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Objectives: Despite the growing interest on the Russian-Ukrainian war and its repercussion on the children's health, there is no previous systematic review compiling the current evidence on this topic. This study conducted a rapid systematic review to investigate the current findings concerning the impact of the Ukraine war on the social and health aspects of the Ukrainian pediatric population. Methods: A rapid systematic review was conducted. PubMed, Scopus, CINAHL, PsycINFO, Web of Science, and Virtual Health Library (BVS Spain) were searched between February and April 2023. In addition, high-impact journals and institutions focused on pediatric health and human rights were also consulted. All relevant original articles, letters, editorials, and policy papers assessing the health and social repercussions of the war on Ukrainian children were included. Results: From 134 publications matching the search criteria, 23 were included. These publications were categorized into three distinct domains: ‘Public health challenges for the physical and mental health of children and adolescents’, ‘Lack of Healthcare resources and initiatives to mitigate suffering’, and ‘Policies, Government, and Children's rights’. Our findings revealed that the war is seriously impacting the life and the health of Ukrainian children, resulting in worse physical and mental health outcomes and perpetrating a deprived situation. To overcome such problems, several initiatives have been proposed by European and non-European countries, relying mostly on receiving refugees, providing mental health support, complementing lack of resources, and establishing policies to improve health care. Conclusion: It could help health professionals, policy makers, and governments to plan preventive, promotive, and therapeutic strategies for Ukrainian children.

El término “bioética” proviene de los términos griegos bios – vida y ethos – ética, es decir, la ética de la vida. Por lo tanto, representa una rama particular de la investigación dentro de la ética aplicada. La bioética trata de responder a la siguiente cuestión: ¿cuáles son o cuáles deberían ser los comportamientos deseables de la humanidad en general, y de los individuos en particular, frente a las situaciones en que cada uno se encuentra, por el estado de salud y su participación en el cuidado de la salud, por un lado, y en el desarrollo de tecnologías que traen consigo nuevas amenazas a la humanidad, además de las que la humanidad busca disminuir o eliminar, por el otro (Sandu,2020). Esta es la pregunta estructurante que deben analizar los estudiantes, de la que parte el primer seminario y que debe estar presente en todos ellos. Este tema es el vehiculizador de todos los contenidos.

Objective: To investigate the perceptions and experiences of health and social care professionals concerning the use of technology for the care of older adults during the COVID-19 pandemic. Design and measures: A phenomenological qualitative, exploratory, and descriptive design using semi-structured interviews. Sample: Twenty Spanish health and social care workers in six Spanish cities between February and July 2021, during the COVID-19 pandemic. Results:During the COVID-19 pandemic care workers have become more familiar with technology devices, but they also recognize certain barriers for the implementation of technology, mainly in nursing homes and homecare, related to concerns of lack of humanization and difficulties in accessing and using these devices. Conclusion: Politicians and social and healthcare managers should be aware of the benefits of techno-care, reducing the difficulties in implementing it and making more funding and further training available to care providers.

Los usos de las tecnologías han ido en aumento en las prácticas de cuidado durante las últimas décadas, impulsados por la llegada de internet y los dispositivos móviles, y en particular por la rápida expansión de las tecnologías de la información y la comunicación asociada a los mismos.

Los usos de las tecnologías han ido en aumento en las prácticas de cuidado durante las últimas décadas, impulsados por la llegada de internet y los dispositivos móviles, y en particular por la rápida expansión de las tecnologías de la información y la comunicación asociada a los mismos.

This study aims to investigate the current evidence for the use of complementary and alternative medicine (CAM) in fibromyalgia (FM). A systematic review was conducted searching for PubMed, Scopus, CINAHL, PsycInfo, and Web of Science databases. Randomized controlled trials published up to December 2023 in peer-reviewed journals were included. Methodological quality was assessed by the Quality Assessment of Controlled Intervention Studies tool. A total of 216 articles were identified and 15 constituted the final sample. The type of CAM most used was traditional Chinese medicine (60%), and the most common instrument used was the Fibromyalgia Impact Questionnaire (60%). Our review was grouped into four themes based on the origin of the therapies: 1) Traditional Chinese Medicine; 2) Japanese natural harmonization (eg, Reiki); 3) Ayurvedic Medicine; and 4) Other nondrug therapies. Our systematic review showed that there is a wide range of CAMs used to treat FM. Most of the clinical trials have shown significant results for the effectiveness of these interventions in both physical and mental health outcomes of FM as compared to control groups. However, the heterogeneity of the interventions and outcomes warrants further studies on this topic.

Objectives: To investigate the perceptions and attitudes of health professionals working in emergency services and critical care units in Spain about spiritual care provided during the COVID-19 pandemic. Methods: A qualitative investigation was carried out using in-depth interviews. Setting: Emergency and emergency and ICU health professionals from different regions of Spain. Findings: The sample consisted of 47 nursing and one nursing assistant. The qualitative analysis yielded four main themes that reflect the following categories: “the experience with spirituality in clinical practice”; “resources and barriers to provide spiritual care”; “the COVID pandemic and spiritual care” and “training in spiritual care”. In addition, two subdeliveries were also obtained: “ethical dilemma” and “rituals of death”. Conclusions: The majority of emergency and critical care nurses believe spiritual care is important to their clinical practice, but there are still several barriers to address patients’ spiritual needs. During the COVID-19 pandemic in Spain, professionals felt that spiritual beliefs have emerged as important needs of patients and the restrictions imposed by the pandemic made health professionals more exposed to ethical dilemmas and end-of-life religious issues. The general impression of health professionals is that more training and resources are needed on this topic. Implications for clinical practice: Health professionals in emergency intensive care must provide nursing care that meets the spiritual needs of their patients to improve care in crisis situations such as the one suffered by the COVID-19 pandemic. For this, emergency services professionals must work and participate in the development of measures to overcome certain barriers present in emergency services, such as lack of time, lack of training and misconceptions that make it difficult to approach emergency services these needs.

Objectives: To investigate the perceptions and attitudes of health professionals working in emergency services and critical care units in Spain about spiritual care provided during the COVID-19 pandemic. Methods: A qualitative investigation was carried out using in-depth interviews. Setting: Emergency and emergency and ICU health professionals from different regions of Spain. Findings: The sample consisted of 47 nursing and one nursing assistant. The qualitative analysis yielded four main themes that reflect the following categories: “the experience with spirituality in clinical practice”; “resources and barriers to provide spiritual care”; “the COVID pandemic and spiritual care” and “training in spiritual care”. In addition, two subdeliveries were also obtained: “ethical dilemma” and “rituals of death”. Conclusions: The majority of emergency and critical care nurses believe spiritual care is important to their clinical practice, but there are still several barriers to address patients’ spiritual needs. During the COVID-19 pandemic in Spain, professionals felt that spiritual beliefs have emerged as important needs of patients and the restrictions imposed by the pandemic made health professionals more exposed to ethical dilemmas and end-of-life religious issues. The general impression of health professionals is that more training and resources are needed on this topic. Implications for clinical practice: Health professionals in emergency intensive care must provide nursing care that meets the spiritual needs of their patients to improve care in crisis situations such as the one suffered by the COVID-19 pandemic. For this, emergency services professionals must work and participate in the development of measures to overcome certain barriers present in emergency services, such as lack of time, lack of training and misconceptions that make it difficult to approach emergency services these needs.

Background: Culture influences the way in which patients, families and professionals provide care and undergo decision-making at the end of life. Objective: Therefore, our research questions were: How do cultural aspects influence the needs, perceptions, and experiences of patients and their families in end-of-life care? What implications does cultural diversity have for professionals who care for individuals at the end of life? Methods: A narrative review was conducted between June and July 2022. Articles published between 2017 and 2022 in peer-reviewed journals were included. Results: A total of 43 studies were included. Our findings were grouped into four themes: 1) places to die and preferences about healthcare interventions (e.g. parts of the immigrant population tend to receive more aggressive and invasive interventions); 2) advance care planning and verbalization of death (e.g. less use of ACP in some minority groups); 3) rituals and family involvement during healthcare; 4) professionals addressing multiculturalism in care at the end of life (e.g. lack of training in addressing the context of multiculturalism). Conclusions: These findings could contribute to making professionals more aware of cultural aspects that influence the process of death and highlight the need for further training in the handling of such situations.

Objectives: To investigate the perceptions and attitudes of health professionals working in emergency services and critical care units in Spain about spiritual care provided during the COVID-19 pandemic. Methods: A qualitative investigation was carried out using in-depth interviews. Setting: Emergency and emergency and ICU health professionals from different regions of Spain. Findings: The sample consisted of 47 nursing and one nursing assistant. The qualitative analysis yielded four main themes that reflect the following categories: “the experience with spirituality in clinical practice”; “resources and barriers to provide spiritual care”; “the COVID pandemic and spiritual care” and “training in spiritual care”. In addition, two subdeliveries were also obtained: “ethical dilemma” and “rituals of death”. Conclusions: The majority of emergency and critical care nurses believe spiritual care is important to their clinical practice, but there are still several barriers to address patients’ spiritual needs. During the COVID-19 pandemic in Spain, professionals felt that spiritual beliefs have emerged as important needs of patients and the restrictions imposed by the pandemic made health professionals more exposed to ethical dilemmas and end-of-life religious issues. The general impression of health professionals is that more training and resources are needed on this topic. Implications for clinical practice: Health professionals in emergency intensive care must provide nursing care that meets the spiritual needs of their patients to improve care in crisis situations such as the one suffered by the COVID-19 pandemic. For this, emergency services professionals must work and participate in the development of measures to overcome certain barriers present in emergency services, such as lack of time, lack of training and misconceptions that make it difficult to approach emergency services these needs.

The aim of this study is to analyze the influence of Confucianism on health behaviors, health outcomes and medical decisions. The research was conducted using the following databases: PubMed, Scopus, CINHAL, PsycINFO and Web of Science, without restrictions of language and year of publication. The search process identified 833 publications matching the search criteria, and after the review process, 40 articles were included. Family is a central aspect of Confucianism, and it seems to affect participation in medical decisions, taking care of relatives, ethical dilemmas and mental health problems. Although most Confucianist influence seems to be positive, some ways of thinking could increase suffering, burnout and a delay in healthcare seeking. Understanding these values could help health professionals to deal with the growing contingent of patients with different cultures and religious beliefs.

The pandemic caused by the new coronavirus SARS-CoV-2 has been afecting populations globally since the end of 2019. Previous studies have indicated that spirituality in these times of crisis serves as a source of hope and well-being that helps people get through the day. This study investigated the role of spirituality and religiosity in healthcare during the COVID-19 pandemic. An integrative review of the scientifc literature available on PubMed, Scopus, and Web of Science databases and a review of the gray literature in the Information System on Gray Literature in Europe (OpenGrey) were carried out. From a total of 1,338 articles searched; 25 articles were included in this review (22 quantitative observational, 2 qualitative and one randomized controlled trial). Our fndings revealed the importance of includ ing spirituality in clinical practice for both health professionals and patients. On the one hand, spirituality can be considered a good coping strategy used by healthcare professionals to promote mental health and well-being during the COVID-19 pan demic and resulting in greater patient satisfaction with the care given. On the other hand, addressing spiritual needs of individuals leads to a reduction in stress, anxiety, depression, and an increase in resilience and hope among patients.

The pandemic caused by the new coronavirus SARS-CoV-2 has been afecting populations globally since the end of 2019. Previous studies have indicated that spirituality in these times of crisis serves as a source of hope and well-being that helps people get through the day. This study investigated the role of spirituality and religiosity in healthcare during the COVID-19 pandemic. An integrative review of the scientifc literature available on PubMed, Scopus, and Web of Science databases and a review of the gray literature in the Information System on Gray Literature in Europe (OpenGrey) were carried out. From a total of 1,338 articles searched; 25 articles were included in this review (22 quantitative observational, 2 qualitative and one randomized controlled trial). Our fndings revealed the importance of includ ing spirituality in clinical practice for both health professionals and patients. On the one hand, spirituality can be considered a good coping strategy used by healthcare professionals to promote mental health and well-being during the COVID-19 pan demic and resulting in greater patient satisfaction with the care given. On the other hand, addressing spiritual needs of individuals leads to a reduction in stress, anxiety, depression, and an increase in resilience and hope among patients.

Background: Spiritual interventions have proved to alleviate suffering, help the patient to prepare for end of life issues, improve quality of life, and well-being. Objective: This study aims to investigate the efficacy of religious and spiritual interventions in nursing care to promote mental, physical and spiritual health as compared to control groups not receiving such care. Methods: This is a systematic review and meta-analysis of clinical trials from SCOPUS, PUBMED, Web of Science and CINAHL databases. The searches were carried out between May and July 2020 without restrictions con cerning the date of publication. Peer-reviewed articles published in English, Portuguese or Spanish, focusing on nurses were included. This study followed the PRISMA guidelines. In addition, the CONSORT and The Cochrane Collaborations tool for assessing risk of bias were followed. Results: The search process identified 1308 publications, 18 randomized controlled trials were included for the systematic review and 9 for the meta-analysis. The meta-analyses revealed that spiritual interventions were associated with lower mental health symptoms (SMD = -6.91 [− 9.83,-3.98], p < 0.001, I2 = 99 %), greater well being (SMD = 1.26 [0.58, 1.93], p < 0.001, I2 = 94 %) and higher levels of spirituality (SMD = 0.48 [0.29, 0.67], p < 0.001, I2 = 31 %) as compared to individuals in the control group. Conclusions: Spiritual interventions seem to be effective to promote health, as seen for mental health, spirituality, well-being and physical outcomes. Nevertheless, more than half of the studies have a high risk of bias in any of the dimensions evaluated and there is an important heterogeneity among interventions and outcomes. This is particularly important to nurses and nurse managers who want to provide a holistic care to their patients.

The aim of this study is to analyze the influence of Confucianism on health behaviors, health outcomes and medical decisions. The research was conducted using the following databases: PubMed, Scopus, CINHAL, PsycINFO and Web of Science, without restrictions of language and year of publication. The search process identified 833 publications matching the search criteria, and after the review process, 40 articles were included. Family is a central aspect of Confucianism, and it seems to affect participation in medical decisions, taking care of relatives, ethical dilemmas and mental health problems. Although most Confucianist influence seems to be positive, some ways of thinking could increase suffering, burnout and a delay in healthcare seeking. Understanding these values could help health professionals to deal with the growing contingent of patients with different cultures and religious beliefs.

Background: Spiritual interventions have proved to alleviate suffering, help the patient to prepare for end of life issues, improve quality of life, and well-being. Objective: This study aims to investigate the efficacy of religious and spiritual interventions in nursing care to promote mental, physical and spiritual health as compared to control groups not receiving such care. Methods: This is a systematic review and meta-analysis of clinical trials from SCOPUS, PUBMED, Web of Science and CINAHL databases. The searches were carried out between May and July 2020 without restrictions con cerning the date of publication. Peer-reviewed articles published in English, Portuguese or Spanish, focusing on nurses were included. This study followed the PRISMA guidelines. In addition, the CONSORT and The Cochrane Collaborations tool for assessing risk of bias were followed. Results: The search process identified 1308 publications, 18 randomized controlled trials were included for the systematic review and 9 for the meta-analysis. The meta-analyses revealed that spiritual interventions were associated with lower mental health symptoms (SMD = -6.91 [− 9.83,-3.98], p < 0.001, I2 = 99 %), greater well being (SMD = 1.26 [0.58, 1.93], p < 0.001, I2 = 94 %) and higher levels of spirituality (SMD = 0.48 [0.29, 0.67], p < 0.001, I2 = 31 %) as compared to individuals in the control group. Conclusions: Spiritual interventions seem to be effective to promote health, as seen for mental health, spirituality, well-being and physical outcomes. Nevertheless, more than half of the studies have a high risk of bias in any of the dimensions evaluated and there is an important heterogeneity among interventions and outcomes. This is particularly important to nurses and nurse managers who want to provide a holistic care to their patients.

The aim of this study is to analyze the influence of Confucianism on health behaviors, health outcomes and medical decisions. The research was conducted using the following databases: PubMed, Scopus, CINHAL, PsycINFO and Web of Science, without restrictions of language and year of publication. The search process identified 833 publications matching the search criteria, and after the review process, 40 articles were included. Family is a central aspect of Confucianism, and it seems to affect participation in medical decisions, taking care of relatives, ethical dilemmas and mental health problems. Although most Confucianist influence seems to be positive, some ways of thinking could increase suffering, burnout and a delay in healthcare seeking. Understanding these values could help health professionals to deal with the growing contingent of patients with different cultures and religious beliefs.

The pandemic caused by the new coronavirus SARS-CoV-2 has been afecting populations globally since the end of 2019. Previous studies have indicated that spirituality in these times of crisis serves as a source of hope and well-being that helps people get through the day. This study investigated the role of spirituality and religiosity in healthcare during the COVID-19 pandemic. An integrative review of the scientifc literature available on PubMed, Scopus, and Web of Science databases and a review of the gray literature in the Information System on Gray Literature in Europe (OpenGrey) were carried out. From a total of 1,338 articles searched; 25 articles were included in this review (22 quantitative observational, 2 qualitative and one randomized controlled trial). Our fndings revealed the importance of includ ing spirituality in clinical practice for both health professionals and patients. On the one hand, spirituality can be considered a good coping strategy used by healthcare professionals to promote mental health and well-being during the COVID-19 pan demic and resulting in greater patient satisfaction with the care given. On the other hand, addressing spiritual needs of individuals leads to a reduction in stress, anxiety, depression, and an increase in resilience and hope among patients.

Background: Spiritual care could help family members and critically ill patients to cope with anxiety, stress and depression. However, health care professionals are poorly prepared and health managers are not allocating all the resources needed. Aims and objectives: To critically review the empirical evidence concerning the influence of spirituality and religion (S-R) on critical care nursing. Methods: An integrative review of the literature published in the last 10 years (2010-2019) was conducted in PubMed, Scopus, CINHAL, PsycINFO, Web of Science, Cochrane and LILACS. In addition, searches were performed in the System for Information on Grey Literature in Europe and the Grey Literature Report. Quantitative and/or qualitative studies, assessing S-R and including health care professionals caring for critically ill patients (i.e. adults or children), were included. Results: Forty articles were included in the final analysis (20 qualitative, 19 quantitative and 1 with a mixed methodology). The studies embraced the following themes: S-R importance and the use of coping among critical care patients and families; spiritual needs of patients and families; health care professionals' awareness of spiritual needs; ways to address spiritual care in the intensive care unit (ICU); definition of S-R by health care professionals; perceptions and barriers of addressing spiritual needs; and influence of S-R on health care professionals' outcomes and decisions. Our results indicate that patients and their families use S-R coping strategies to alleviate stressful situations in the ICU and that respecting patients' spiritual beliefs is an essential component of critical care. Although nurses consider spiritual care to be very important, they do not feel prepared to address S-R and report lack of time as the main barrier. Conclusion and implications for practice: Critical care professionals should be aware about the needs of their patients and should be trained to handle S-R in clinica

Introduction Spiritual care has a positive influence when patients are subjected to serious illnesses, and critically ill situations such as the case of the COVID-19 pandemic. Purpose The purpose of this study was to investigate the perceptions and attitudes of nurses working at critical care units and emergency services in Spain concerning the spiritual care providing to patients and families during the COVID-19 pandemic. Methods A qualitative investigation was carried out using in-depth interviews with 19 ICU nursing professionals. Findings During the pandemic, nurses provided spiritual care for their patients. Although they believed that spirituality was important to help patients to cope with the disease, they do not had a consensual definition of spirituality. Work overload, insufficient time and lack of training were perceived as barriers for providing spiritual healthcare. Discussion These results support the role of spirituality in moments of crisis and should be considered by health professionals working in critical care settings.

Objective:To investigate the relationship between spirituality / religiousness and Burnout Syndrome innurses, as well as to examine the current evidence for spiritual/religious interventions to alleviate theirsymptoms.Data sources:A scoping review was conducted using CINAHL, SCOPUS, Web of Science, Pubmed databases,and grey literature, between January and July 2020.Study selection:Two researchers performed the searches with a 95% agreement rate for the inclusion andexclusion of the studies. Both quantitative and qualitative studies published in peer-reviewed journals, usingSpanish, Portuguese or English language were included. Restriction on publication date was not applied.Data Extraction:A total of 1143 articles were identified and 18 were included in thefinal analysis. Qualityassessment was performed, following CONSORT, STROBE, PRISMA and COREQ guidelines. Finally, the follow-ing data were extracted: authors, year, country, study design and sample characteristics, purpose of thestudy, and majorfindings.Data synthesis:The results of the present review show that spirituality / religiousness is a common strategyused by nurses when coping with stress and burnout. Most studies reveal that spiritual and religious beliefsare correlated with lower levels of burnout, exhaustion and depersonalization in different settings. Neverthe-less, two studies have not found any relationship and one study has found worse outcomes.Conclusions:There is a lack of experimental studies trying to examine if spiritual interventions could modifyburnout levels in clinical practice. Health managers should be aware of the spirituality / religiousness of theirnurses and provide the appropriate spiritual support.

Aim: To elicit the experiences and perspectives of health professionals working on the frontline in the COVID-19 pandemic. Background: Although some qualitative studies have been carried out in health professionals during COVID-19 pandemic, to our knowledge, no study has used the Photovoice method. Design: A qualitative descriptive study using Photovoice was carried out between March and June 2020. Methods: A total of 20 health professionals were recruited from public and private healthcare services. The participants were invited to share photographs about their experiences while working during COVID-19 pandemic. Following the Photovoice method, audio-recorded interviews were conducted. The data were analysed using the ‘SHOWED’ mnemonic, with five questions answered about each photograph. The EQUATOR checklist has been used. Results/Findings: Three themes emerged: (1) Personal attitudes of health professionals; (2) Support from the community; and (3) Management of institutional resources. Despite the fact that health professionals in this study were exposed to major risks while caring for patients with COVID-19’ they felt a strong sense of responsibility towards the community. In order to handle these stressful situations, they used coping mechanisms, good humour and leisure, but also received support from the population, who saw them as highly skilled health professionals. Conclusion: These findings highlight the essential role of health professionals in the COVID-19 pandemic and the tireless work they are carrying out to provided highly skilled care. Relevance to clinical practice: These findings could contribute to raise awareness on the needs of health professionals during the pandemic, allowing managers to plan strategies to ensure the safety, and well-being of these professionals, as well as adopting similar strategies in their practice to create a space for critical reflection through participatory approaches.

Background: Spiritual care could help family members and critically ill patients to cope with anxiety, stress and depression. However, health care professionals are poorly prepared and health managers are not allocating all the resources needed. Aims and objectives: To critically review the empirical evidence concerning the influence of spirituality and religion (S-R) on critical care nursing. Methods: An integrative review of the literature published in the last 10 years (2010-2019) was conducted in PubMed, Scopus, CINHAL, PsycINFO, Web of Science, Cochrane and LILACS. In addition, searches were performed in the System for Information on Grey Literature in Europe and the Grey Literature Report. Quantitative and/or qualitative studies, assessing S-R and including health care professionals caring for critically ill patients (i.e. adults or children), were included. Results: Forty articles were included in the final analysis (20 qualitative, 19 quantitative and 1 with a mixed methodology). The studies embraced the following themes: S-R importance and the use of coping among critical care patients and families; spiritual needs of patients and families; health care professionals' awareness of spiritual needs; ways to address spiritual care in the intensive care unit (ICU); definition of S-R by health care professionals; perceptions and barriers of addressing spiritual needs; and influence of S-R on health care professionals' outcomes and decisions. Our results indicate that patients and their families use S-R coping strategies to alleviate stressful situations in the ICU and that respecting patients' spiritual beliefs is an essential component of critical care. Although nurses consider spiritual care to be very important, they do not feel prepared to address S-R and report lack of time as the main barrier. Conclusion and implications for practice: Critical care professionals should be aware about the needs of their patients and should be trained to handle S-R in clinica

Introduction Spiritual care has a positive influence when patients are subjected to serious illnesses, and critically ill situations such as the case of the COVID-19 pandemic. Purpose The purpose of this study was to investigate the perceptions and attitudes of nurses working at critical care units and emergency services in Spain concerning the spiritual care providing to patients and families during the COVID-19 pandemic. Methods A qualitative investigation was carried out using in-depth interviews with 19 ICU nursing professionals. Findings During the pandemic, nurses provided spiritual care for their patients. Although they believed that spirituality was important to help patients to cope with the disease, they do not had a consensual definition of spirituality. Work overload, insufficient time and lack of training were perceived as barriers for providing spiritual healthcare. Discussion These results support the role of spirituality in moments of crisis and should be considered by health professionals working in critical care settings.

Objective:To investigate the relationship between spirituality / religiousness and Burnout Syndrome innurses, as well as to examine the current evidence for spiritual/religious interventions to alleviate theirsymptoms.Data sources:A scoping review was conducted using CINAHL, SCOPUS, Web of Science, Pubmed databases,and grey literature, between January and July 2020.Study selection:Two researchers performed the searches with a 95% agreement rate for the inclusion andexclusion of the studies. Both quantitative and qualitative studies published in peer-reviewed journals, usingSpanish, Portuguese or English language were included. Restriction on publication date was not applied.Data Extraction:A total of 1143 articles were identified and 18 were included in thefinal analysis. Qualityassessment was performed, following CONSORT, STROBE, PRISMA and COREQ guidelines. Finally, the follow-ing data were extracted: authors, year, country, study design and sample characteristics, purpose of thestudy, and majorfindings.Data synthesis:The results of the present review show that spirituality / religiousness is a common strategyused by nurses when coping with stress and burnout. Most studies reveal that spiritual and religious beliefsare correlated with lower levels of burnout, exhaustion and depersonalization in different settings. Neverthe-less, two studies have not found any relationship and one study has found worse outcomes.Conclusions:There is a lack of experimental studies trying to examine if spiritual interventions could modifyburnout levels in clinical practice. Health managers should be aware of the spirituality / religiousness of theirnurses and provide the appropriate spiritual support.

Aim: To elicit the experiences and perspectives of health professionals working on the frontline in the COVID-19 pandemic. Background: Although some qualitative studies have been carried out in health professionals during COVID-19 pandemic, to our knowledge, no study has used the Photovoice method. Design: A qualitative descriptive study using Photovoice was carried out between March and June 2020. Methods: A total of 20 health professionals were recruited from public and private healthcare services. The participants were invited to share photographs about their experiences while working during COVID-19 pandemic. Following the Photovoice method, audio-recorded interviews were conducted. The data were analysed using the ‘SHOWED’ mnemonic, with five questions answered about each photograph. The EQUATOR checklist has been used. Results/Findings: Three themes emerged: (1) Personal attitudes of health professionals; (2) Support from the community; and (3) Management of institutional resources. Despite the fact that health professionals in this study were exposed to major risks while caring for patients with COVID-19’ they felt a strong sense of responsibility towards the community. In order to handle these stressful situations, they used coping mechanisms, good humour and leisure, but also received support from the population, who saw them as highly skilled health professionals. Conclusion: These findings highlight the essential role of health professionals in the COVID-19 pandemic and the tireless work they are carrying out to provided highly skilled care. Relevance to clinical practice: These findings could contribute to raise awareness on the needs of health professionals during the pandemic, allowing managers to plan strategies to ensure the safety, and well-being of these professionals, as well as adopting similar strategies in their practice to create a space for critical reflection through participatory approaches.

This article aims to explore the food patterns of Chinese immigrants living in Spain and to understand the factors associated with these behaviors. This qualitative ethnographic study included 133 Chinese immigrants; using interviews with scripts were based on the National Health Survey of Spain. Three categories were defined: “Differences between Chinese food and Western food”; “Products and dishes consumed by Chinese immigrants” and “Modification of eating habits”. Participants found a remarkable difference between eastern (i.e., vegetables and rice) and western (i.e., dairy, high-fat, bread) foods. They also experienced a change in their eating habits, mostly related to acculturation and lack of time. Chinese immigrants have different eating patterns as compared to the native population in Spain and this information could help in future healthcare strategies. Knowing the food culture could infer aspects, such as insertion or integration, and promoting health and well-being.

Objective To investigate the use of healthcare services and factors associated with accessing them among Chinese immigrants living in Southern Spain. Method A mixed methodology was used. A cross-sectional survey was first administered to Chinese immigrants (n = 133), and they were asked about their visits to the doctor, use of emergency services, and hospitalization. A phenomenological approach was then used with key informants (n = 7). In the interviews, additional information, such as barriers and facilitators to improving accessibility, was explored. Results In the previous year, 51% had visited a doctor and 34% had visited an Emergency Department. The main reasons for hospitalization were pregnancy (37.5%) and surgery (25%). At least 20% of the sample reported having never visited a doctor. Language difficulties and time constraints were identified as important barriers to accessibility. Sex differences were found among the reasons for lack of time, which, in men, were related to work (odds ratio [OR] = 7.7) and, in women, were related to childcare (OR = 12). The majority of Chinese immigrants preferred to use Traditional Chinese Medicine as their first treatment rather than visiting a doctor. Conclusions A lower use of health services was found among Chinese immigrants in Spain compared to the native population. When using health services, they choose acute care settings. Communication and waiting times are highlighted as major barriers. Adapting these demands to the healthcare system may help immigrants to trust their healthcare providers, thus increasing their use of health services and improving their treatment., Objetivo Investigar el uso y los factores asociados al acceso a los servicios de salud en inmigrantes chinos residentes en el sur de España. Método Se utilizó una metodología mixta. Primero se administró una encuesta transversal a inmigrantes chinos (n = 133). Se les preguntó sobre sus visitas al médico y el uso de servicios de emergencia y de hospitalización. Luego se utilizó un enfoque fenomenológico con informantes clave (n = 7), explorando información adicional, como barreras y facilitadores para mejorar la accesibilidad. Resultados El último año, el 51% había visitado al médico y el 34% un servicio de urgencias. La hospitalización se debió principalmente a embarazo (37,5%) y cirugía (25%). El 20% informó que nunca había visitado al médico. Las dificultades de lenguaje y las limitaciones de tiempo fueron barreras importantes para la accesibilidad. Se encontraron diferencias de sexo para la falta de tiempo; en hombres se relacionaron con el trabajo (odds ratio [OR] = 7,7) y en mujeres con el cuidado infantil (OR = 12). La mayoría prefirió usar medicina tradicional china como primer tratamiento en lugar de visitar al médico. Conclusiones Se encontró un menor uso de los servicios de salud entre los inmigrantes chinos en España en comparación con la población autóctona. Al utilizar los servicios de salud, eligen los cuidados agudos. La comunicación y los tiempos de espera destacan como barreras principales. Adaptar estas demandas al sistema de salud puede ayudarles a confiar en sus proveedores de atención médica, aumentando el uso de los servicios de salud y mejorando su tratamiento.

Background: Spiritual care could help family members and critically ill patients to cope with anxiety, stress and depression. However, health care professionals are poorly prepared and health managers are not allocating all the resources needed. Aims and objectives: To critically review the empirical evidence concerning the influence of spirituality and religion (S-R) on critical care nursing. Methods: An integrative review of the literature published in the last 10 years (2010-2019) was conducted in PubMed, Scopus, CINHAL, PsycINFO, Web of Science, Cochrane and LILACS. In addition, searches were performed in the System for Information on Grey Literature in Europe and the Grey Literature Report. Quantitative and/or qualitative studies, assessing S-R and including health care professionals caring for critically ill patients (i.e. adults or children), were included. Results: Forty articles were included in the final analysis (20 qualitative, 19 quantitative and 1 with a mixed methodology). The studies embraced the following themes: S-R importance and the use of coping among critical care patients and families; spiritual needs of patients and families; health care professionals' awareness of spiritual needs; ways to address spiritual care in the intensive care unit (ICU); definition of S-R by health care professionals; perceptions and barriers of addressing spiritual needs; and influence of S-R on health care professionals' outcomes and decisions. Our results indicate that patients and their families use S-R coping strategies to alleviate stressful situations in the ICU and that respecting patients' spiritual beliefs is an essential component of critical care. Although nurses consider spiritual care to be very important, they do not feel prepared to address S-R and report lack of time as the main barrier. Conclusion and implications for practice: Critical care professionals should be aware about the needs of their patients and should be trained to handle S-R in clinica

This study aims to identify acculturation experiences about social relations and health behaviors of first-generation Chinese immigrants in the South of Spain, including food patterns, physical exercise, and tobacco and alcohol use. A phenomenological qualitative study was conducted using semi-structured interviews, informal conversations, and field notes. All data were analyzed under the Berry’s Model of Acculturation. A total of 133 Chinese immigrants were included. Our findings show that separation was the dominant acculturation strategy, followed by integration and assimilation, while marginalization was not present in this immigrant population. Most of the immigrant population maintains a link to the customs of their home country, favoring the process of identity and collective self-esteem. These results can help health managers and the government to further understand Chinese immigrants in Europe and to establish appropriate health interventions to this group.

Introduction Spiritual care has a positive influence when patients are subjected to serious illnesses, and critically ill situations such as the case of the COVID-19 pandemic. Purpose The purpose of this study was to investigate the perceptions and attitudes of nurses working at critical care units and emergency services in Spain concerning the spiritual care providing to patients and families during the COVID-19 pandemic. Methods A qualitative investigation was carried out using in-depth interviews with 19 ICU nursing professionals. Findings During the pandemic, nurses provided spiritual care for their patients. Although they believed that spirituality was important to help patients to cope with the disease, they do not had a consensual definition of spirituality. Work overload, insufficient time and lack of training were perceived as barriers for providing spiritual healthcare. Discussion These results support the role of spirituality in moments of crisis and should be considered by health professionals working in critical care settings.

Objective:To investigate the relationship between spirituality / religiousness and Burnout Syndrome innurses, as well as to examine the current evidence for spiritual/religious interventions to alleviate theirsymptoms.Data sources:A scoping review was conducted using CINAHL, SCOPUS, Web of Science, Pubmed databases,and grey literature, between January and July 2020.Study selection:Two researchers performed the searches with a 95% agreement rate for the inclusion andexclusion of the studies. Both quantitative and qualitative studies published in peer-reviewed journals, usingSpanish, Portuguese or English language were included. Restriction on publication date was not applied.Data Extraction:A total of 1143 articles were identified and 18 were included in thefinal analysis. Qualityassessment was performed, following CONSORT, STROBE, PRISMA and COREQ guidelines. Finally, the follow-ing data were extracted: authors, year, country, study design and sample characteristics, purpose of thestudy, and majorfindings.Data synthesis:The results of the present review show that spirituality / religiousness is a common strategyused by nurses when coping with stress and burnout. Most studies reveal that spiritual and religious beliefsare correlated with lower levels of burnout, exhaustion and depersonalization in different settings. Neverthe-less, two studies have not found any relationship and one study has found worse outcomes.Conclusions:There is a lack of experimental studies trying to examine if spiritual interventions could modifyburnout levels in clinical practice. Health managers should be aware of the spirituality / religiousness of theirnurses and provide the appropriate spiritual support.

Aim: To elicit the experiences and perspectives of health professionals working on the frontline in the COVID-19 pandemic. Background: Although some qualitative studies have been carried out in health professionals during COVID-19 pandemic, to our knowledge, no study has used the Photovoice method. Design: A qualitative descriptive study using Photovoice was carried out between March and June 2020. Methods: A total of 20 health professionals were recruited from public and private healthcare services. The participants were invited to share photographs about their experiences while working during COVID-19 pandemic. Following the Photovoice method, audio-recorded interviews were conducted. The data were analysed using the ‘SHOWED’ mnemonic, with five questions answered about each photograph. The EQUATOR checklist has been used. Results/Findings: Three themes emerged: (1) Personal attitudes of health professionals; (2) Support from the community; and (3) Management of institutional resources. Despite the fact that health professionals in this study were exposed to major risks while caring for patients with COVID-19’ they felt a strong sense of responsibility towards the community. In order to handle these stressful situations, they used coping mechanisms, good humour and leisure, but also received support from the population, who saw them as highly skilled health professionals. Conclusion: These findings highlight the essential role of health professionals in the COVID-19 pandemic and the tireless work they are carrying out to provided highly skilled care. Relevance to clinical practice: These findings could contribute to raise awareness on the needs of health professionals during the pandemic, allowing managers to plan strategies to ensure the safety, and well-being of these professionals, as well as adopting similar strategies in their practice to create a space for critical reflection through participatory approaches.

In this study, we investigate the health problems and the use of medications and traditional therapies among Chinese immigrants in the Southern region of Spain. A qualitative study using semi-structured interviews and including 133 immigrants and 7 stakeholders was conducted in 2017. Transcription, literal reading, and theoretical categorization were performed, and a narrative content analysis was carried out. The most common health problems were musculoskeletal (28.6%) and allergies (25.6%) related to work activity and unhealthy lifestyles. Key informants also reported gastric problems, stress, and changes in eating habits, mostly related to their work activity. For these problems, a large number of traditional remedies (herbs, diet therapy, acupuncture, vitamins, etc.) were used, usually combined with pharmaceutical drugs used for colds, flu, general malaise (29%), pain and fever (23%), and allergy drugs (9.2%). Chinese immigrants reported health conditions associated with their working conditions and life habits in Spain, using Traditional Chinese Medicine instead of pharmacological drugs. Understanding these health problems and promoting awareness towards traditional therapies in the healthcare system may help to design public policies and Health Promotion strategies targeting this group.

In this study, we investigate the health problems and the use of medications and traditional therapies among Chinese immigrants in the Southern region of Spain. A qualitative study using semi-structured interviews and including 133 immigrants and 7 stakeholders was conducted in 2017. Transcription, literal reading, and theoretical categorization were performed, and a narrative content analysis was carried out. The most common health problems were musculoskeletal (28.6%) and allergies (25.6%) related to work activity and unhealthy lifestyles. Key informants also reported gastric problems, stress, and changes in eating habits, mostly related to their work activity. For these problems, a large number of traditional remedies (herbs, diet therapy, acupuncture, vitamins, etc.) were used, usually combined with pharmaceutical drugs used for colds, flu, general malaise (29%), pain and fever (23%), and allergy drugs (9.2%). Chinese immigrants reported health conditions associated with their working conditions and life habits in Spain, using Traditional Chinese Medicine instead of pharmacological drugs. Understanding these health problems and promoting awareness towards traditional therapies in the healthcare system may help to design public policies and Health Promotion strategies targeting this group.

Background: Spiritual care could help family members and critically ill patients to cope with anxiety, stress and depression. However, health care professionals are poorly prepared and health managers are not allocating all the resources needed. Aims and objectives: To critically review the empirical evidence concerning the influence of spirituality and religion (S-R) on critical care nursing. Methods: An integrative review of the literature published in the last 10 years (2010-2019) was conducted in PubMed, Scopus, CINHAL, PsycINFO, Web of Science, Cochrane and LILACS. In addition, searches were performed in the System for Information on Grey Literature in Europe and the Grey Literature Report. Quantitative and/or qualitative studies, assessing S-R and including health care professionals caring for critically ill patients (i.e. adults or children), were included. Results: Forty articles were included in the final analysis (20 qualitative, 19 quantitative and 1 with a mixed methodology). The studies embraced the following themes: S-R importance and the use of coping among critical care patients and families; spiritual needs of patients and families; health care professionals' awareness of spiritual needs; ways to address spiritual care in the intensive care unit (ICU); definition of S-R by health care professionals; perceptions and barriers of addressing spiritual needs; and influence of S-R on health care professionals' outcomes and decisions. Our results indicate that patients and their families use S-R coping strategies to alleviate stressful situations in the ICU and that respecting patients' spiritual beliefs is an essential component of critical care. Although nurses consider spiritual care to be very important, they do not feel prepared to address S-R and report lack of time as the main barrier. Conclusion and implications for practice: Critical care professionals should be aware about the needs of their patients and should be trained to handle S-R in clinica

This study aims to identify acculturation experiences about social relations and health behaviors of first-generation Chinese immigrants in the South of Spain, including food patterns, physical exercise, and tobacco and alcohol use. A phenomenological qualitative study was conducted using semi-structured interviews, informal conversations, and field notes. All data were analyzed under the Berry’s Model of Acculturation. A total of 133 Chinese immigrants were included. Our findings show that separation was the dominant acculturation strategy, followed by integration and assimilation, while marginalization was not present in this immigrant population. Most of the immigrant population maintains a link to the customs of their home country, favoring the process of identity and collective self-esteem. These results can help health managers and the government to further understand Chinese immigrants in Europe and to establish appropriate health interventions to this group.

Introduction Spiritual care has a positive influence when patients are subjected to serious illnesses, and critically ill situations such as the case of the COVID-19 pandemic. Purpose The purpose of this study was to investigate the perceptions and attitudes of nurses working at critical care units and emergency services in Spain concerning the spiritual care providing to patients and families during the COVID-19 pandemic. Methods A qualitative investigation was carried out using in-depth interviews with 19 ICU nursing professionals. Findings During the pandemic, nurses provided spiritual care for their patients. Although they believed that spirituality was important to help patients to cope with the disease, they do not had a consensual definition of spirituality. Work overload, insufficient time and lack of training were perceived as barriers for providing spiritual healthcare. Discussion These results support the role of spirituality in moments of crisis and should be considered by health professionals working in critical care settings.

Objective:To investigate the relationship between spirituality / religiousness and Burnout Syndrome innurses, as well as to examine the current evidence for spiritual/religious interventions to alleviate theirsymptoms.Data sources:A scoping review was conducted using CINAHL, SCOPUS, Web of Science, Pubmed databases,and grey literature, between January and July 2020.Study selection:Two researchers performed the searches with a 95% agreement rate for the inclusion andexclusion of the studies. Both quantitative and qualitative studies published in peer-reviewed journals, usingSpanish, Portuguese or English language were included. Restriction on publication date was not applied.Data Extraction:A total of 1143 articles were identified and 18 were included in thefinal analysis. Qualityassessment was performed, following CONSORT, STROBE, PRISMA and COREQ guidelines. Finally, the follow-ing data were extracted: authors, year, country, study design and sample characteristics, purpose of thestudy, and majorfindings.Data synthesis:The results of the present review show that spirituality / religiousness is a common strategyused by nurses when coping with stress and burnout. Most studies reveal that spiritual and religious beliefsare correlated with lower levels of burnout, exhaustion and depersonalization in different settings. Neverthe-less, two studies have not found any relationship and one study has found worse outcomes.Conclusions:There is a lack of experimental studies trying to examine if spiritual interventions could modifyburnout levels in clinical practice. Health managers should be aware of the spirituality / religiousness of theirnurses and provide the appropriate spiritual support.

Aim: To elicit the experiences and perspectives of health professionals working on the frontline in the COVID-19 pandemic. Background: Although some qualitative studies have been carried out in health professionals during COVID-19 pandemic, to our knowledge, no study has used the Photovoice method. Design: A qualitative descriptive study using Photovoice was carried out between March and June 2020. Methods: A total of 20 health professionals were recruited from public and private healthcare services. The participants were invited to share photographs about their experiences while working during COVID-19 pandemic. Following the Photovoice method, audio-recorded interviews were conducted. The data were analysed using the ‘SHOWED’ mnemonic, with five questions answered about each photograph. The EQUATOR checklist has been used. Results/Findings: Three themes emerged: (1) Personal attitudes of health professionals; (2) Support from the community; and (3) Management of institutional resources. Despite the fact that health professionals in this study were exposed to major risks while caring for patients with COVID-19’ they felt a strong sense of responsibility towards the community. In order to handle these stressful situations, they used coping mechanisms, good humour and leisure, but also received support from the population, who saw them as highly skilled health professionals. Conclusion: These findings highlight the essential role of health professionals in the COVID-19 pandemic and the tireless work they are carrying out to provided highly skilled care. Relevance to clinical practice: These findings could contribute to raise awareness on the needs of health professionals during the pandemic, allowing managers to plan strategies to ensure the safety, and well-being of these professionals, as well as adopting similar strategies in their practice to create a space for critical reflection through participatory approaches.

This article aims to explore the food patterns of Chinese immigrants living in Spain and to understand the factors associated with these behaviors. This qualitative ethnographic study included 133 Chinese immigrants; using interviews with scripts were based on the National Health Survey of Spain. Three categories were defined: “Differences between Chinese food and Western food”; “Products and dishes consumed by Chinese immigrants” and “Modification of eating habits”. Participants found a remarkable difference between eastern (i.e., vegetables and rice) and western (i.e., dairy, high-fat, bread) foods. They also experienced a change in their eating habits, mostly related to acculturation and lack of time. Chinese immigrants have different eating patterns as compared to the native population in Spain and this information could help in future healthcare strategies. Knowing the food culture could infer aspects, such as insertion or integration, and promoting health and well-being.

Objective To investigate the use of healthcare services and factors associated with accessing them among Chinese immigrants living in Southern Spain. Method A mixed methodology was used. A cross-sectional survey was first administered to Chinese immigrants (n = 133), and they were asked about their visits to the doctor, use of emergency services, and hospitalization. A phenomenological approach was then used with key informants (n = 7). In the interviews, additional information, such as barriers and facilitators to improving accessibility, was explored. Results In the previous year, 51% had visited a doctor and 34% had visited an Emergency Department. The main reasons for hospitalization were pregnancy (37.5%) and surgery (25%). At least 20% of the sample reported having never visited a doctor. Language difficulties and time constraints were identified as important barriers to accessibility. Sex differences were found among the reasons for lack of time, which, in men, were related to work (odds ratio [OR] = 7.7) and, in women, were related to childcare (OR = 12). The majority of Chinese immigrants preferred to use Traditional Chinese Medicine as their first treatment rather than visiting a doctor. Conclusions A lower use of health services was found among Chinese immigrants in Spain compared to the native population. When using health services, they choose acute care settings. Communication and waiting times are highlighted as major barriers. Adapting these demands to the healthcare system may help immigrants to trust their healthcare providers, thus increasing their use of health services and improving their treatment., Objetivo Investigar el uso y los factores asociados al acceso a los servicios de salud en inmigrantes chinos residentes en el sur de España. Método Se utilizó una metodología mixta. Primero se administró una encuesta transversal a inmigrantes chinos (n = 133). Se les preguntó sobre sus visitas al médico y el uso de servicios de emergencia y de hospitalización. Luego se utilizó un enfoque fenomenológico con informantes clave (n = 7), explorando información adicional, como barreras y facilitadores para mejorar la accesibilidad. Resultados El último año, el 51% había visitado al médico y el 34% un servicio de urgencias. La hospitalización se debió principalmente a embarazo (37,5%) y cirugía (25%). El 20% informó que nunca había visitado al médico. Las dificultades de lenguaje y las limitaciones de tiempo fueron barreras importantes para la accesibilidad. Se encontraron diferencias de sexo para la falta de tiempo; en hombres se relacionaron con el trabajo (odds ratio [OR] = 7,7) y en mujeres con el cuidado infantil (OR = 12). La mayoría prefirió usar medicina tradicional china como primer tratamiento en lugar de visitar al médico. Conclusiones Se encontró un menor uso de los servicios de salud entre los inmigrantes chinos en España en comparación con la población autóctona. Al utilizar los servicios de salud, eligen los cuidados agudos. La comunicación y los tiempos de espera destacan como barreras principales. Adaptar estas demandas al sistema de salud puede ayudarles a confiar en sus proveedores de atención médica, aumentando el uso de los servicios de salud y mejorando su tratamiento.

This article aims to explore the food patterns of Chinese immigrants living in Spain and to understand the factors associated with these behaviors. This qualitative ethnographic study included 133 Chinese immigrants; using interviews with scripts were based on the National Health Survey of Spain. Three categories were defined: “Differences between Chinese food and Western food”; “Products and dishes consumed by Chinese immigrants” and “Modification of eating habits”. Participants found a remarkable difference between eastern (i.e., vegetables and rice) and western (i.e., dairy, high-fat, bread) foods. They also experienced a change in their eating habits, mostly related to acculturation and lack of time. Chinese immigrants have different eating patterns as compared to the native population in Spain and this information could help in future healthcare strategies. Knowing the food culture could infer aspects, such as insertion or integration, and promoting health and well-being.

Background: Spain hosts the fourth largest number of immigrants in Europe, resulting in a large proportion of migrant workers. To date, few studies have examined the working conditions of immigrants in Southern Spain who are known to be at risk for adverse working conditions. This study aimed to investigate the patterns of work and working conditions of immigrants living in southern Spain and to understand how these factors may affect their health. Methods: A qualitative study using semi-structured interviews was conducted throughout 2019 and included 93 immigrants. Transcription, literal reading, and theoretical categorization were performed and a narrative content analysis was carried out. Results: Three themes emerged on working conditions of this study population, including social and labor-related characteristics, working conditions, and occupational health issues. Four employment sectors were most commonly occupied by these immigrants, including caregiving and food service for women and agriculture and construction for men. Most immigrants were from Latin America, unemployed or working part-time jobs, and not hired under an employment contract. Most worked in low-qualified jobs, and were exposed to occupational hazards such as falls from heights, manual handling of materials, and psychological strain. The lack of training on occupational risk prevention and labor rights was related to a low identification of work situations having a negative impact on the health of immigrants. Conclusions/Application to Practice: These findings should be taken into account by the government and public health managers to provide better assistance to immigrant workers in Europe.

Background: Spiritual care could help family members and critically ill patients to cope with anxiety, stress and depression. However, health care professionals are poorly prepared and health managers are not allocating all the resources needed. Aims and objectives: To critically review the empirical evidence concerning the influence of spirituality and religion (S-R) on critical care nursing. Methods: An integrative review of the literature published in the last 10 years (2010-2019) was conducted in PubMed, Scopus, CINHAL, PsycINFO, Web of Science, Cochrane and LILACS. In addition, searches were performed in the System for Information on Grey Literature in Europe and the Grey Literature Report. Quantitative and/or qualitative studies, assessing S-R and including health care professionals caring for critically ill patients (i.e. adults or children), were included. Results: Forty articles were included in the final analysis (20 qualitative, 19 quantitative and 1 with a mixed methodology). The studies embraced the following themes: S-R importance and the use of coping among critical care patients and families; spiritual needs of patients and families; health care professionals' awareness of spiritual needs; ways to address spiritual care in the intensive care unit (ICU); definition of S-R by health care professionals; perceptions and barriers of addressing spiritual needs; and influence of S-R on health care professionals' outcomes and decisions. Our results indicate that patients and their families use S-R coping strategies to alleviate stressful situations in the ICU and that respecting patients' spiritual beliefs is an essential component of critical care. Although nurses consider spiritual care to be very important, they do not feel prepared to address S-R and report lack of time as the main barrier. Conclusion and implications for practice: Critical care professionals should be aware about the needs of their patients and should be trained to handle S-R in clinica

Objective To investigate the use of healthcare services and factors associated with accessing them among Chinese immigrants living in Southern Spain. Method A mixed methodology was used. A cross-sectional survey was first administered to Chinese immigrants (n = 133), and they were asked about their visits to the doctor, use of emergency services, and hospitalization. A phenomenological approach was then used with key informants (n = 7). In the interviews, additional information, such as barriers and facilitators to improving accessibility, was explored. Results In the previous year, 51% had visited a doctor and 34% had visited an Emergency Department. The main reasons for hospitalization were pregnancy (37.5%) and surgery (25%). At least 20% of the sample reported having never visited a doctor. Language difficulties and time constraints were identified as important barriers to accessibility. Sex differences were found among the reasons for lack of time, which, in men, were related to work (odds ratio [OR] = 7.7) and, in women, were related to childcare (OR = 12). The majority of Chinese immigrants preferred to use Traditional Chinese Medicine as their first treatment rather than visiting a doctor. Conclusions A lower use of health services was found among Chinese immigrants in Spain compared to the native population. When using health services, they choose acute care settings. Communication and waiting times are highlighted as major barriers. Adapting these demands to the healthcare system may help immigrants to trust their healthcare providers, thus increasing their use of health services and improving their treatment., Objetivo Investigar el uso y los factores asociados al acceso a los servicios de salud en inmigrantes chinos residentes en el sur de España. Método Se utilizó una metodología mixta. Primero se administró una encuesta transversal a inmigrantes chinos (n = 133). Se les preguntó sobre sus visitas al médico y el uso de servicios de emergencia y de hospitalización. Luego se utilizó un enfoque fenomenológico con informantes clave (n = 7), explorando información adicional, como barreras y facilitadores para mejorar la accesibilidad. Resultados El último año, el 51% había visitado al médico y el 34% un servicio de urgencias. La hospitalización se debió principalmente a embarazo (37,5%) y cirugía (25%). El 20% informó que nunca había visitado al médico. Las dificultades de lenguaje y las limitaciones de tiempo fueron barreras importantes para la accesibilidad. Se encontraron diferencias de sexo para la falta de tiempo; en hombres se relacionaron con el trabajo (odds ratio [OR] = 7,7) y en mujeres con el cuidado infantil (OR = 12). La mayoría prefirió usar medicina tradicional china como primer tratamiento en lugar de visitar al médico. Conclusiones Se encontró un menor uso de los servicios de salud entre los inmigrantes chinos en España en comparación con la población autóctona. Al utilizar los servicios de salud, eligen los cuidados agudos. La comunicación y los tiempos de espera destacan como barreras principales. Adaptar estas demandas al sistema de salud puede ayudarles a confiar en sus proveedores de atención médica, aumentando el uso de los servicios de salud y mejorando su tratamiento.