Artículos (Enfermería)
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Artículo The impact of humanising hospital care on health outcomes: an observational study protocol(Springer science and business media LLC, 2025) Allande Cussó, Regina; Mejías-Martín, Yolanda-Angustias; Quiñoz-Gallardo, María Dolores; Porcel Gálvez, Ana María; Universidad de Sevilla. Departamento de Enfermería; Universidad de Sevilla. CTS1050: Cuidados Complejos, Cronicidad y Resultados en SaludThe humanisation of care has emerged as a crucial element in contemporary healthcare, with several countries adopting the concept of patient and family-centred care. This change signifies an ongoing evolution within contemporary healthcare, emphasising person-centred approaches, patient autonomy and preferences. The humanisation of care extends beyond patients to include their families and healthcare professionals, to enhance health outcomes, clinical safety, accessibility and therapeutic relationships holistically. This project aims to evaluate the humanisation of care in hospital settings in southern Spain, examining its impact on health outcomes and identifying areas for improvement. Methods The research employs a three-year multiphase approach, combining cross-sectional designs, qualitative-quantitative analyses and psychometric assessments. The study involves a diverse sample population, including patients admitted to several hospitals in southern Spain along with nursing professionals. Data collection incorporates a range of validated tools, items developed ad hoc and sociodemographic variables. Discussion The study findings are expected to offer insight into healthcare management, clinical practice and education. Humanising care has the potential to positively impact health outcomes, and the study methodology may serve as a model for future research and educational programmes in healthcare. Whilst acknowledging its limitations, the study represents a critical step in evaluating the humanisation of care in Spanish hospitals and informing strategies for improvement. In conclusion, this comprehensive study addresses the humanisation of care in hospital settings, examining its dimensions and potential impact on health outcomes. The findings may influence policy decisions, emphasising the need to enhance the humanisation of care as a fundamental aspect of healthcare management. rial registration NCT06174844 (18/12/2023)Artículo Pneumocystis infection in pregnant women: a scoping review(MDPI, 2025-04-25) Calderón-Baturone, Irene; Salsoso, R; Charpentier, Eléna; de Armas, Yaxsier; Guadix, Pilar; Morilla Romero de la Osa, Rubén; Friaza, Vicente; Calderón Sandubete, Enrique José; Universidad de Sevilla. Departamento de Cirugía; Universidad de Sevilla. Departamento de Enfermería; Universidad de Sevilla. Departamento de Medicina; Instituto de Biomedicina de Sevilla (IBIS); Universidad de Sevilla. CTS607: Salud Reproductiva de la MujerPneumocystis jirovecii is an opportunistic fungus that causes severe pneumonia in immunosuppressed individuals. While Pneumocystis colonization, a subclinical form of infection, has been studied in different populations, its implications during pregnancy remain poorly understood. Given the immune modulation of pregnancy, maternal colonization or infection may contribute to vertical transmission and neonatal respiratory complications. This scoping review aims to map the existing evidence on Pneumocystis colonization/infection during pregnancy, identifying knowledge gaps, prevalence, risk factors, and potential neonatal outcomes. A systematic literature search was conducted in three databases following PRISMA-ScR guidelines. A total of 26 studies were included, covering Pneumocystis pneumonia cases (n = 19) and Pneumocystis colonization (n = 7). The review found that most Pneumocystis pneumonia cases in pregnant women were associated with HIV before antiretroviral therapy. More recent cases were related to hematologic malignancies. Pneumocystis colonization rates varied widely (5.4–46.5%). Evidence of vertical transmission was observed, but neonatal impact remains underexplored. This review highlights the need for HIV screening in pregnant women and the need to include Pneumocystis in the diagnosis of pregnant women with pneumonia. Increased awareness and research on Pneumocystis in pregnancy are necessary to improve maternal and neonatal outcomes. Future studies should focus on vertical transmission and neonatal respiratory health.Artículo Impact on health, resources, and satisfaction: a qualitative study of primary health care case-management nurses(MDPI, 2025-04-23) Molina-Gil, María José; Guerra Martín, María Dolores; Diego Cordero, Rocío de; Universidad de Sevilla. Departamento de Enfermería; Universidad de Sevilla. CTS1158: Desarrollo y Evaluación de Intervenciones en Salud y en Educación; Universidad de Sevilla. CTS1149: Salud integral y sostenible: enfoque Bio-psico-social, Cultural y Espiritual para el Desarrollo HumanoThe aging population and the increasing prevalence of chronic diseases necessitate new healthcare models. Case-Management Nurses (CMNs) emerge as a promising alternative to enhance patient care. Objective: To explore CMNs’ perceptions of the impact on health, resources, and professional satisfaction. Methods: A qualitative study using semi-structured interviews was conducted with CMNs from a southern Spanish province. This study adheres to the Standards for Reporting Qualitative Research (SRQR). The population consisted of 61 CMNs. Three analytical categories of a theoretical or deductive nature were identified, directly related to this study’s objective. This study was approved by the Andalusian Biomedical Research Ethics Committee (Code: 1139-N-22) and conducted in accordance with the Declaration of Helsinki. Data analysis was performed using ATLAS.ti. Results: The sample was comprised of 31 CMNs (24 women). The mean age was 56.3 years. A total of 12 CMNs had more than 20 years of experience. Interviews were conducted between October and November 2022. Within each category, different emerging subcategories were identified: 1. Impact on health: Patients and caregivers. 2. Impact on resources: Computer tools, effectiveness/efficiency of the CMNs, and material resources. 3. Impact on professional satisfaction: Positive professional satisfaction and negative professional satisfaction. Conclusions: The findings suggest that the practice of CMNs in primary care improves the health and quality of life of patients and their caregivers while reducing healthcare resource utilization. CMNs reported high levels of job satisfaction. These findings support the implementation of this care model to optimize the management of chronic patients in home and residential care settings. However, larger-scale quantitative studies are needed to confirm these results and explore their generalizability.Artículo Impact of school-based health promotion interventions aimed at different behavioral domains: a systematic review(ScienceDirect, 2014-10) Lima Serrano, Marta; Lima Rodríguez, Joaquín Salvador; Universidad de Sevilla. Departamento de Enfermería; Instituto de Biomedicina de Sevilla (IBIS); Universidad de Sevilla. CTS969: Innovación en Cuidados y Determinantes Sociales en SaludObjective: Given that lifestyleshave similar determinants and that school-based interventions are usually targeted at all the risks that affect adolescents, the objective of this systematic review was to summarize the characteristics and effects of school-based interventions acting on different behavioral domains of adolescent health promotion. Methods: The review process was conducted by two independent reviewers who searched PubMed, Scopus, PsycINFO, and ERIC databases for experimental or observational studies with at least two measures of results published from 2007 to 2011, given that the research information available doubles every 5 years. Methodological quality was assessed with a standardized tool. Results: Information was extracted from 35 studies aiming to prevent risk behaviors and promote healthy nutrition, physical activity, and mental and holistic health. Activities were based on theoretical models and were classified into interactive lessons, peer mediation, environmental changes, parents’ and community activities, and tailored messages by computer-assisted training or other resources, usually including multiple components. In some cases, we identified some moderate to large, short- and long-term effects on behavioral and intermediate variable. Conclusions: This exhaustive review found that well-implemented interventions can promote adolescent health. These findings are consistent with recent reviews. Implications for practice, public health, and research are discussed.Artículo Enfermería Comunitaria y salud digital en tiempos de la COVID-19(Asociación de Enfermería Comunitaria, 2021-05) Lima Serrano, Marta; Carrión Robles, Trinidad; Herráiz Mallebrera, Antonia; Arrabal Téllez, Ana Belén; Universidad de Sevilla. Departamento de Enfermería; Instituto de Biomedicina de Sevilla (IBIS); Universidad de Sevilla. CTS969: Innovación en Cuidados y Determinantes Sociales en SaludObjetivo: actualizar y ampliar conocimientos de salud digital en el ámbito de la Enfermería Comunitaria y la Atención Primaria de Salud durante la pandemia de la COVID-19. Método: revisión narrativa. Descripción de las competencias y herramientas de salud digital más utilizadas en la pandemia y de estudios relacionados con su uso en Atención Primaria de Salud por las enfermeras comunitarias; incluyendo el análisis de la experiencia llevada a cabo por las enfermeras del Centro de Salud de Nerja (Málaga). Resultados: organizaciones internacionales de la salud y otras fuentes aportan valiosa bibliografía sobre el potencial de las herramientas digitales, bajo el marco de la pandemia por COVID-19, recomendando su utilización a las enfermeras en la aplicación del cuidado. Los estudios consultados muestran la utilidad de la salud digital para la enfermera comunitaria en el mantenimiento de la atención domiciliaria a las personas en situación de aislamiento, así como el análisis de la experiencia llevada a cabo por las enfermeras. Conclusiones: la salud digital representa un escenario ideal en situaciones de aislamiento, como el producido por una pandemia, en este caso por el virus SARS CoV-2, y las enfermeras obsevan que es un buen recurso en situaciones de aislamiento, al tiempo que se muestra capacidad de adaptación a los cambios estructurales que la pandemia por COVID-19 exige. Ante el colapso vivido en Atención Primaria, las intervenciones de salud digital podrían facilitar los cuidados enfermeros por medios virtuales siempre que se acelere la innovación digital en el Sistema Nacional de Salud. El impacto de la COVID-19 exige, como enfermeras comunitarias implicación en la transformación hacia la salud digital.Artículo Claves metodológicas y estratégicas para estudios basados en encuestas online: un análisis basado en la iniciativa Checklist for Reporting Results of Internet E-Surveys(Elsevier, 2024-06) Torrejón Guirado, María del Carmen; San Martín-Erice, Isabel; San Martín-Rodríguez, Leticia; Lima Serrano, Marta; Universidad de Sevilla. Departamento de Enfermería; Instituto de Biomedicina de Sevilla (IBIS); Universidad de Sevilla. CTS969: Innovación en Cuidados y Determinantes Sociales en SaludEl uso de encuestas online se ha convertido en una herramienta útil y muy utilizada en la investigación sanitaria. Sin embargo, el uso de este tipo de instrumentos necesita de una rigurosidad metodológica y de una optimización en su diseño para obtener las mejores tasas de respuesta. Con base en la bibliografía de referencia, así como a la guía internacional Checklist for Reporting Results of Internet E-Surveys (CHERRIES) para el desarrollo de encuestas online, se proporcionan aspectos metodológicos relacionados con los aspectos éticos y protección de datos (siendo un referente la guía de ética online de la Association of Internet Research [AOIR]), el diseño y la validación del estudio, el reclutamiento, el proceso de recogida de datos, y el manejo y análisis de datos. Para finalizar, en un contexto de sobreexposición a las encuestas online, que puede afectar al reclutamiento y la tasa de respuestas, se aportan estrategias para su maximización, que tienen que ver con cuestiones estáticas como dinámicas de su diseño.Artículo Análisis de la función gestora de la enfermera escolar en España: uso de registros e interacción con atención primaria, comunidad educativa y otras instituciones(Elsevier, 2025-03) Vargas Martínez, Ana Magdalena; Guillén-Martínez, Daniel; Domingo-Pérez, Tamara; Solián-Enríquez, Alba; Zafra-Agea, José Antonio; Hollos-Cillero, Itziar; Lima Serrano, Marta; Tarriño Concejero, Lorena; Universidad de Sevilla. Departamento de Enfermería; Instituto de Biomedicina de Sevilla (IBIS); Universidad de Sevilla. CTS969: Innovación en Cuidados y Determinantes Sociales en SaludObjetivo: Analizar la función gestora de la enfermera escolar en España. Método: Estudio descriptivo transversal, con una muestra de 376 enfermeras escolares de centros educativos públicos, concertados o privados no universitarios y centros de educación especial a nivel nacional. La recogida de datos se llevó a cabo a través de cuestionario autoadministrado y anónimo diseñado por expertos en enfermería escolar, llevado a cabo, de marzo a junio de 2023, a través de una plataforma online. Resultados: La función gestora de las enfermeras escolares en España se pone de manifiesto en la interacción con los ámbitos educativo y sanitario. Los resultados subrayan la importancia de la colaboración intersectorial. El 96,28% de las enfermeras realizan registros en la historia clínica. La integración de la enfermera escolar en atención primaria se asocia significativamente con el servicio que contrata a la enfermera, el tipo de contrato, la situación contractual, el tipo de centro educativo, la pertenencia a zona rural y a zonas de transformación social. Conclusiones: Las enfermeras escolares desempeñan un papel crucial en la promoción de un entorno educativo saludable y seguro. El registro de datos clínicos es esencial para el seguimiento y la calidad del cuidado. Los datos ponen de manifiesto la necesidad de implementar políticas que den garantía jurídica a la actividad de la enfermera escolar y seguridad al alumnado y a toda la comunidad educativa.Artículo Effectiveness of digital interventions to reduce school-age adolescent sexual risks: A systematic review(Wiley, 2025-03) Aguilar-Quesada, Ana; Sierra-Yagüe, Alba; González Cano-Caballero, María; Zafra-Agea, José Antonio; Lima Serrano, Marta; Universidad de Sevilla. Departamento de Enfermería; Universidad de Granada; Universidad de Sevilla. CTS969: Innovación en Cuidados y Determinantes Sociales en SaludIntroduction: The increase in risky sexual behaviors among adolescent students has sparked alarm and has become an area of research interest. As adolescents prioritize confidentiality and accessibility, digital interventions are becoming increasingly relevant in sex education. We therefore posed the following research question: Are digital application interventions effective to prevent risky sexual behaviors in school adolescents? Design: A systematic peer review was conducted between January and December 2023 in five databases (PubMed, Web of Science, Scopus, EMBASE, and PsycINFO) without restricting for language or year of publication. Method: We included randomized control trials or quasi-experimental studies that measured the effectiveness of interventions targeting young people aged 10–19 years or their parents and developed in a school setting. Interventions aimed at young people with intellectual disabilities, learning difficulties, or any disease requiring a specific intervention were excluded. Results: The search ultimately yielded 27 studies covering a total of 18 digital interventions that demonstrated positive effects, not maintained over time, on knowledge, attitudes, and behaviors, although the latter to a lesser extent. Discussion: We have found very interesting digital interventions with effects, among others, on knowledge, attitudes, and contraceptive use in adolescents. In general, digital interventions have positive effects on knowledge and attitudes, but it is more difficult to modify behaviors with strictly digital interventions or combined with complementary face-to-face sessions or group class activities. Conclusion: We thus believe that digital interventions are adequate to reduce adolescent sexual risk behaviors, and our systematic review facilitates the implementation of these interventions by sharing existing digital interventions that have had positive effects, as well as the main characteristics a digital intervention should possess to reduce sexually risky behaviors in adolescents. Clinical relevance: Digital interventions with adolescents improve sexual behaviors and can be a valuable resource in education on this topic due to their accessibility and confidentiality, two key points for young people.Artículo Factors that influence the adoption of a school-based eHealth alcohol prevention program among Spanish personnel: a mixed methods study(BMC, 2025-02) Rosado-Pulido, Ester Alejandra; Fernández León, Pablo; Lima Serrano, Marta; De Vries, Hein; Universidad de Sevilla. Departamento de Enfermería; Ministerio de Sanidad y Consumo. España; Universidad de Sevilla. CTS969: Innovación en Cuidados y Determinantes Sociales en SaludBackground: Evidence-based research has shown that using eHealth interventions effectively reduces risk behaviors such as alcohol consumption, a public health problem worldwide. However, despite its benefits, there has been a poor intention to adopt such innovations, and limited resources exist to understand factors influencing the uptake decision to use school-based eHealth alcohol prevention programs. This study aims to identify the factors that influence the adoption of a computer-tailored eHealth alcohol prevention program among school personnel in Spain. Methods: A cross-sectional study employing an exploratory sequential mixed methods research design was carried out. First, interviews were conducted with ten Spanish school counselors to assess factors influencing the adoption of the school-based eHealth program by exploring participants' awareness and salient beliefs concerning attitudes, social influences, and self-efficacy. Second, an online quantitative questionnaire was developed based on the qualitative research findings. Third, the new questionnaire was administered to Spanish school personnel (N = 100), including the school management team, school counselors, and teachers. Rogers' Diffusion of Innovations theory and the Integrated Change Model frameworks were used as theoretical bases for understanding the adoption process. Results: School personnel with a strong intention to adopt the program (intenders) perceived significantly more advantages and positive innovation attributes, than those participants with a weaker intention to adopt (non-intenders). Intenders perceived a higher personal relevance and responsibility towards using the program, more self-efficacy (e.g., ability to understand, manage time and incorporate the program) and positive social influences from their colleagues, as well as greater willingness in preparing action plans, such as monitor students’ alcohol consumption and discussing the program with coworkers, than the non-intenders group. Advantages and social support were found to explain a significant portion of the variance in the adoption intention. Conclusions: This study suggests that health intervention researchers should develop strategies to enhance educators' pro-innovation attitudes, personal relevance and responsibility, and perceived ease of use towards adopting an eHealth program. Furthermore, our results highlight that fostering school personnel's acceptance of the intervention and planning goal-oriented actions are crucial elements in optimizing adoption promotion of eHealth programs in school settings.Artículo Exploring Cultural Adaptations: A Scoping Review on Adolescent Mental Health and Substance Use Prevention Programs(Springer Nature, 2025-01) Corpus-Espinosa, Claudia; Mac Fadden, Isotta; Torrejón Guirado, María del Carmen; Lima Serrano, Marta; Universidad de Sevilla. Departamento de Enfermería; Universidad de Sevilla. CTS969: Innovación en Cuidados y Determinantes Sociales en SaludAdolescence is a critical period for developing risk behaviors such as substance use, which can impact health in adulthood. Culturally adapted evidence-based programs (EBPs) are promising for prevention. This review explores the processes for culturally adapting EBPs targeting alcohol, tobacco, or cannabis use, and/or anxiety or depression in adolescents. We searched multiple databases, grey literature, and relevant websites for studies detailing the cultural adaptation process of EBPs. We then categorized common adaptation steps, classified adaptations using the cultural sensitivity model, identified prevalent adaptation techniques, and determined effectiveness assessment methods. We reviewed the cultural adaptation processes of 43 EBPs. These programs were implemented in schools (51%), followed by family settings (30%), community settings (14%), and multi-component settings (5%). Eleven key steps were identified across the documents: local needs assessment, program selection, understanding of the program's curriculum, advisory group establishment, first draft of initial adaptation changes, staff selection and training, pilot study, enhanced cultural adaptation, implementation, evaluation and monitoring, and dissemination. Most programs integrated both surface (e.g., use of local images, material translation) and deep adaptations (e.g., incorporation of cultural values like "familismo"). Despite the common use of the cultural sensitivity model, detailed adaptation frameworks were often lacking. The field has advanced, but clearer documentation is needed to improve research and practical application.Artículo Incorporation mutational profile might reduce the importance of blast count in prognostication of low-risk myelodysplastic syndromes(Wiley, 2024-08-28) García-Culebras, Marta; Alcalde, Patricia; Márquez Malaver, Francisco J.; Carrillo, Estrella; Soria, Elena; Prats, Concepción; Álvarez Morales, Rosario; Vargas de los Monteros, María Teresa; Pérez Simón, José Antonio; Falantes, Jose F.; Universidad de Sevilla. Departamento de Enfermería; Universidad de Sevilla. Departamento de Citología e Histología Normal y Patológica; Universidad de Sevilla. Departamento de MedicinaAddition of molecular data to prognostic models has improved risk stratification ofmyelodysplastic neoplasms (MDS). However, the role of molecular lesions, particu-larly in the group of low-risk disease (LR-MDS), is uncertain. We evaluated a set of227 patients with LR-MDS. Overall survival (OS) and probability of leukaemic pro-gression were the main endpoints. RUNX1 was associated with lower OS and SF3B1with a reduced risk of death (HR: 1.7, 95% CI, 1.1–2.9; p = 0.05; and HR: 0.23, 95% CI0.1–0.5; p < 0.001; respectively). TP53 and RUNX1 mutations were predictive covari-ates for the probability of leukaemic progression (p < 0.001). Blast percentage, neitheranalysed as categorical (<5% vs. 5%–9%; HR: 1.3, 95% CI, 0.7–2.9; p = 0.2) nor as acontinuous variable (HR: 1.07, 95% CI, 0.9–1.1; p = 0.07), had impact on survival orprobability of progression (sHR: 1.05, 95% CI, 0.9–1.1; p = 0.2). These results retainedstatistical significance when analysis was restricted to the definition of LR-MDSaccording to the WHO 2022 and ICC classifications (<5% blasts). Thus, with theincorporation of molecular data, blast percentage happens to lose clinical signifi-cance both for survival and probability of progression in the group of patients withLR-MDS.Artículo Association between religious/spiritual coping and quality of life among hemodialysis patients in Ecuador(Frontiers media SA, 2025-04-02) Bonilla Sierra, Patricia; Pérez Jiménez, José Miguel; Espinoza Quezada, Denisse Paulina; Lucchetti, Giancarlo; Diego Cordero, Rocío de; Universidad de Sevilla. Departamento de Enfermería; Universidad de Sevilla. CTS1149: Salud Integral y Sostenible: Enfoque Bio-Psico-Social, Cultural y Espiritual para el Desarrollo HumanoThere is evidence concerning the association between religiousness and quality of life in hemodialysis patients However, studies carried out in South America are scarce in the literature, particularly in Ecuador. This study aims to investigate the influence of religious/spiritual coping on the quality of life of Ecuadorian hemodialysis patients. This is a cross-sectional study carried out in a reference public hospital in Ecuador. Hemodialysis patients answered a questionnaire including sociodemographics, medical data, quality of life (“Kidney Disease Quality of Life-KDQOL-36), SF-12 and religious/spiritual coping (Abbreviated Religious/Spiritual Coping Scale-Brief-RCOPE). Unadjusted and adjusted models were carried out to investigate the association between religious/spiritual coping and quality of life. A total of 58 participants were included. Hemodialysis patients presented higher levels of positive than negative religious/spiritual coping. Although religious/spiritual positive coping was associated with level of education, the relationship between religious/spiritual coping and quality of life were not statistically significant. Despite the lack of statistical significance, our findings highlight the widespread use of R/S coping among hemodialysis patients, emphasizing the need to integrate spiritual support into clinical care. This study provides valuable insights into a predominantly Catholic population (98.3%) in Ecuador, contributing to the limited research on R/S coping in Latin America. Given the homogeneous religious profile, future studies should include more diverse populations and longitudinal designs to assess its impact on quality of life. The lack of a significant association may be influenced by the religious homogeneity of the sample, as well as factors such as social support and illness perception, warranting further exploration in future research.Artículo Effectiveness of advanced practice nursing interventions on diabetic patients: a systematic review(MDPI, 2025-03-26) Rodríguez-García, Ana; Borrallo Riego, Álvaro; Magni, Eleonora; Guerra Martín, María Dolores; Universidad de Sevilla. Departamento de Enfermería; Instituto de Biomedicina de Sevilla (IBIS); Universidad de Sevilla. CTS969: Innovación en Cuidados y Determinantes Sociales en SaludBackground: Diabetes mellitus is a complex chronic condition requiring continuous healthcare. Consequently, various organisations recommend therapeutic education to enhance treatment adherence. This is often facilitated by Advanced Practice Nurses, who provide a range of advanced interventions that impact clinical health outcomes and deliver healthcare services to these patients. Objective: To analyse the effectiveness of interventions performed by Advanced Practice Nurses in patients with diabetes. Method: A peer-reviewed systematic review was conducted and registered in PROSPERO. The databases consulted included PubMed, Scopus, Web of Science, and CINAHL. Inclusion criteria comprised studies published between 2014 and 2024 on the effectiveness of interventions by Advanced Practice Nurses in diabetic patients. The review included qualitative, quantitative, and mixed methods designs. Various screenings were carried out, including the assessment of methodological quality. Results: A total of 600 studies were identified, of which 17 were selected for final review. Among these, 12 studies focused on diabetic education. Interventions were predominantly delivered in person in primary care settings, private clinics, and hospitals. Reported outcomes included reductions in HbA1c levels, improved patient self-knowledge and self-efficacy, and decreased rates of readmission and mortality. Conclusions: The sample consisted predominantly of women over 60 years of age. Diabetic education emerged as the most common intervention, primarily delivered in person by Advanced Practice Nurses across diverse settings. Nearly all interventions proved effective in improving health outcomes for diabetic patients.Artículo Comprehensive care in critical services: a spanish qualitative study(MDPI, 2025-03-27) Diego Cordero, Rocío de; Flores-Alpresa, Thalía; Fernández-Rodríguez, Miriam; Vega Escaño, Juan; Pérez Jiménez, José Miguel; Universidad de Sevilla. Departamento de Enfermería; Universidad de Sevilla. CTS1149: Salud Integral y Sostenible: Enfoque Bio-Psico-Social, Cultural y Espiritual para el Desarrollo HumanoBackground/Objectives: Comprehensive care is crucial in emergency healthcare. In intensive care units, a holistic approach may be difficult to implement due to the conditions of the patients and existing work protocols aimed at maintaining vital functions for the survival of patients. The present study aims to explore and describe the knowledge, attitudes, and perceptions of critical care and emergency health professionals regarding the implementation of integrated care practices within intensive care units, with the goal of identifying barriers and facilitators to adopting a holistic approach in emergency healthcare settings. Methods: This study implemented an exploratory and descriptive qualitative design with a phenomenological approach through semi-structured interviews with health professionals who had worked in intensive care units or emergency services for both public and private health institutions in Spain (n = 25). The study was conducted during the years 2023 and 2024, using a convenience sampling method along with snowball sampling, and a narrative discourse analysis was performed. The MAXQDA 2022 software program was used. This study was granted due permission by the Research Ethics Committee belonging to the Junta de Andalucía, under protocol code 0768-N-20. Results: The total sample consisted of 25 healthcare professionals from critical care and emergency services in Spain. The main themes, as key findings, were knowledge and perception, determining factors, resources and infrastructure, the bioethical dimension, perspectives on comprehensive care, and multidimensional impact. Most of the professionals were familiar with comprehensive care, but lack of resources and time prevented them from carrying it out in their units. Conclusions: For critical care and emergency professionals, comprehensive care is important to their clinical practice, but barriers to its realization still exist. Understanding the importance to these professionals of the application of comprehensive care is fundamental to establishing measures for its implementation in these services. It is also a motivation to continue providing humanized and compassionate care that respects the patient’s dignity. It is a priority to provide the necessary infrastructure and human resources so that patients admitted to these units can be cared for with this tool.Artículo Prejuicios, actitudes y estereotipos de los profesionales de la salud hacia la fibromialgia: una revisión sistemática(Elsevier, 2025) Vázquez-González, Gloria; Allande Cussó, Regina; Gómez-Salgado, Juan; Yildirim, Murat; Fagundo-Rivera, Javier; Climent-Rodríguez, José Antonio; Navarro-Abal, Yolanda; Universidad de Sevilla. Departamento de Enfermería; Universidad de Sevilla. CTS1050: Cuidados Complejos, Cronicidad y Resultados en SaludObjetivo Describir los prejuicios, las actitudes y los estereotipos que tienen los profesionales de la salud, principalmente, de medicina general, medicina de familia, medicina interna, reumatología, salud mental, enfermería y fisioterapia, hacia la fibromialgia. Diseño Revisión sistemática. Fuentes de datos Pubmed, Web of Science, Scopus, CINAHL y PsycINFO. Selección de estudios Se realizó la búsqueda el 17 de junio de 2024. Se incluyeron los artículos originales y reporte de casos, cuya temática fuera afín al propósito principal de este trabajo, y publicados en los últimos 10 años. Extracción de datos Dos revisores realizaron la extracción de datos. Se valoró la calidad metodológica con las herramientas de evaluación crítica para estudios no aleatorizados del Joanna Briggs Institute (JBI). Resultados Fueron incorporados un total de 19 estudios. El retraso en el diagnóstico, la ausencia de formación en la atención hacia esta patología, así como la subjetividad de su sintomatología, hacen que la fibromialgia sea un gran desafío para los profesionales de la salud. Se describe un prototipo estereotipado de paciente, que convierte la fibromialgia en una enfermedad de prestigio inferior, sin base orgánica que la legitime. Conclusiones Los profesionales de la salud señalan la falta de formación adecuada para diagnosticar y tratar la fibromialgia. Las personas que padecen esta enfermedad suelen ser consideradas pacientes difíciles, cuya credibilidad se cuestiona constantemente y están marcadas por el estigma. Este trabajo identifica los factores que generan discordancia tanto en profesionales como en los propios afectados para optimizar la práctica clínica.Artículo One-stage technique with calcaneal graft for the treatment of brachymetatarsia: a case report(MDPI, 2025-03-25) Ortiz Romero, Mercedes; Fernández-Garzón, Álvaro; Cáceres Matos, Rocío; García de la Peña, Raquel; Rayo-Perez, Ana M.; Universidad de Sevilla. Departamento de EnfermeríaBrachymetatarsia is a rare congenital anomaly characterized by the shortening of one or more metatarsals, which can lead to functional impairment, pain, and aesthetic concerns. This case report describes a 17-year-old female patient with brachymetatarsia affecting the third and fourth metatarsals of the right foot, which was unresponsive to conservative treatment and caused persistent pain while standing. To address this condition, a single-stage surgical approach was performed using an autologous calcaneal bone graft to lengthen the affected metatarsals. Additionally, the second and fifth metatarsals were shortened to restore a physiological metatarsal parabola and resolve chronic metatarsalgia. The procedure resulted in complete correction of the metatarsal parabola, full resolution of metatarsal pain, and satisfactory functional recovery. The use of an autologous calcaneal graft proved to be an effective and reliable surgical option due to its cortico-cancellous composition, high osteogenic potential, and low antigenicity. This case highlights the advantages of autologous bone grafting as a valuable technique in the surgical management of brachymetatarsia.Artículo Economic evaluations of technology-based interventions used to provide care support for people with mild dementia or mild cognitive impairment and their caregivers: a systematic review(IOS Press; Sage publications LTD, 2024-11-08) Vargas Martínez, Ana Magdalena; Universidad de Sevilla. Departamento de Enfermería; Universidad de Sevilla. CTS969: Innovación en Cuidados y Determinantes Sociales en SaludBackground: The cost-effectiveness of interventions is a key issue owing to the limited resources of healthcare services. Objective: To conduct a systematic review of economic evaluations of technology-based healthcare interventions in care support for people with dementia or mild cognitive impairment (MCI) and their caregivers, and of the tools used to assess effectiveness and costs. Methods: The following databases were used: PubMed, National Health Service Economic Evaluation Database, and Health Technology Assessment. A total of 207 articles from 2012 to 2024 were identified and then screened. Results: Seventeen studies were included, of which nine were study protocols. Almost half (n = 8) the interventions were multicomponent. The most common components used in the interventions were cognitive stimulation, physical functioning and continuing support. Regarding the efficiency results of these interventions, only three studies provided a full economic evaluation. The most frequent tools in the economic evaluations used to measure effectiveness (measured in quality-adjusted life years) and costs were the European Quality of Life-5 Dimensions and Resource Utilization in Dementia instruments, respectively. Conclusions: Most of the interventions evaluated were cost-effective. However, these results should be interpreted with caution, given the scarcity of the literature, and further economic evaluations of technology-based healthcare interventions for people with mild dementia or MCI care support and their caregivers are therefore needed. Additionally, a meta-analysis could not be performed due to the heterogeneity of the data.Artículo Contribution of clinical nurses to hospital efficiency and economic sustainability: a systematic review(Wiley; Wiley-Hindawi, 2025-03-19) Bárcenas Villegas, Daniel; Cáceres Matos, Rocío; Vázquez Santiago, María Soledad; Universidad de Sevilla. Departamento de Enfermería; Universidad de Sevilla. CTS1050: Cuidados Complejos, Cronicidad y Resultados en SaludAim: To analyze the existing evidence on the contribution of the nursing profession to efciency and healthcare sustainability in the hospital setting. Background: Promoting economic efciency in hospital centers is a key factor in ensuring their long-term sustainability. In this regard, nursing professionals with caregiving roles could emerge as valuable contributors to the survival of the existing hospital model. Design: A systematic review was conducted following PRISMA guidelines. Tis review has been registered with PROSPERO under the registration number: CRD42023481140. Method: A search was conducted across four international databases (CINAHL, PubMed, Scopus, and WOS) from 2013 to the present for studies in English and Spanish. Primary studies on economic evaluations and systematic reviews were included. Te study selection was carried out in three stages, with two reviewers independently analyzing the data and resolving disagreements through discussion and consensus. Te quality assessment utilized the CASP tool, the CHEERS checklist, and the STROBE statement. Results: Out of 3058 records identifed, nine were deemed eligible, comprising one longitudinal study, four descriptive studies, two systematic reviews, two randomized controlled trials, one cohort study, and two case-control studies, with a total of 333,597 patients. Te studies varied in sample size, intervention strategy, content, measurement scales, and statistical analysis of the primary outcome. Te studies indicate that health education provided by hospitals is cost-efective, potentially generating costs below 100,000 dollars per quality-adjusted life year. Investing in nursing specialty, advanced practice nurses, and clinical safety reduces the number of admissions and decompensations. Conclusions: Tis review highlights that health education and clinical safety are the areas where nursing tasks have the most signifcant economic impact. Nursing specialty and the inclusion of advanced practice nurses are proving to be felds towards which health systems should focus to promote a more economically sustainable model.Artículo Assessment of levels of anxiety and fear of Covid-19 in a population of pregnant women in Spain(2023) Muñoz-Vela, Francisco Javier; Fernández-Carrasco, Francisco Javier; Gómez-Salgado, Juan; Allande Cussó, Regina; Marques Monteiro Dias Mendes, Isabel Margarida; Martins Teixeira-da-Costa, Emilia Isabel; Rodríguez Díaz, Luciano; Universidad de Sevilla. Departamento de EnfermeríaObjective: 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 anxietyArtículo Adaptation and psychometric study of the scale for the measurement of fear and anxiety of COVID-19 disease in pregnant women (AMICO_Pregnant(2023) Muñoz-Vela, Francisco Javier; Rodríguez Díaz, Luciano; Fernández Carrasco, Francisco Javier; Allande Cussó, Regina; Vázquez-Lara, Juana María; Fagundo Rivera, Javier; Gómez-Salgado, Juan; Universidad de Sevilla. Departamento de EnfermeríaObjective: The aim of this research was to adapt and explore the psychometric properties of a specific scale to assess the levels of fear and anxiety of COVID-19 disease in pregnant women. Methods: An adaptation phase, by a panel of experts, and a psychometric descriptive cross-sectional study were carried out on the final version of the 16-item, self-administered AMICO_Pregnant scale. Univariate and bivariate analyses were carried out, followed by exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). The consistency of the scale was assessed using the Omega coefficient and Cronbach’s Alpha. Results: With a sample of 1,013 pregnant women living in Spain and over 18 years of age, the mean age was 33 years. The scale showed a bifactor structure (anxiety and fear) that was confirmed with good fit parameters. Reliability was assessed in terms of internal consistency by calculating Cronbach’s Alpha coefficient (0.95) and McDonald’s Omega coefficient (0.94) as indicators of robustness of the scale’s reliability. Conclusion: The AMICO_Pregnant scale of 16 items with scores ranging from 1 to 10 is a valid and reliable tool to assess levels of anxiety and fear of COVID_19 in Spanish pregnant women. Pregnant women have shown moderate levels of anxiety and fear regarding the COVID_19 disease in the final phase of the pandemic. item, self-administered AMICO_Pregnant scale. Univariate and bivariate analyses were carried out, followed by exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). The consistency of the scale was assessed using the Omega coefficient and Cronbach’s Alpha. Results: With a sample of 1,013 pregnant women living in Spain and over 18 years of age, the mean age was 33 years. The scale showed a bifactor structure (anxiety and fear) that was confirmed with good fit parameters. Reliability was assessed in terms of internal consistency by calculating Cronbach’s Alpha coefficient (0.95) and McDonald’s Omega coefficient (0.94) as indicators of robustness of the scale’s reliability. Conclusion: The AMICO_Pregnant scale of 16 items with scores ranging from 1 to 10 is a valid and reliable tool to assess levels of anxiety and fear of COVID_19 in Spanish pregnant women. Pregnant women have shown moderate levels of anxiety and fear regarding the COVID_19 disease in the final phase of the pandemic.