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Maria Conceição Pinto Moreira Freitas,1 Bruno Magalhães,2 Juan Miguel Martínez-Galiano,3,4 Juan Gómez-Salgado5,6 1Instituto Politécnico de Viana do Castelo, Escola Superior de Saúde, Viana do Castelo, Portugal; 2Department of Nursing, School of Health, University of Trás-os-Montes and Alto Douro (UTAD), Vila Real, Portugal; 3Department of Nursing, University of Jaen, Jaen, Spain; 4Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain; 5Department of Sociology, Social Work and Public Health, Faculty of Labour Sciences, University of Huelva, Huelva, Spain; 6Safety and Health Postgraduate Programme, Universidad Espíritu Santo, Guayaquil, EcuadorCorrespondence: Juan Miguel Martínez-Galiano, Department of Nursing, University of Jaen, Campus de Las Lagunillas s/n, Jaén, 23071, Spain, Tel +34 953212121, Email jgaliano@ujaen.es Juan Gómez-Salgado, Department of Sociology, Social Work, and Public Health, Faculty of Labour Sciences, University of Huelva, Av. 3 de Marzo. Campus El Carmen, Huelva, 21071, Spain, Tel +34 959219703, Email salgado@uhu.esIntroduction: The number of women who present this perineal loss is high. Identifying the existing knowledge about the women’s experiences and perceptions of pregnancy loss is essential to understand the impact of the phenomenon on women. This identification is also crucial to adapt and improve the healthcare provided.Subjects and Methods: A systematic literature review, meta-synthesis, of qualitative studies will be developed with the goal of obtaining a comprehensive understanding of mothers’ perception of pregnancy loss and identifying their specific support needs.Inclusion Criteria: This review will consider qualitative investigations that study the perceptions or experiences of adult women who have suffered prenatal loss. All studies published in English, Spanish or Portuguese between January 1, 2012, and December 31, 2022 will be considered. This systematic review will follow the Joanna Briggs Institute statement for systematic reviews of qualitative design. The Psychology and Behavioral Sciences Collection, Scopus, CINAHL®, MEDLINE® and Cochrane Database of Systematic Reviews (CDRS) databases will be utilized for research. Data extraction will be performed in-peers by the researchers, using the Joanna Briggs Institute model. Finally, the available data will be analysed using a meta-aggregation approach.Conclusion: A better understanding of this phenomenon will be useful, identifying, on the one hand, the support needs of women who have suffered fetal loss and, on the other hand, also identifying the support and interventions that can be implemented by health professionals.Systematic Review Registration Number: PROSPERO® (CRD42023407314).Keywords: mother, gestational loss, perinatal loss, systematic review, thematic synthesis

Diego José Montero-Tejero,1 Nerea Jiménez-Picón,2 Juan Gómez-Salgado,3,4,* Elena Vidal-Tejero,5 Javier Fagundo-Rivera6,* 1Department of Emergency, Hospital Universitario Lucus Augusti, Galician Health Service, Lugo, Galicia, Spain; 2Department of Nursing, Faculty of Nursing, Physiotherapy and Podiatry, University of Seville, Seville, Andalusia, Spain; 3Department of Sociology, Social Work and Public Health, Faculty of Labour Sciences, University of Huelva, Huelva, Andalusia, Spain; 4Safety and Health Postgraduate Programme, Universidad Espíritu Santo, Guayaquil, Ecuador; 5Department of Cardiology, Hospital Universitario Virgen Del Rocío, Andalusian Health Service, Sevilla, Andalusia, Spain; 6Centro Universitario de Enfermería Cruz Roja, University of Seville, Sevilla, Andalusia, Spain*These authors contributed equally to this workCorrespondence: Juan Gómez-Salgado, Department of Sociology, Social Work and Public Health, Faculty of Labour Sciences, University of Huelva, Avda. Tres de Marzo, S/N, Huelva, 21007, Spain, Tel +34 959219700, Email salgado@uhu.es Javier Fagundo-Rivera, Centro Universitario de Enfermería Cruz Roja, Sevilla, Spain, Avda, de la Cruz Roja, 1, duplicado, Sevilla, 41009, Spain, Tel +34 954350997, Email javier.fagundo@cruzroja.esObjective: To assess personal and work-related factors influencing the stress levels of nurses during prehospital care. Specifically, to identify associations between the level of perceived stress, the degree of professional experience, and the level of knowledge. Secondly, to examine the relationship between stress levels and violence in the work environment. And third, to investigate the main protective factors against work-related stress during prehospital care.Methods: Systematic review in PubMed, WOS, Enfispo, Cochrane, and LILACS databases following the PRISMA methodology (last search 08/Aug/2023). Following the PECO framework, studies on occupational stress factors in ambulance emergency nurses were investigated. Studies in English or Spanish, from 2013 to 2023, and only research articles were admitted, thus excluding reviews, dissertations, and grey literature. Possible bias and level evidence were assessed using critical appraisal tools and GRADE. This protocol was registered in PROSPERO with code CRD42023446080.Results: Fourteen articles were selected, and n=855 prehospital nurses were identified. One study was a clinical trial, and the others were observational and qualitative. The level of evidence was very low (n=7), low (n=6), and moderate (n=1); any study was excluded due to methodological bias. Five categories of stressors were extracted: the management of the health service (ie, workload organisation, and resources), patient care (mainly paediatric care), interpersonal stressors (relationship with peers), environmental factors (exposure to injuries), and personal factors (training, experience, and coping strategies). Violence at work is frequent for prehospital nurses, implying both verbal and physical aggressions. Support from peers was associated with positive results against stress.Conclusion: Managing workload and improving resources in the work environment are essential to reduce fatigue and allow emotional processes to be addressed. Providing workers with coping skills also imposes on them the responsibility to cope with stress. Collective awareness is the main element in reducing the incidence of stress.Keywords: ambulance, prehospital, emergency care, nurses, stress, occupational health, management

Murat Yıldırım,1,2 Ümit Dilekçi,3 Francesco Marcatto,4 Juan Gómez-Salgado5,6 1Department of Psychology, Faculty of Science and Letters, Agri Ibrahim Cecen University, Agri, Turkey; 2Department of Social and Educational Sciences, Lebanese American University, Beirut, Lebanon; 3Department of Child Development, Batman University, Batman, Turkey; 4Department of Life Sciences, University of Trieste, Trieste, Italy; 5Department of Sociology, Social Work and Public Health, Faculty of Labour Sciences, University of Huelva, Huelva, Spain; 6Safety and Health Postgraduate Program,Universidad Espíritu Santo, Guayaquil, EcuadorCorrespondence: Murat Yıldırım, Department of Psychology, Faculty of Science and Letters, Agri Ibrahim Cecen University, Fırat Mahallesi Yeni Üniversite Caddesi, No: 2 AE/1 04100 Merkez, Ağrı, Turkey, Email muratyildirim@agri.edu.tr; muratyildirimphd@gmail.com Juan Gómez-Salgado, Department of Sociology, Social Work and Public Health, Faculty of Labour Sciences, University of Huelva, Avenida Tres de marzo, s/n, Huelva, 21007, Spain, Tel +34 959219700, Email salgado@uhu.es; jgsalgad@gmail.comIntroduction: Measuring and understanding perceived occupational stress is crucial for understanding workers’ experiences of stress in the workplace and its potential implications on mental health outcomes and job performance. However, there is a scarcity of brief measures containing relevant items focused solely on occupational stress, suitable for integration with risk assessment tools for work-related stress. This study aimed to validate the Perceived Occupational Stress (POS) scale in Turkish and examined its measurement invariance across Turkish and Italian samples.Methods: The participants included 350 Turkish teachers (55.7% male) and 160 Italian workers (60.6% female).Results: The results showed a single-factor structure explaining 69.61% of the total variance for the POS. The internal consistency was found to be high in both samples. The results also indicated that the factor structure of the POS was equivalent across the two groups, supporting measurement invariance.Conclusion: Overall, the POS demonstrated solid measurement properties, including validated factor structure, internal reliability, and measurement invariance.Keywords: perceived occupational stress, work-related stress, measurement invariance, cross-cultural comparisons, Turkish transcultural translation, validity and reliability

Francisco Javier Muñoz-Vela,1,2,* Francisco Javier Fernández-Carrasco,3 Juan Gómez-Salgado,4,5 Regina Allande-Cussó,6,* Isabel Margarida Marques Monteiro Dias Mendes,7 Emilia Isabel Martins Teixeira-da-Costa,8,9 Juana María Vázquez-Lara,3 Javier Fagundo-Rivera,10 Luciano Rodríguez-Díaz3 1Department of Nursing, Faculty of Health Sciences, University of Málaga, Málaga, Spain; 2Obstetrics and Gynecology Area, Hospital Regional Universitario de Málaga, Málaga, Spain; 3Department of Gynaecology and Obstetrics, Ceuta University Hospital, Midwifery Teaching Unit of Ceuta, University of Granada, Ceuta, Spain; 4Department of Sociology, Social Work and Public Health, Faculty of Labour Sciences, University of Huelva, Huelva, Spain; 5Safety and Health Postgraduate Programme, Universidad Espíritu Santo, Guayaquil, Ecuador; 6Department of Nursing. University of Seville, Seville, Spain; 7Unidade Científico-Pedagógica de Enfermagem de Saúde Materna, Obstétrica e Ginecológica, UICISA: E. Escola Superior de Enfermagem de Coimbra, Coimbra, Portugal; 8Department of Nursing, Health School, University of Algarve, Faro, Portugal; 9Health Sciences Research Unit: Nursing, Escola Superior de Enfermagem de Coimbra, Coimbra, Portugal; 10Centro Universitario de Enfermería Cruz Roja, Sevilla, Spain*These authors contributed equally to this workCorrespondence: Juan Gómez-Salgado, Department of Sociology, Social Work and Public Health, Faculty of Labour Sciences, University of Huelva. Avda. Tres de Marzo, S/N, 21007, Huelva, Spain, Tel +34 959219700, Email salgado@uhu.esObjective: The aim of the study was to assess the levels of fear and anxiety in the particularly vulnerable population group of women during pregnancy.Methods: Cross-sectional study between March 2022 and July 2022 involving 978 pregnant women aged 16 to 50 years. It was carried out based on the scale for the assessment of fear and anxiety in pregnant women (AMICO_Pregnant) and the collection of sociodemographic data. Normality analysis was performed prior to univariate and bivariate statistical analysis.Results: The sample was composed of a total of 978 pregnant women. The mean of the AMICO_Pregnant scale was intermediate (5.04 points; SD=2.36). The bivariate analysis showed a statistically significant relationship between the AMICO_Pregnant scale and the following variables: vaccination schedule status, contact with the disease, weeks of gestation, altered delivery or birth plan.Conclusion: Women with pregnancies closer to term, with no contact with the disease, without a complete vaccination schedule, or who had undergone changes in their delivery or birth plans, showed higher levels of fear and anxiety.Keywords: pregnancy, COVID-19, fear, anxiety, questionnaire, mental health, public health

Francisco Javier Muñoz-Vela,1,2 Francisco Javier Fernández-Carrasco,3 Juan Gómez-Salgado,4,5 Regina Allande-Cussó,6 Isabel Margarida Marques Monteiro Dias Mendes,7 Emilia Isabel Martins Teixeira-da-Costa,8,9 Juana María Vázquez-Lara,3 Javier Fagundo-Rivera,10 Luciano Rodríguez-Díaz3 1Department of Nursing, Faculty of Health Sciences, University of Malaga, Malaga, Spain; 2Obstetrics and Gynecology Area, Hospital Regional Universitario de Malaga, Málaga, Spain; 3Department of Gynaecology and Obstetrics, Ceuta University Hospital, Midwifery Teaching Unit of Ceuta, Spain, University of Granada, Ceuta, Spain; 4Department of Sociology, Social Work and Public Health, Faculty of Labour Sciences, University of Huelva, Huelva, Spain; 5Safety and Health Postgraduate Programme, Universidad Espíritu Santo, Guayaquil, Ecuador; 6Department of Nursing. University of Seville, Seville, Spain; 7Unidade Científico-Pedagógica de Enfermagem de Saúde Materna, Obstétrica e Ginecológica, UICISA: E. Escola Superior de Enfermagem de Coimbra, Coimbra, Portugal; 8Nursing Department. Health School. University of Algarve, Faro, Portugal; 9Health Sciences Research Unit: Nursing, Escola Superior de Enfermagem de Coimbra, Coimbra, Portugal; 10Centro Universitario de Enfermería Cruz Roja, Sevilla, SpainCorrespondence: Juan Gómez-Salgado, Department of Sociology, Social Work and Public Health, Faculty of Labour Sciences, University of Huelva, Avda. Tres de Marzo, S/N, Huelva, 21007, Spain, Tel +34 959219700, Email salgado@uhu.es

Sara Domínguez-Salas,1 Carmen Rodríguez-Domínguez,1 Ana Isabel Arcos-Romero,1 Regina Allande-Cussó,2 Juan Jesús García-Iglesias,3 Juan Gómez-Salgado3,4 1Department of Psychology, Universidad Loyola Andalucía, Dos Hermanas, Seville, Spain; 2Department of Nursing, University of Seville, Seville, Spain; 3Department of Sociology, Social Work and Public Health, University of Huelva, Huelva, Spain; 4Safety and Health Postgraduate Programme, Universidad Espíritu Santo, Guayaquil, EcuadorCorrespondence: Carmen Rodríguez-Domínguez, Department of Psychology, Universidad Loyola Andalucía, Avenida de las Universidades s/n, Dos Hermanas, Seville, 41007, Spain, Tel +34 955 641 600 (Ext. 2625), Email mcrodriguez@uloyola.esPurpose: The impact of the COVID-19 pandemic on the working, personal and health conditions of health professionals has been highlighted, although it is necessary to verify whether certain instruments used in research on this topic have sufficient psychometric support for their use. This need was the main motivation for undertaking the present study. We aimed to analyse the psychometric properties of the Utrecht Work Engagement Scale (UWES-9) in a sample of active health care workers during the pandemic.Patients and Methods: A cross-sectional study was conducted from March to August 2020 with 2326 active health care workers (78.7% women). The instruments that were applied included the UWES-9 scale, the Sense of Coherence scale (SOC-13), the Goldberg General Health Questionnaire (GHQ-12) and an item on self-perceived health.Results: The three-factor structure related to the correlation of pairs of errors presented the best fit. The reliability of the UWES-9 was highlighted by the adequate internal consistency of the items, the existence of invariance according to gender, and its convergent and discriminant validity.Conclusion: The findings of this work support the use of the UWES-9 to assess the work engagement of health personnel during the COVID-19 pandemic and identify it as an adequate measure of this psychological variable and the constructs that comprise it.Keywords: gender invariance, UWES-9, engagement, health care professionals, COVID-19, psychometric

Cristina Morgado-Toscano,1 Regina Allande-Cussó,2 Javier Fagundo-Rivera,3 Juan Jesús García-Iglesias,4 Jose Antonio Climent-Rodríguez,5 Yolanda Navarro-Abal,5 Juan Gómez-Salgado4,6 1Health Sciences Doctorate School, University of Huelva, Huelva, Spain; 2Department of Nursing, University of Seville, Seville, Spain; 3Centro Universitario de Enfermería Cruz Roja, University of Seville, Seville, Spain; 4Department of Sociology, Social Work and Public Health, Faculty of Labour Sciences, University of Huelva, Huelva, Spain; 5Department of Social, Evolutionary and Educational Psychology, Faculty of Labour Sciences, University of Huelva, Huelva, Spain; 6Safety and Health Postgraduate Programme, Universidad Espíritu Santo, Guayaquil, EcuadorCorrespondence: Regina Allande-Cussó, Department of Nursing, University of Seville, Sevilla, 41009, Spain, Email rallande@us.es Juan Gómez-Salgado, Department of Sociology, Social Work and Public Health, Faculty of Labour Sciences, University of Huelva, Avenida Tres de marzo s/n, 21007, Huelva, Spain, Email salgado@uhu.esObjective: The effects caused by COVID-19 on the physical and mental health show the need to renew and create tools that specifically measure the fear and anxiety caused by the pandemic in healthcare professionals. The aim of the study was to measure fear and anxiety of COVID-19 in the nursing population group using a specific assessment scale.Methods: A descriptive, cross-sectional study was carried out in Spain based on questionnaires. The sample was selected by non-probabilistic snowball sampling. Univariate and bivariate descriptive analyses were performed. For qualitative variables, a categorical regression analysis was performed.Results: The sample consisted of 1012 nurses residing in Spain, 86.6% of whom were women, with a mean age of 40.84 years (SD = 11.51). The bivariate analysis revealed statistically significant differences in the mean score of the scale and the variables sex, level of education, m2 of the dwelling, and work area.Conclusion: The validation of this scale provides a new management tool that should enable managers to assess anxiety and fear among their nurses, whether in the current COVID-19 pandemic or in other possible epidemiological situations to come.Keywords: COVID-19, anxiety, fear, nurses, mental health

Oral anticoagulation self-control programs have demonstrated efficiency and cost-effectiveness over recent years. This study aimed to evaluate the effectiveness of a training intervention focused on patients with antivitamin K anticoagulants included in a self-care program. For this, we made a quasi-experimental study, pretest and post-test, using a validated questionnaire with 2 measures, before and after an educational intervention about oral anticoagulation focused on patients that will initiate the self-control program in consultation. To check the patient's adherence and coagulation level, we evaluated the Rosendaal time in therapeutic rank, both before and after the intervention. One hundred fifty patients were included since the start of the self-monitoring program in our center in 2016. The mean age was 49 years (standard deviation [SD] = 17.24). The distribution by gender was 76 women and 69 men (52.4%-47.6%). The mean score for the first test was 14.61 (SD = 3.26) and the mean score for the second test was 17.01 (SD = 2.14) (P <.001). We also measured Rosendaal time in therapeutic rank, a parameter that indicates stabilization in international normalized ratio determinations and quality of the anticoagulation management. Values before and after interventions were also statistically significant (67.46 vs 70.53, P <.001). Patients' knowledge improved after the training session, with statistical significance. Despite intentional sampling, the population was homogeneous. Scoring data dispersion in the second test was significantly lower than in the first one. Time on therapeutic rank values was better after the training. We intend to adapt its content to the rest of anticoagulated patients to enhance and improve their follow-up., Competing Interests: The authors have no funding and conflicts of interest to disclose., (Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.)

Background: The aim of this study was to assess the sense of coherence (SOC) in the Spanish-speaking population during the 2019 coronavirus disease pandemic., Methods: A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines in the PubMed, Scopus, and Web of Science electronic databases in August 2024. The methodological quality of the included studies was evaluated using the critical appraisal tools developed by the Joanna Briggs Institute., Results: A total of 25 studies were included in the review, which demonstrated that high SOC is associated with improved coping styles, a reduced incidence of mental disorders, and greater resilience to traumatic events. The findings indicated that SOC acts as a crucial protective factor in diverse population groups, including health professionals, university students, and older adults, particularly during the 2019 coronavirus disease pandemic., Conclusions: The study concludes that there are significant benefits for the mental and physical health of the population, regardless of cultural context, to be gained from strengthening the SOC. It is therefore essential that interventions which enhance the SOC are implemented in order to improve public health in times of crisis. Furthermore, it is crucial that SOC measurement instruments are validated in different cultural contexts in order to ensure the reliability and validity of the results obtained., Competing Interests: The authors have no funding and conflicts of interest to disclose., (Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.)

Background: Postoperative delirium is a neurobehavioral disorder that can appear after surgery. It is characterized by an altered level of consciousness and impaired cognitive function. The aim of this study was to evaluate the impact of visual projection of images of relatives or loved ones in patients undergoing cardiac surgery in the immediate postoperative period, and its influence on the incidence and development of postoperative delirium., Methods: A randomized, double-blind clinical trial was designed in the immediate postoperative period of adult patients undergoing cardiac surgery. Consolidated Statement of Reporting Trials guidelines were followed. A control group (CG) and an intervention group (IG) were established. In the IG, the patients underwent a visual projection, while the usual unit treatment was carried out with the CG. Sociodemographic, anthropometric, anesthetic, and surgical variables were also recorded. The postoperative delirium assessment scale used was the confusion assessment method for diagnosing delirium in intensive care unit patients., Results: Information was collected from 104 patients undergoing cardiac surgery. Most of the patients included in the study were men (66.35%) and the most performed surgical intervention was aortic valve replacement (34.62%). In the CG, positive patients in postoperative delirium increased from 19.23% to 25%, while in the IG they decreased from 5.77% to 1.92%. The logistic regression analysis presents a prediction model where the variables that influence the model are gender and group membership, meaning that being female and belonging to the IG significantly reduce the presence of delirium., Conclusion: The projection of visual material reduced the incidence of postoperative delirium in patients undergoing cardiac surgery, although it cannot be established that it is effective as a treatment once the pathology is already established., Competing Interests: The authors have no funding and conflicts of interest to disclose., (Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.)

The claw toe deformity is a painful condition that mainly affects the adult population. Although there are many different treatments to solve the deformity, there is no optimal procedure to restore the normal foot mechanics. The objective of this review was to identify the technical features of the kinematic evaluation methods used in patients with claw toes. Furthermore, the aim of this review was to clarify what is known and what is needed apart from the surgical procedures to correct the claw toe deformity, with the purpose of reducing risk factors of falling in elderly people. A search in electronic databases, such as Scopus (n = 78), Google Scholar (n = 705) and ScienceDirect (n = 290) was conducted. There were seven articles (43.75%) related to the fixation (arthrodesis) of proximal and distal interphalangeal joints, one article (6.25%) describes the correction of the claw toe through plantar plate tenodesis and release of collateral ligaments, four articles (25%) describe the procedure of tendon transfer, one article (6.25%) describes flexor digitorum brevis tenotomy and a proximal interphalangeal joint arthrolysis, and another article (6.25%) presented the impact of partial phalanx osteotomy to treat the claw toe deformity. In conclusion, the review indicates that there are several studies related to the treatment or correction of claw toe deformity. However, there is a lack of knowledge of the postsurgical effects of treating claw toe condition, especially in the structural mechanics (plantar pressure distribution, stability, gait, foot mechanics and so on) of the foot after the correction of the claw toe deformity. The analysis of the foot mechanics after the correction of the claw toes has to be paramount to determine the benefits of the correction., (© 2024 The Author(s). International Wound Journal published by Medicalhelplines.com Inc and John Wiley & Sons Ltd.)

Introduction: The fifth metatarsal fracture is a foot injury that occurs in sports activities. This fracture has been associated with risk factors based on intrinsic variables such as type of feet (flatfoot or cavus foot), foot pathologies, and bone density among others. Extrinsic variables associated with fifth metatarsal fractures include sports maneuvers, the type of sports practice, and contact surface. Although this injury has been investigated over the years, there is no consensus on the most relevant risk factors that cause this injury. An increase in the number of people with fractures makes it a relevant topic of research. The objective of this review was to identify an overview of the risk factors for producing the fifth metatarsal fracture based on intrinsic and extrinsic variables in sports activities. Furthermore, this review aimed to clarify what is known and what is needed on the risk factors that can influence the appearance of the fracture., Methods: A search in electronic databases, such as Scopus (n = 87), PubMed (n = 187), and Web of Science (n = 173) was conducted. The initial search yielded 447 titles and abstracts, from which 31 papers were selected for detailed analysis after screening all citations against the eligibility criteria., Results: After screening the manuscripts, it was found that the fifth metatarsal fracture can be produced by multiple factors. However, most of the studies focus on one or two specific risk factors. It was found that soccer (38.7%) is the sports activity that presents a higher risk of getting a fifth metatarsal fracture compared to other sports activities. The second risk factor was the performance of critical maneuvers (22.5%) and the third one was the biomechanics of the foot (22.5%)., Conclusion: It is paramount to identify the most critical risk factors linked to the fifth metatarsal fracture to be able to implement effective treatments and prevention strategies., (© 2024 The Author(s). Journal of Foot and Ankle Research published by John Wiley & Sons Australia, Ltd on behalf of Australian Podiatry Association and The Royal College of Podiatry.)

Objective: This research aimed to investigate whether subjective general health mediated the relationship between social networks and subjective well-being and whether the perception of fair payment moderated the mediating effect of subjective general health on subjective well-being., Methods: Data were drawn from round 9 of the European Social Survey (ESS), involving 3,843 respondents from 19 countries, with ages ranging from 65 to 90 years (Mean age  = 73.88 ± 6.61 years). The participants completed self-reported measures assessing subjective well-being, social networks, subjective general health, and perception of fair payment., Results: Subjective general health played a mediating role in the relationship between social networks and subjective well-being. The perception of fair payment emerged as a moderator in the mediating effect of subjective general health on the association between social networks and subjective well-being., Conclusion: This study suggests that the impact of social networks on both subjective general health and subjective well-being is contingent upon individuals' perceptions of fair payment. These results highlight the significance of social networks in fostering social connections and promoting overall subjective well-being., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision., (Copyright © 2024 Güler, Yıldırım and Gómez-Salgado.)

Objective: To evaluate the foot-health-related quality of life in individuals with versus without lower-limb lymphedema., Methods: A case-control study was carried out in an academic clinic in Lisbon, Portugal. Eighty participants (40 controls and 40 with lymphedema) were included in the study. The researchers examined sociodemographic and clinical data and foot-health-related quality of life in both groups. In the group with lymphedema, lower-limb lymphedema was also characterized., Results: Individuals with lower-limb lymphedema had significantly lower scores on all dimensions of the Foot Health Status Questionnaire in comparison with the control group., Conclusions: Individuals with lower-limb lymphedema appear to have a poorer foot-health-related quality of life than the general population., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Objective: The objective was to develop and validate a predictive model of initiation of breastfeeding in the first hour after delivery., Methods: Retrospective cohort study on women who gave birth between 2013 and 2018 in Spain. For data collection, an ad hoc questionnaire was designed to be filled in by the mothers, which was distributed to the different Spanish breastfeeding associations which, in turn, shared it with their associate partners. The development of the predictive model was made on a cohort of 3218 women (2/3) and was validated on a cohort of 1609 women (1/3). Mothers whose children were admitted to hospital at the time of birth were excluded. A multivariate analysis was performed by means of logistic regression, and predictive ability was determined by areas under the ROC curve (AUC)., Results: 81.0 % (2608) women started breastfeeding in the first hour in the derivation cohort, and 80.1 % (1289) in the validation cohort. The predictive factors in the final model were: the highest number of children and skin-to-skin contact at birth as flattering factors, while dystocic delivery reduced the likelihood of the onset of breastfeeding. The predictive ability (ROC AUC) in the derivation cohort was 0.89 (CI 95 %: 0.87-0.90), while in the validation cohort it was 0.89 (CI 95 %: 0.87-0.92)., Conclusions: This three-variable predictive model has excellent predictive ability in both the derivation cohort and the validation cohort. This model can identify women who are at high risk of non-initiating breastfeeding within the first hour after delivery., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Objective: Psychological capital refers to internal resources including self-efficacy, hope, optimism and resilience to overcome adverse life events. The current study sought to examine the mediating role of psychological capital in the relationship between intolerance of uncertainty and job satisfaction and work performance in healthcare professionals. Methods: Participants were 302 healthcare professionals [48% females; M(SD) age = 34.0 (7.5)] and completed measures of intolerance of uncertainty, psychological capital, work performance, and job satisfaction. Results: The findings indicated that intolerance of uncertainty was negatively correlated with psychological capital, work performance, and job satisfaction, whereas psychological capital was positively correlated with job satisfaction and work performance. More importantly, the findings revealed that these relationships were mediated by psychological capital. Conclusion: The results provide several contributions that help to understand the role of psychological capital in the relationship between intolerance to uncertainty and job satisfaction and work performance., Competing Interests: The authors declare that they do not have any conflicts of interest., (Copyright © 2024 Yıldırım, Çağış and Gómez-Salgado.)

The COVID-19 pandemic posed a major challenge for construction companies, which were confronted with the need to prevent the enormous negative socio-psychological impact of the pandemic on their employees. The aim of this study was to evaluate the level of psychological distress among construction workers in an advanced phase of the COVID-19 pandemic in Andalusia, southern Spain. For this, a cross-sectional descriptive study was conducted using online questionnaires with data on sociodemographic variables and employment situation, COVID-19 pandemic-related data, and Goldberg's General Health Questionnaire (GHQ-12). A total of 860 questionnaires from all provinces of Andalusia, Spain, were collected between March and May 2022. Descriptive statistical analyses and non-parametric Mann-Whitney U and Chi-squared tests were performed, followed by logistic regression analysis. The incidence of psychological distress was higher among women, individuals under 43 years of age, those with a family income below EUR 1200, participants whose working conditions had been affected by the pandemic, those who had not received adequate means or specific training to protect themselves from infection, those who had experienced symptoms, those who had suffered side effects after vaccination, and those who had been hospitalised. The logistic regression analysis predicted the occurrence of psychological distress in this study by the effect of the pandemic on mental/emotional well-being, the working conditions affected during the pandemic, health-related variables, and the age of the worker. The correctly classified percentage was 75.1%. Assessing psychological distress in construction sectors may allow for the identification of vulnerable groups or even help to reduce the number of errors in daily practice and potential risks of occupational injury or illness.

During the severe acute respiratory syndrome coronavirus 2 pandemic, hospital resources, particularly critical care units, were overburdened and this had a significant impact on both the therapies and the prognosis of these patients. This study aimed to identify factors and therapies that may improve prognosis and other factors associated with increased mortality. A secondary objective was to evaluate the impact that obesity had on these patients. An observational study was conducted on 482 patients aged 18 years or older who were diagnosed with SARS-CoV-2 pneumonia and admitted to the Intensive Care Units of 3 national hospitals registered in the CIBERESUCICOVID database between September 2020 and March 2021. After identifying the sample profile, risk factors were analyzed, the predictive model was constructed, and crude odd ratios were calculated for each factor. Additionally, logistic regression was used to build the multivariate model adjusting for potential confounders. The final model included only the variables selected using the Backward method. A sample of 335 men (69.5%) and 145 women (30.08%) aged 61.94 ± 12.75 years with a body mass index (BMI) of 28.05 (25.7; 31.2) was obtained. A total of 113 patients received noninvasive mechanical ventilation. The most common comorbidities were: high blood pressure (51.04%), obesity (28%), diabetes mellitus (23.44%), other metabolic diseases (21.16%), chronic heart failure (18.05%), chronic obstructive pulmonary disease (11.62%), and chronic kidney disease (10.16%). In-hospital, 3-month and 6-month post-discharge mortality in patients with BMI > 30 (n = 135) versus BMI ≤ 30 (n = 347) was significantly different (P = .06). Noninvasive mechanical ventilation failed in 42.4% of patients with BMI > 30 compared to 55% of patients with BMI ≤ 30. This study identified the factors associated with failure of mechanical ventilation. The most common comorbidities were congestive heart failure, high blood pressure, chronic kidney disease, severe liver disease, diabetes mellitus, and solid organ transplantation. In terms of ventilatory support, patients who received high-flow nasal oxygen therapy on admission had lower mortality rates. The use of renal replacement therapy was also significantly associated with higher mortality., Competing Interests: The authors have no funding and conflicts of interest to disclose., (Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.)

The aim of this study was to analyze the impact and the clinical and evolutionary characteristics of hypotonic hyponatremia in patients hospitalized in Internal Medicine units. Prospective multicenter observational study of patients with hypotonic hyponatremia (<135 mmol/L) in 5 hospitals in southern Spain. Patients were included according to point prevalence studies carried out every 2 weeks between March 2015 and October 2017, by assessing demographic, clinical, analytical, and management data; each patient was subsequently followed up for 12 months, during which time mortality and readmissions were assessed. A total of 501 patients were included (51.9% women, mean age = 71.3 ± 14.24 years), resulting in an overall prevalence of hyponatremia of 8.3%. The mean comorbidities rate was 4.50 ± 2.41, the most frequent diagnoses being heart failure (115) (23%), respiratory infections (65) (13%), and oncological pathologies (42) (6.4%). Of the total number of hyponatremia cases, 180 (35.9%) were hypervolemic, 164 (32.7%) hypovolemic, and 157 (31.3%) were euvolemic. A total of 87.4% did not receive additional diagnostic tests to establish the origin of the condition and 30% did not receive any treatment. Hospital mortality was 15.6% and the mean length of stay was 14.7 days. Euvolemic and admission hyponatremia versus hyponatremia developed during admission were significantly associated with lower mortality rates (P = .037). Mortality at 1 year and readmissions were high (31% and 53% of patients, respectively). Hyponatremia was common in Internal Medicine areas, with hypervolemic hyponatremia being the most frequent type. The mortality rate was high during admission and at follow-up; yet there is a margin for improvement in the clinical management of this condition., Competing Interests: The authors have no funding and conflicts of interest to disclose., (Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.)

Objectives: The aim of this study was to analyse the relationship between sense of coherence, work engagement, and work environment variables as predictors of the level of psychological distress during the first phase of the COVID-19 pandemic in Chile., Methods: Cross-sectional descriptive study collected between April 22 and December 16, 2020, using non-probabilistic snowball sampling. The study variables and instruments were socio-demographic variables, work engagement (UWES-9 scale), sense of coherence (Antonovsky SOC-13 scale), and psychological distress (GHQ-12 scale). Multivariate analysis and binary logistic regression were performed including the scores of the three questionnaires and other variables such as effectiveness, safety, stress, health perception, and sex. Finally, the CHAID technique was applied to create a segmentation tree., Results: 72.7 % of participants had high levels of psychological distress, more predominantly among women, with work stress and low sense of coherence acting as the most influential mediators in generating psychological distress, and even more so when both were combined. Low work engagement and the availability of safe and effective means to prevent infection were predictors of psychological distress among workers., Conclusion: During the first phase of the COVID-19 pandemic, factors that contributed to psychological distress in the Chilean population were identified. These included a fair or poor perception of health, being a woman, work-related stress, availability of safety measures, low level of work engagement, and low level of sense of coherence. Identifying these factors may help prevent similar effects in future phases of the current pandemic or in future pandemics., Competing Interests: The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: The author Juan Gómez-Salgado, PhD, is an Associate Editor of the Public Health section of this journal (Heliyon). If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Authors.)

Background: Ankylosing spondylitis (AS) is a chronic, inflammatory, and autoimmune disease. This condition primarily affects the axial skeleton and presents direct foot involvement, such as Achilles enthesitis or plantar fascia involvement., Objective: This study aimed to investigate the impact of foot health on the quality of life of individuals with AS compared to a control group without AS., Materials and Methods: A sample of 112 subjects was recruited, with a mean age of 46.80 ± 10.49 years, divided into two groups: 56 individuals with AS (cases) and 56 individuals without AS (controls). Demographic data were collected, and the scores obtained in the Foot Health Status Questionnaire domains were recorded., Results: Of the participants, 27.79% ( N  = 30) were men and 73.21% ( N  = 82) were women. The mean age in the group was 46.80 ± 10.49. Significant differences ( p  < 0.05) were found in the domains of foot function, foot pain, footwear, overall foot health, general health-related physical activity, and social capacity between the AS group and the control group., Conclusion: Individuals with AS exhibited a decreased quality of life, as indicated by their Foot Health Status Questionnaire scores., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Cortes-Rodríguez, Alves-Gomes, Losa-Iglesias, Gómez-Salgado, Becerro-de-Bengoa-Vallejo, Saavedra-García, Montiel-Luque, López-López and Jiménez-Cebrián.)

Migrants living in the informal settlements of Southern Spain tend to have precarious employment and poor living conditions, making then vulnerable to mental health issues. This study aimed to assess psychological distress in a sample of unemployed migrants residing in informal settlements in the province of Huelva (southern Spain), during the fourth wave of the COVID-19 pandemic. A descriptive cross-sectional study was conducted during the months of April to June 2021, through a heteroadministered questionnaire, in informal settlements. The measurement instrument was the General Health Questionnaire (GHQ-12), used to analyze psychological distress, and other sociodemographic and health-related variables. Univariate and bivariate descriptive data analysis were performed, using the nonparametric statistics Mann-Whitney U test, Kruskal-Wallis H test, and Tau β correlation. A categorical regression analysis was performed to study the relationship between psychological distress and the rest of the variables. The sample consisted of 317 subjects, 83.9% of whom were males, and the mean age was 33.4 years (SD = 10.7 years). The mean score obtained in the GHQ-12 questionnaire was 13.69 points (SD = 3.86). Significant differences were found between levels of psychological distress and substance abuse (H = 14.085; P = .049), people who wished to stay in Spain (t = 6987; P = .049), people who experienced isolation due to COVID-19 contact (t = 1379.5; P = .001), people who needed medical assistance due to COVID-19 (t = 7.990; P = .018), and those who reported having chronic illnesses (t = 2686.5, P = .02). The mean score of psychological distress indicates general high levels of psychological distress. Participants who had experienced isolation due to COVID-19 contact, who consumed substances, and who had chronic illnesses reported the highest levels of psychological distress., Competing Interests: The authors have no funding and conflicts of interest to disclose., (Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.)

Objective: The objective of this study was to investigate the relationship between upper limb kinetics and perceived fatigability in elderly individuals during an upper limb position sustained isometric task., Methods: A total of 31 elderly participants, 16 men (72.94±4.49 years) and 15 women (72.27±6.05 years), performed a upper limb position sustained isometric task. Upper-limb acceleration was measured using an inertial measurement unit. Perceived fatigability was measured using the Borg CR10 scale., Results: Higher mean acceleration in the x-axis throughout the activity was associated with higher final perceived fatigability scores. Moderate correlations were observed between perceived fatigability variation and mean acceleration cutoffs in all axes during the second half of the activity. In women, significant correlations were found between all perceived fatigability cutoffs and mean acceleration in the y- and x-axes. However, in men, the relationships between perceived fatigability variation and mean acceleration were more extensive and stronger., Conclusion: The acceleration pattern of the upper limb is linked to perceived fatigability scores and variation, with differences between sexes. Monitoring upper limb acceleration using a single inertial measurement unit can be a useful and straightforward method for identifying individuals who may be at risk of experiencing high perceived fatigability or task failure.

Introduction: Silver-releasing dressings are used in the treatment of infected wounds. Despite their widespread use, neither the amount of silver released nor the potential in vivo toxicity is known. The aim of this study was to evaluate the cytotoxic effects and the amount of silver released from commercially available dressings with infected wounds., Methods: The review was conducted according to the PRISMA statement. The Web of Science, PubMed, Embase, Scopus, and CINAHL databases were searched for studies from 2002 through December 2022. The criteria were as follows: population (human patients with infected wounds); intervention (commercial dressings with clinical silver authorized for use in humans); and outcomes (concentrations of silver ions released into tissues and plasma). Any study based on silver-free dressings, experimental dressings, or dressings not for clinical use in humans should be excluded. According to the type of study, systematic reviews, experimental, quasi-experimental, and observational studies in English, Spanish, or Portuguese were considered. The quality of the selected studies was assessed using the JBI critical appraisal tools. Studies that assessed at least 65% of the included items were included. Data were extracted independently by two reviewers., Results: 740 articles were found and five were finally selected (all of them quasi-experimental). Heterogeneity was found in terms of study design, application of silver dressings, and methods of assessment, which limited the comparability between studies., Conclusion: In vivo comparative studies of clinical dressings for control of infection lack a standardized methodology that allows observation of all the variables of silver performance at local and systemic levels, as well as evaluation of its cytotoxicity. It cannot be concluded whether the assessed concentrations of released silver in commercial dressings for the topical treatment of infected wounds are cytotoxic to skin cells., Systematic Review Registration: https://www.crd.york.ac.uk/prospero/display&#95;record.php?ID=CRD42022351041, PROSPERO [CRD42022351041]., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Sánchez-Gálvez, Martínez-Isasi, Gómez-Salgado, Rumbo-Prieto, Sobrido-Prieto, Sánchez-Hernández, García-Martínez and Fernández-García.)

Introduction: Kinesiophobia and lymphedema appear to be related conditions, and it is important to understand this relationship, as many of the symptoms and comorbidities presented by individuals with lower limb lymphedema are prevented and treated through movement, thus constituting kinesiophobia as a barrier to intervention. The objective of this study is, therefore, to evaluate and analyze the kinesiophobic beliefs reported by individuals with and without lower limb lymphedema, regarding the agreement, severity and differences found, and to establish levels of kinesiophobia., Methods: A case-control study with a total sample of 80 participants (40 with lower limb lymphedema and 40 without) was performed. Both groups (with and without lymphedema) were characterized anthropologically, sociodemographically, and clinically. In the case group, lymphedema was evaluated. Participants in both groups completed the Tampa Scale for Kinesiophobia - 13 items (TSK-13)., Results: Individuals with lower limb lymphedema had higher TSK-13 scores than their matched group without lymphedema. The items belonging to the activity avoidance subscale had the highest agreement and score in both groups. Differences between groups were mainly established for items belonging to the somatic focus subscale, showing that individuals with lower limb lymphedema have kinesiophobic beliefs related to the perceived severity of their lymphedema. The prevalence of kinesiophobia was increased in both groups, but the severity was mild., Conclusions: Considering the apparent tendency of people with lower limb lymphedema to present kinesiophobia and movement-limiting beliefs regarding the condition, greater attention should be paid to its assessment, prevention and treatment from a multidisciplinary and multimodal perspective, which takes into account the multiplicity of factors inherent to kinesiophobia and lymphedema and thus reduce their impact on the management of lymphedema., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Monteiro, de Labra, Losa-Iglesias, Dias, Becerro-de-Bengoa-Vallejo, Silva-Migueis, Macedo, López-López and Gómez-Salgado.)

Background: COVID-19 pandemic imposed drastic and abrupt changes to working environment and organization and that might have caused additional negative effects on mental health. Thus, this study aimed to quantify and assess the severity of psychological distress experienced by Brazilian essential and nonessential workers during the first months of the COVID-19 pandemic., Methods: This descriptive study included 2,903 participants who answered an online questionnaire between April and May 2020. The research questionnaire was translated and culturally adapted to the Brazilian population from a questionnaire developed and validated for the Spanish population. Variables were analyzed using simple and cumulative percentage distributions and measures of central tendency and dispersion. The Wilson score interval was used to calculate confidence interval (CI) for the main outcome, psychological distress., Results: It was observed a high prevalence (72.6%) of psychological distress among the study's participants. They also presented a median risk perception score of 60 (out of a maximum of 90), and their greatest concern was transmitting the virus to family members, close contacts or patients. Furthermore, it was found a lower sense of coherence and work engagement among the participants than those observed in previous studies conducted in other countries., Conclusion: Almost three quarters of the study's participants were classified as presenting psychological distress. Thus, it is imperative to provide mental health remotely delivered interventions to workers during public health events that require prolonged social distancing measures., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Alonso, Lima, Dias, Camacho-Vega, García-Iglesias, Ruiz-Frutos, Bernardes and Gómez-Salgado.)

Foot problems are very common in the community. Studies indicate that between 18% and 63% of people have foot pain or stiffness and that foot problems have a large impact on people's functional decline and a significant detrimental impact on measures of quality of life related to health. The general objective of this research was to compare foot health in people from the rural population compared to people from the urban population and its relationship with quality of life. A case-control descriptive study was developed with a sample of 304 patients, 152 patients from the rural population and 152 patients from the urban population. Quality of life was measured through the SF-36 Health Questionnaire in its Spanish version. The rural population group had a mean age of 46.67 ± 13.69 and the urban population group 49.02 ± 18.29. Regarding the score of the lowest levels of quality of life related to foot problems, the rural population group compared to the urban population group showed: for body pain (52.21 ± 30.71 vs. 67.80 ± 25.28, p < 0.001); and for mental health (69.58 ± 18.98 vs. 64.60 ± 14.88, p < 0.006). Differences between groups were analysed using Student's t-test for independent samples, which showed statistical significance (p < 0.05). This research offers evidence that the rural population presents better levels of mental health and lower levels of bodily pain in the domains of the SF-36 Health Questionnaire comparing with the urban population., (© 2024 The Authors. International Wound Journal published by Medicalhelplines.com Inc and John Wiley & Sons Ltd.)

Objectives: To validate the items of the Emotional Impact Questionnaire coronavirus disease-2019 (COVID-19) related to risk perception, estimating its degree, among healthcare workers in the first wave of COVID-19 pandemic, identifying possible associated factors.Methods: cross-sectional study in 1872 healthcare workers of Brazil. The population was characterized by sociodemographic and occupational information, knowledge about COVID-19, quality of information received, risk perception and preventive measures about the disease, and sense of coherence., Results: Being divorced, having a chronic disease, spending more than 1 h per day getting informed about COVID-19, and always or almost always wearing a mask regardless of symptoms, as well as self-perception of health were associated with high-risk perception. An inverse association was found between risk perception, sense of coherence and not knowing if one has had occasional contact with confirmed COVID-19 cases., Conclusion: Risk perception is influenced by emotions, experiences, and knowledge. Sense of coherence and resilience have a role in reducing risk perception. Understanding risk perception is crucial for developing effective strategies to mitigate the impact of the COVID-19 pandemic and other similar scenarios., Competing Interests: The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: The author Prof. Juan Gómez-Salgado, PhD, is an Associate Editor of Heliyon's Public Health section. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Authors.)

Pregnancy is one of the most complex periods in a woman's life, not only because of the biological changes involved but also because of the psychological aspects. Stress during pregnancy refers to the concerns and distress that arise during pregnancy and that can be assessed by means of psychological and physiological scales. The aim of this study was to analyse prenatal stress and to evaluate its consequences on the health of both the mother and the foetus. A descriptive longitudinal study was carried out on a sample of 398 pregnant women being followed up during their entire pregnancy, who gave birth at the Punta de Europa University Hospital in Algeciras (Spain) between September 2021 and August 2023. The Prenatal Distress Questionnaire (PDQ) was used, as well as serum cortisol levels in each trimester of pregnancy and birth experience using the Childbirth Experience Questionnaire in its validated Spanish version, CEQ-E. Demographic and obstetric variables were included. One of the main findings was that experiencing more stress in late pregnancy had a negative impact on obstetric outcomes. Women who had higher levels of prenatal distress had higher blood cortisol levels and increased risk of having a caesarean section at delivery. A significant negative correlation was also found between stress and Apgar test values in the first minute of life. It is concluded that interventions promoted by the health system that provide comprehensive prenatal care contribute to decreased stress as perceived by these pregnant women, thus reducing the risk of maternal and foetal morbidity.

Objectives: Pregnancy is a stage in which different physical and psychological changes take place that can affect the sexuality of the couple. The aim of the study is to identify how the physical and psychological changes derived from pregnancy affect the sexual desire of women and men. Methods: A systematic review of the literature was carried out in five databases, from which a total of 16,126 documents were obtained. After applying the PRISMA selection criteria, a total of 19 documents were selected. Results: Levels of sexual desire fluctuate during pregnancy, being the second trimester of gestation the period in which desire is at its highest and in which physical limitations and emotional changes decrease. Women have lower levels of sexual desire in the first trimester, while men have the lowest levels of desire in the third trimester. Conclusion: Pregnancy is a stage marked by physiological and psychological changes that modify several areas, including sexuality. Healthcare professionals should promote a healthy sexuality, avoiding the appearance of fears or sexual dysfunctions caused by the changes that occur during pregnancy., Competing Interests: The authors declare that they do not have any conflicts of interest., (Copyright © 2024 Fernández-Carrasco, Batugg-Chaves, Ruger-Navarrete, Riesco-González, Palomo-Gómez, Gómez-Salgado, Rodriguez Diaz, Vázquez-Lara, Fagundo-Rivera and Vázquez-Lara.)

Cancer is a social issue as its outreach affects not only mortality (it is the second cause of death in our environment) but also the costs due to morbidity and the distress it causes, as well as the losses and consequences in personal, family, work, and even social areas. This study is trying to find out the health needs of long-term cancer survivors and their perceptions and expectations of the care they received during their survival stage. For this, a joint, cross-sectional descriptive study with a qualitative and quantitative approach has been designed. For the qualitative approach, we have used different focus groups representing different geographical areas of the Spanish territory. For the qualitative approach, we have used a validated questionnaire. This study will provide a better knowledge of the quality of life of these patients, as well as their level of unmet and even unexpressed needs, in order to develop effective strategies and interventions that allow for the implementation of adapted care plans that include such unexpressed needs. This study will also allow for the creation and development of assessment methods for health results from the patient's perspective and experience. These issues require a multidisciplinary, complex approach. These survivors may require not well-known health services, as the number of these patients has grown recently, and their survival time is also longer. This research explores a wider and more thorough perspective of long-term cancer survivors' needs, experiences, and expectations to be achieved.

Aim: The aim of this study is to validate the Spanish version of the five-item General Self-Efficacy scale in a sample of nursing students, by: 1) offering evidence of validity and reliability; 2) studying the longitudinal measurement invariance of the scale; 3) providing evidence on the changes in the levels of self-efficacy that occur after one year of nursing education; and 4) offering longitudinal evidence on the relationship between nursing students' self-efficacy and resilience levels., Background: Nurses' general self-efficacy has been related to both personal and organizational outcomes. In Spain, some competencies the students must acquire during the Degree in Nursing implicitly refer to self-efficacy. For the measurement of general self-efficacy, the General Self-Efficacy Scale is one of the most widely used in Europe., Design: A longitudinal design was used. Research took place at the University of Valencia and the University of the Balearic Islands (Spain). Participants were 324 nursing students, in the first year of the Nursing Degree., Methods: The five-item General Self-Efficacy scale and the Brief Resilience Coping Scale were used. Analyses included descriptive statistics, reliability estimates, confirmatory factor analysis, a longitudinal measurement invariance routine and several competing cross-lagged models., Results: Evidence of reliability shown by the scale was adequate and a one-factor solution for the structure was found. Additionally, the five-item GSE showed evidence of invariance over time. A causal effect of self-efficacy on nursing students' levels of resilience was found., Conclusions: The Spanish version of the five-item General Self-Efficacy scale is a brief instrument that can contribute to the assessment of some of the basic competencies of the Degree in Nursing, which improve during their education and how these changes are related to other skills important for the nursing profession, such as resilience., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.)