propensity score matching was used to match confounders. (3) Results: The total number of hospitalizations for anaphylaxis remained stable, with a decrease in 2020 probably due to the COVID-19 pandemic. Drug-induced anaphylaxis increased, in addition to being the main triggering factor. Asthma prevalence among those admitted for anaphylaxis emerged from 7.63% to 10.69%, with a higher frequency of respiratory failure and need for mechanical ventilation in this group; despite this, ICU admissions and in-hospital mortality did not differ significantly between asthmatics and non-asthmatics. Asthma was also not a risk factor for severe anaphylaxis. Multivariable analysis identified advanced age, ischemic heart disease, acute respiratory failure, and invasive mechanical ventilation as factors associated with severe anaphylaxis. (4) Conclusions: This study provides valuable information on the complexity of anaphylaxis, its relationship with asthma, and factors influencing its severity. Overall, clinical outcomes did not differ significantly in asthmatic patients compared to non-asthmatic patients, although asthmatic patients had more respiratory complications. Further research is necessary to delve deeper into the multifactorial nature of anaphylaxis and its implications in clinical practice. [ABSTRACT FROM AUTHOR]

Background: Coronavirus disease 2019 (COVID-19) was declared as a pandemic and public health emergency on 11 March 2020 by the World Health Organization. Different clinical trials on the efficacy of mRNA vaccination have excluded pregnant women, leading to a lack of empirical evidence on the efficacy of the vaccine in this population. The aim of the study was to examine the association between severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection at birth and adverse perinatal outcomes in infected and non-infected women from a university hospital in Spain. Methods: The data were obtained from electronic health records from 1 March 2020 to 28 February 2022. A bivariate descriptive analysis was performed, comparing women with and without confirmed SARS-CoV-2 infection during pregnancy using the chi-square test. A multivariate logistic regression was complementarily conducted to determine whether SARS-CoV-2 infection increases the risk of adverse obstetric and perinatal outcomes. Results: A total of 2676 women were divided into two groups: non-infected with SARS-CoV-2 (n = 2624) and infected with SARS-CoV-2 (n = 52). Infected women were primarily multiparous (p < 0.03) and had received an incomplete vaccination regimen (p < 0.001). A greater incidence of premature rupture of membranes (p < 0.04) was observed among the non-infected women. Pertaining to perinatal outcomes, there was a notable rise in NICU admissions (p < 0.014), coupled with an extended duration of stay (p < 0.04), for neonates born to infected mothers in comparison to their non-infected counterparts. Conclusion: Although SARS-CoV-2 infection may pose significant risks to pregnant women and their infants, adverse obstetrical/puerperal outcomes do not significantly differ between women infected and non-infected to SARS-CoV-2 in our study. NICU admissions were higher for neonates born to infected mothers. Additionally, coronavirus disease 2019 vaccination during pregnancy is not associated with severe adverse perinatal outcomes. [ABSTRACT FROM AUTHOR]

Adolescents have a greater risk of acquiring sexually transmitted infections (STIs), which is a serious public health problem. Education is an effective strategy to improve adolescent sexual health outcomes. However, Spanish adolescents have a lack of sex education. The aim of this study was to explore the perceptions and opinions of a sample of adolescents regarding sexually transmitted infections (STIs). Photovoice is a research method that uses the search for images of everyday events with the intention of bringing about social change. An exploratory, descriptive design was used with a qualitative approach based on the Photovoice methodology. The sample consisted of 26 high school and baccalaureate students of Almería (Spain) selected through a convenience sample. The age of the participants ranged from 14 to 17 years, with a mean age of 15.31 years. Two main categories were extracted from the data analysis: 'Towards a culture of preventing STIs and promoting healthy sexual practices' and 'Adolescents' needs from their perspective'. In conclusion, numerous changes take place at the biopsychosocial level during adolescence that imply a need to explore their sexuality in depth. A lack of knowledge and a carefree attitude during sexual initiation can increase the risk of developing STIs. The study's adolescents stated that they do not have adequate sex education to acquire sufficient knowledge about sexuality and sexual health, and therefore, request that the traditional format be modified in order to achieve better results. [ABSTRACT FROM AUTHOR]

Background: With life expectancy increasing, there is a growing need to train healthcare support workers who provide care for dependent people in healthcare centres and at home. This qualitative study, based on Gadamer's hermeneutic philosophy, aimed to understand the learning experiences of future healthcare support workers currently enrolled in an intermediate, dual modality vocational training programme with regard to caring for dependent people. Methods: Convenience sampling was used to recruit the participants, who were all students enrolled in an intermediate level vocational training programme in care for dependent people. Fourteen in-depth interviews and one focus group session were conducted with the students. Atlas.ti 8.0 software was used to analyse the participants' accounts. Results: The students highlighted the vocational nature of their studies and the need to feel competent and useful as a healthcare support worker for dependent people. Practice-based learning and the need for training in core competences are complementary and essential elements of the training process. Conclusions:The participants' previous experiences were key in determining their academic trajectory and reflect their motivation and interest to learn. However, they feel vulnerable, unprotected, and lack training in psychosocial skills. Educational institutions should focus training programmes on the practice and development of psychosocial skills that motivate students to acquire transversal competences. [ABSTRACT FROM AUTHOR]