Artículos (Enfermería)
URI permanente para esta colecciónhttps://hdl.handle.net/11441/11010
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Artículo Terapias complementarias no farmacológicas en el cuidado de personas con dolor crónico no oncológico: una revisión bibliográfica(Edyte Farma S.L., 2024) Guerra Martín, María Dolores; Irene Delgado-Saldaña; Andrea Nieto-Pérez; Borrallo Riego, Álvaro; Universidad de Sevilla. Departamento de Enfermería; Universidad de Sevilla. CTS-969: Innovación en cuidados y determinantes sociales en saludObjetivo: Examinar los problemas (físicos, psicológicos, sociales y económicos) de las personas con dolor crónico no oncológico y analizar las distintas terapias complementarias no farmacológicas utilizadas para el cuidado. Metodología: Se llevó a cabo una revisión bibliográfica en las bases de datos CINAHL, PubMed, PsycINFO y Scopus. Los criterios de inclusión fueron: 1) estudios de investigación con metodología cuantitativa, cualitativa y/o mixta; 2) que versasen sobre el tópico de la revisión, y 3) publicados en los últimos 10 años (2013-2023). Resultados: Se localizaron 289 estudios, y se seleccionaron 15. Todos los estudios describieron distintos problemas de forma combinada en las personas con dolor crónico no oncológico. Las principales terapias complementarias referenciadas fueron acupuntura, hipnosis y meditación. Conclusiones: El dolor crónico no oncológico afecta mayoritariamente a nivel físico, pero también muestra efectos a nivel psicológico, social y económico. Los estudios evidencian una mejora de los síntomas del dolor crónico no oncológico en las personas que han hecho uso de las terapias complementarias.Artículo Nursing students’ experiences about clinical practice tutoring: a cross-sectional observational study(MDPI, 2024-12-13) Borrallo Riego, Álvaro; Magni, Eleonora; Pérez Jiménez, José Miguel; Guerra Martín, María Dolores; Universidad de Sevilla. Departamento de Enfermería; Universidad de Sevilla. CTS-969: Innovación en cuidados y determinantes sociales en salud; Universidad de Sevilla. CTS-1149: Salud integral y sostenible: enfoque Bio-psico-social, Cultural y Espiritual para el Desarrollo HumanoObjective: Nursing students’ experiences about clinical practice tutoring in a public university from southern Spain and at its two attached educational centres were analysed. Methods: A cross-sectional observational study was carried out. The population was comprised of nursing students attending their fourth year of university during the 2023/2024 academic period, with a final sample of 179 subjects. Sociodemographic data were collected and a validated questionnaire on opinions about the figure of clinical practice tutors was applied, with 34 closed questions offering five answer options. The questions were categorized into 17 dimensions. A question on the students’ satisfaction with tutoring of the practices was included, in addition to an open question to gather the students’ comments and/or suggestions in relation to clinical practice tutoring. The analysis was performed through a data matrix in SPSS. The Kruskal–Wallis test was used to compare the centres according to the questionnaire dimensions, considering p-values < 0.05 to establish statistically significant differences. The open question was analysed using Atlas.ti. Results: Most of the students were women, with an approximate mean age of 23 years old. Significant differences were detected among the centres in almost all dimensions from the questionnaire. High satisfaction levels were obtained in the three centres. A total of 83 verbatims were collected in the open question and grouped into eight categories. Conclusion: Nursing students place significant importance on the role of the clinical tutor. Clinical tutors who demonstrate enthusiasm for teaching, foster a positive environment based on active listening, respect, and the encouragement of autonomy, are essential to enhancing the students’ experience during clinical placements.Artículo Health promotion in glycemic control and emotional well-being of people with type 1 diabetes Mellitus: a systematic review and meta-analysis(MDPI, 2024-12-06) Garrido-Bueno, Miguel; Pabón Carrasco, Manuel; Jiménez Picón, Nerea; Romero Castillo, Rocío; Universidad de Sevilla. Departamento de Enfermería; Universidad de Sevilla. CTS1050: Cuidados Complejos, Cronicidad y Resultados en Salud.; Universidad de Sevilla. CTS1054: Intervenciones y cuidados de salud. Cruz Roja - (Sistema Sanitario Público de Andalucía. Fundación para la Investigación Biomédica de Córdoba (FIBICO))Background/Objectives: Structured therapeutic patient education is the key to improving biopsychosocial outcomes in people with type 1 diabetes mellitus. This study aimed to determine the effects of structured therapeutic education on glycemic control and emotional well-being in people with type 1 diabetes mellitus. Methods: This is a systematic review with a meta-analysis (PROSPERO ID: CRD42023390079). Searches were performed in Scopus, MEDLINE, Web of Science, CINAHL, APA PsycInfo, APA PsycArticles, and the Psychology Database (June–August 2024). The eligibility criteria included randomized controlled trials published in English or Spanish within the past 10 years. Data extraction and risk of bias evaluations were independently conducted by two reviewers. The outcomes analyzed included glycated hemoglobin, time in range, emotional well-being, self-management behaviors, and adherence to treatment. Meta-analyses were performed using RevMan with random and fixed effects models. Results: Seventeen studies met the eligibility criteria. There was a significant improvement in glycemic control, stress, anxiety, and treatment satisfaction, although the results for the other emotional outcomes were mixed. Conclusions: Structured therapeutic patient education improves glycemic control and selected emotional outcomes in individuals with type 1 diabetes mellitus. Further trials are needed to refine the characteristics of the intervention and broaden the applicability of the findings to diverse populations.Artículo Benefits of complementary therapies during pregnancy, childbirth and postpartum period: a systematic review(MDPI, 2024-12-09) Lima-De-La-Iglesia, Consolación; Magni, Eleonora; Botello Hermosa, Alicia; Guerra Martín, María Dolores; Universidad de Sevilla. Departamento de Enfermería; Universidad de Sevilla. CTS-969: Innovación en cuidados y determinantes sociales en salud; Universidad de Sevilla. SEJ-066: Mujeres, bienestar y ciudadaníaBackground/Objectives: The current trend in maternal health is to foster more natural and less medicalized therapies, with increasing interest in complementary therapies. This study has analyzed the benefits of complementary therapies during pregnancy, delivery and the postpartum period. Methods: A paired systematic review was carried out (PROSPERO: CRD42024543981). The following databases were consulted: PubMed, Scopus, Web of Science and CINAHL. Inclusion criteria were randomized clinical trials about complementary therapies in women during pregnancy, delivery and/or the postpartum period. The risk of bias of the clinical trials was evaluated using the revised Cochrane Risk of Bias tool for randomized trials version 2 (RoB-2). Results: A total of 1684 studies were found, with a final selection of 17. The most studied symptom was pain. Hydrotherapy, perinatal Swiss ball exercises, acupressure, virtual reality and foot reflexology provided a significant reduction in pain during labor. Similarly, aromatherapy, electroacupuncture and massage have shown significant benefits in pain management after Cesarean. Yoga, when practiced during pregnancy, effectively reduces anxiety and depression, with similar benefits observed when practiced during the postpartum period. Conclusions: Complementary therapies improve pain, anxiety and depression management across maternal health phases.Artículo Cross-cultural adaptation of the integrare scale into Brazilian Portuguese*(Scielo, 2024) Vidor, Isabella Duarte; Bavaresco, Taline; Silva, Ana Carolina Fioravanti Eilert da; Dos Santos, Cássia Teixeira; Porcel Gálvez, Ana María; Lucena, Amália de Fátima; Universidad de Sevilla. Departamento de Enfermería; Universidad de Sevilla. CTS1050: "Cuidados Complejos, Cronicidad y Resultados en Salud"ABSTRACT Objective: to carry out the cross-cultural adaptation and evaluation of the psychometric properties of the INTEGRARE Scale for Brazilian Portuguese. Method: methodological study with translation, synthesis, back-translation, and expert review stages. The psychometric properties were assessed for reliability, content validation and convergent construct validation with the Braden Scale. The pre-test was carried out with 30 patients and the validation with 120 adult patients admitted to the clinical and surgical units of a university hospital in southern Brazil. Results: the INTEGRARE Scale was easy to apply and understand, proving to be applicable in Brazil. In the analysis of the psychometric reliability properties, internal consistency was identified with questionable Cronbach’s alpha (α=0.63); however, in convergent validity there was a significant, positive, and strong correlation (Rho=0.741; p<0.001) in relation to Braden. Conclusion: the adaptation broadens the scope of nursing in the use of instruments that predict the risk of Pressure Injury.Artículo Thriving of older people assessment scale (TOPAS): Transcultural adaptation, psychometric evaluation, and refinement in a Spanish sample(Elsevier, 2024-08-13) Santana Berlanga, Nicia del Rocío; Romero Sanchez, Jose Manuel; Botello Hermosa, Alicia; Bergland, Adel; Edvardsson, David; Porcel Gálvez, Ana María; Universidad de Sevilla. Departamento de EnfermeríaThe objective of this study was to culturally adapt the Thriving of Older People Assessment Scale (TOPAS) instrument and evaluate its psychometric properties. The study was carried out in two phases: cross-cultural adaptation and psychometric validation and refinement through a cross-sectional study conducted between 2018 and 2020 with 314 participants. The refinement resulted in an abbreviated version of TOPAS, maintain ing the original 5 factors with 16 items. Cronbach alpha was 0.91. Composite reliability (0.72 0.89) and aver age variance extracted (0.57 0.81), supporting discriminant validity. Maximum shared variance for the factors (0.22 0.50) and average shared variance (0.16 0.31), demonstrating discriminant validity. The abbreviated version of TOPAS showed evidence of being a valid and reliable instrument for measuring the adaptability of elderly residents in institutions. Implementing this instrument in Spanish nursing homes allows for a continuous evaluation of residents’ well-being in relation to their environment, a construct not previously assessed with available scales.Artículo Mental health of prison inmates during the COVID-19 pandemic: a systematic review(Springer; Frontiers media SA, 2024-11-21) González-Riera, Francisco Javier; García-Iglesias, Juan Jesús; Allande Cussó, Regina; Ruiz-Frutos, Carlos; Rodríguez-Diaz, Luciano; Vázquez-Lara, Juana María; Fernández-Carrasco, Francisco Javier; Fagundo-Rivera, Javier; Gómez-Salgado, Juan; Universidad de Sevilla. Departamento de Enfermería; Universidad de Sevilla. CTS-1050: Cuidados Complejos, Cronicidad y Resultados en SaludObjectives: The aim of this study was to comprehensively assess how COVID-19 affected the levels of different mental health variables in prison inmates. Methods: A systematic review was conducted following the PRISMA format in the Pubmed, Scopus, Web of Science, PsycINFO, and ScienceDirect electronic databases between August and September 2023. Methodological quality was assessed using the critical appraisal tools for studies of the Joanna Briggs Institute. Results: Thirteen studies were included. The studies found increased levels of stress, anxiety, fear, depression, and negative emotions associated with lack of information about the pandemic and isolation leading to reduced social interaction. In addition, lack of access to common recreational spaces, limited access to support resources, especially mental health resources, fear of contracting the virus, and lack of trust in prison staff and in themselves to be protected were identified. Conclusion: Further research may be necessary in prison populations with added vulnerability, such as the elderly, women, transgender and non-binary persons, to determine specific interventions, after assessing the prevalent psychological sequelae. Prevention strategies and mental health promotion are also encouraged.Artículo Influence of Perceived Maternal Self-Efficacy on Exclusive Breastfeeding Initiation and Consolidation: A Systematic Review(MDPI, 2024) Saavedra Sánchez, Steven; Rodríguez Gallego, Isabel; León Larios, Fátima; Andina Díaz, Elena; Pérez-Contreras, Rosa; González Sanz, Juan Diego; Universidad de Sevilla. Departamento de Enfermería; Universidad de Sevilla. HUM873: Centro de Investigación y Acción Comunitaria de la Universidad de SevillaBackground/Objectives: Different international organizations recommend exclusive breastfeeding during the neonate’s first six months of life; however, figures of around 38% are reported at the global level. One of the reasons for early abandonment is the mothers’ perception of supplying insufficient milk to their newborns. The objective of this research is to assess how mothers’ perceived level of self-efficacy during breastfeeding affects their ability to breastfeed and the rates of exclusive breastfeeding up to six months postpartum. Methods: A systematic review for the 2000–2023 period was conducted in the following databases: Cochrane, Web of Science, Scopus, PubMed, Science Direct, and CINAHL. Original articles, clinical trials, and observational studies in English and Spanish were included. Results: The results comprised 18 articles in the review (2006–2023), with an overall sample of 2004 participants. All studies were conducted with women who wanted to breastfeed, used the Breastfeeding Self-Efficacy Scale or its short version to measure postpartum self-efficacy levels, and breastfeeding rates were assessed up to 6 months postpartum. Conclusions: The present review draws on evidence suggesting that mothers’ perceived level of self-efficacy about their ability to breastfeed affects rates of exclusive breastfeeding up to 6 months postpartum. High levels of self-efficacy are positively related to the establishment and maintenance of exclusive breastfeeding; however, these rates decline markedly at 6 months postpartum.Artículo Self-Perception of Physical Problems in Patients with Non-Vascular Type of Ehlers–Danlos Syndrome: A Qualitative Study(MDPI, 2024) Palomo Toucedo, Inmaculada Concepción; Reina Bueno, María; Munuera Martínez, Pedro Vicente; Vázquez-Bautista, Carmen; Domínguez-Maldonado, Gabriel; León Larios, Fátima; Universidad de Sevilla. Departamento de Enfermería; Universidad de Sevilla. Departamento de Podología; Universidad de Sevilla. HUM873: Centro de Investigación y Acción Comunitaria de la Universidad de Sevilla; Universidad de Sevilla. CTS1136: Patología y Función del PieBackground/Objectives: Ehlers–Danlos syndrome is a group of inherited connective tissue disorders characterized by joint hypermobility, skin hyperextensibility, and tissue fragility. Ehlers–Danlos syndrome is associated with a broad spectrum of clinical manifestations, including chronic pain, severe fatigue, and a range of physical and psychological complications. This study aims to identify, in patients with non-vascular type of Ehlers–Danlos syndrome, the most common physical symptoms, the impact of these symptoms on daily life, and individuals’ perceptions of their health. Methods: A qualitative descriptive study based on content analysis was employed, reviewing 24 individual interviews to gain a comprehensive understanding of participants’ experiences. The study was conducted in accordance with the COREQ (Consolidated Criteria for Reporting Qualitative Research) guidelines, which include a 32-item checklist commonly used in qualitative research. Results: Four main themes were identified: (1) Common physical symptoms, (2) Impact on daily life, (3) Impact on social and family relationships, and (4) Health perception and well-being. Conclusions: The analysis of the interviews reveals that individuals with Ehlers–Danlos syndrome face significant physical and emotional challenges. Physical symptoms, particularly chronic pain, fatigue, and joint issues, severely impact their ability to lead a normal life. These symptoms, along with perceived uncertainty and stress, contribute to a reduced quality of life, affecting both physical and emotional well-being.Artículo Evolution of the use, effectiveness and safety of bismuth-containing quadruple therapy for ['helicobacter pylori', 'h. pylori'] infection between 2013 and 2021: results from the European registry on(BMJ PUBLISHING GROUP, 2024-11-11) Olmedo, Llum; Calvet, Xavier; Gene, Emili; Bordin, Dmitry S; Voynovan, Irina; Castro-Fernandez, M; Ponce Blandón, José Antonio; Gisbert, Javier P.; Universidad de Sevilla. Departamento de Enfermería; Universidad de Sevilla. CTS-1050: Cuidados Complejos, Cronicidad y Resultados en SaludBackground: Bismuth quadruple therapies (BQTs) including bismuth, a proton pump inhibitor (PPI) and two antibiotics have been shown to be highly effective for treating Helicobacter pylori infection even in areas of high bacterial antibiotic resistance. Objective: To describe the time trends of use, effectiveness and safety of BQT in Europe using the European Registry on Helicobacter pylori Management (Hp-EuReg). Design: Patients registered in the Hp-EuReg from 2013 to 2021 who had received BQT were included. The regimens prescribed, the number of eradication attempts, effectiveness, adherence and safety were analysed. The effectiveness was assessed by modified intention to treat (mITT). Time-trend and multivariate analyses were performed to determine variables that predicted treatment success. Results: Of the 49 690 patients included in the Hp-EuReg, 15 582 (31%) had received BQT. BQT use increased from 8.6% of all treatments in 2013 to 39% in 2021. Single-capsule BQT-containing bismuth, metronidazole and tetracycline-plus a PPI (single-capsule BQT, ScBQT) was the most frequent treatment mode (43%). Schemes that obtained an effectiveness above 90% were the 10-day ScBQT and 14-day BQT using tetracycline plus metronidazole, or amoxicillin plus either clarithromycin or metronidazole. Only ScBQT achieved above 90% cure rates in all the geographical areas studied. Using the ScBQT scheme, adherence, the use of standard or high-dose PPIs, 14-day prescriptions and the use of BQT as first-line treatment were significantly associated with higher mITT effectiveness. Conclusion: The use of BQT increased notably in Europe over the study period. A 10-day ScBQT was the scheme that most consistently achieved optimal effectiveness.Artículo Effects of respiratory training on pulmonary function, cough, and functional independence in patients with amyotrophic lateral sclerosis(Mdpi Ag, 2024-11-01) Magni, Eleonora; Hochsprung, Anja; Cáceres Matos, Rocío; Pabón Carrasco, Manuel; Heredia-Camacho, Beatriz; Solís-Marcos, Ignacio; Luque Moreno, Carlos; Universidad de Sevilla. Departamento de Enfermería; Universidad de Sevilla. Departamento de FisioterapiaBackground: Respiratory complications in patients with amyotrophic lateral sclerosis (ALS), due to the involvement of respiratory muscles, are the leading cause of death, and respiratory physiotherapy (RP) focuses on addressing these complications. Objectives: The objective was to evaluate the effectiveness of an RP intervention that combines the four specific techniques (inspi ratory muscle training, lung volume recruitment, manually assisted coughing, and diaphragmatic breathing training) in patients with ALS. Methods: A quasi-experimental study was carried out, and a specific RP programme was implemented in 15 patients with ALS (12 sessions, 30 min/session, one session/week, duration of three months), based on directed ventilation techniques, lung volume recruitment, manually assisted coughing, and the use of incentive spirometry and a cough assist device, along with a daily home exercise programme. Respiratory functions were assessed (pre and post-intervention, with follow-up at three months) using Forced Vital Capacity (FVC) and Peak Expiratory Cough Flow (PECF); functionality was assessed using the Revised ALS Functional Rating Scale (ALSFRS-R) and the Modified Barthel Index by Granger. Results: FVC experienced an increase after three months of the intervention initiation (p = 0.30), which was not sustained at the three month follow-up after the intervention ended. All other variables remained practically constant after treatment, with their values decreasing at follow-up. Conclusion: A specific RP intervention could have beneficial effects on respiratory functions, potentially preventing pulmonary infections and hospitalisations in patients with ALS. It may improve FVC and help stabilize the patient's functional decline. Considering the progressive and degenerative nature of the disease, this finding could support the usefulness of these techniques in maintaining respiratory functionArtículo Stress in novice nurses in new work environments: a systematic review(Frontiers media SA, 2024) Narbona-Gálvez, Ángela; García-Iglesias, Juan Jesús; Ayuso Murillo, Diego; Fontán-Vinagre, Guadalupe; Gómez Salgado, Juan; Allande Cussó, Regina; Fagundo-Rivera, Javier; Macías-Toronjo, Israel; Ruiz-Frutos, Carlos; Universidad de Sevilla. Departamento de Enfermería; Universidad de Sevilla. CTS-1050: Cuidados Complejos, Cronicidad y Resultados en SaludBackground: Inexperienced nursing care can compromise the quality of care and the well-being of patients. The aim of this study was to assess the main sources of stress encountered by nurses and novice nurses in a setting not previously experienced. Methods: A systematic review was conducted following the PRISMA format in Pubmed, Scopus, Web of Science, and CINAHL electronic databases in March 2024. A total of 395 studies were identified, of which 16 met the inclusion criteria. Selection was made on the basis of topic relevance and methodological quality, assessed using the critical tools of the Joanna Briggs Institute (JBI). Results: A total of 16 studies were included in this review. Of the 16 selected, 10 were cross-sectional studies, 3 were cohort studies, 2 were qualitative, and 1 was a systematic review. The studies revealed that the main stressors for novice nurses included time management, workload, and interpersonal relationships. The results underline that organizational factors, such as lack of support and high work demands, play a key role in generating stress. Conclusion: Identifying and addressing the key challenges faced by novice nurses, such as workload, adjustment to the environment, professional expectations, and interpersonal relationships, is crucial to sustain their professional engagement and ensure the quality of health care. This understanding is essential for creating efficient policies and practices that enhance the occupational well-being and stability of nurses in the workforceArtículo Intervention strategies to reduce maternal mortality in the context of the sustainable development goals: a scoping review(MDPI, 2024-10-28) Olea-Ramirez, Lucia Macarena; León Larios, Fátima; Corrales-Gutiérrez, Isabel; Universidad de Sevilla. Departamento de Cirugía; Universidad de Sevilla. Departamento de Enfermería; Universidad de Sevilla. HUM-873: Centro de Investigación y Acción Comunitaria de la Universidad de Sevilla; Universidad de Sevilla. CTS-607: Salud reproductiva de la mujerAccording to the United Nations Population Fund, approximately every two minutes, a woman dies, totalling approximately 800 deaths per day for reasons related to a maternal causes. Therefore, within the Sustainable Development Goals of the 2030 Agenda, the goal is to reduce the global maternal mortality rate to less than 70 deaths per 100,000 live births by 2030. We aim to analyse strategies to reduce maternal mortality in the context of the Sustainable Development Goals, identify barriers that hinder their implementation, and analyse the impact of the COVID-19 pandemic on their achievement. We performed a scoping review of the following databases and distributors of specialised information in the health area: PubMed, Medes, Lilacs, Cuiden, Cinahl, Scopus, SciELO, and websites of the United Nations (UN), United Nations Population Fund (UNFPA), and Cooperanda. A total of 24 articles were reviewed. The results obtainded determined that reviewed studies agree that despite efforts to reduce maternal mortality, significant social and structural barriers still exist in developing countries that slow the implementation of strategies to protect maternal health, especially in the most at-risk populations, and the improvement of the health system. The main strategy consists of increasing the number of deliveries attended by qualified personnel, which is the greatest indicator of progress in reducing maternal mortality. To conclude, Economic, social, and political barriers remain in developing countries in the context of the Sustainable Development Goals. The intervention that has shown the most success is the attendance of deliveries by qualified personnel. It is essential to prioritise maternal care, triangular cooperation, and effective connection between the different Sustainable Development Goals.Artículo Nursing students’ satisfaction with clinical simulation: a cross-sectional observational study(MDPI, 2024-10-25) Jiménez-Álvarez, Juan Antonio; Guerra Martín, María Dolores; Borrallo Riego, Álvaro; Universidad de Sevilla. Departamento de Enfermería; Universidad de Sevilla. CTS-969: Innovacion en cuidados y determinantes sociales en saludClinical Simulation improves results in the students’ learning tests and allows for preserving acquired knowledge for longer periods of time, promoting more significant learning. This study was conducted to analyze Nursing students’ satisfaction with Clinical Simulation in three centres attached to a university from southern Spain. Methods: A quantitative, non-experimental and cross-sectional descriptive study was carried out. The students included were attending their third year of the Nursing undergraduate course and had already taken part in training sessions by means of Clinical Simulation. The Satisfaction Scale with High-Fidelity Clinical Simulation in Students (SSHF) was used for data collection. This scale has been validated and has 33 items grouped into eight factors. The SPSS software (version 28), was used for data analysis, establishing p-values < 0.05 for the statistically significant differences. Results: The participants were 180 students, with a mean age of 22.17 years old. Of them, 90.56% belonged to the female gender. A mean score of 3.82 out of 5 was obtained in the SSHF items. The items that obtained the highest scores were the following: benefits of Clinical Simulation as it relates theory with practise; possibility of learning based on the mistakes made; and comfort and respect while the sessions were developed. The item that obtained the lowest score was “timing for each simulation case”. We found significant differences in the results obtained according to each attached centre. Conclusions: The students showed high satisfaction levels regarding High-Fidelity Clinical Simulation in each of the three attached centres included in the study. Nevertheless, they stated the need to invest more time in Clinical Simulation sessions.Artículo Priorities and challenges in social and healthcare policies for older people living in the Mediterranean basin: A Delphi panel study(BMC, 2024-10-08) Allande Cussó, Regina; Porcel Gálvez, Ana María; Fernández García, Elena; Essawi, Salma; Salama, Mohamed; Universidad de Sevilla. Departamento de Enfermería; Universidad de Sevilla. CTS-1050: Cuidados Complejos, Cronicidad y Resultados en Salud; Universidad de Sevilla. CTS-1141: Investigación Clínica Aplicada a los Cuidados y Nuevos Paradigmas AsistencialesBackground: Recently, the countries in the Mediterranean basin (which share cultural ties) have been showing a common trend of declining social support for the elderly, with deficiencies in social care models for this demographic. Thus, this Delphi panel study analyzed the gaps in social and integrated care among the participating countries in a European research project. Methods: This three-round Delphi panel study focused on the European countries of Greece and Spain and the non-European countries of Egypt, Lebanon, and Tunisia. In this project, experts were identified according to their level of expertise in the subject matter, their gender, and their membership in different social groups. Subsequently, they were asked to identify the current situation of social care, set future goals, and locate the gaps regarding the social and healthcare models for older people in the participating countries. The median score (Mdn) and interquartile range (IQR) were calculated to assess the degree of consensus on the different priorities. Results: Among the participating countries, there was a lack of state agreements to maintain social care models, a lack of coordination between public and private institutions to provide social care services, territorial inequalities in terms of access and coverage of rights, and job insecurity for professionals. The desired situation was to integrate social and healthcare services with a person-centered social care model, thus promoting autonomy and empowering users and families in participation and decision-making. Conclusions: This Delphi study reveals significant disparities in social and healthcare policies for older adults across Mediterranean countries, highlighting shared challenges and specific national needs. European nations like Greece and Spain face fragmented systems, while non-European countries such as Lebanon, Egypt, and Tunisia lack specialized geriatric services and social security. All countries urgently need better professional training, social and economic empowerment of older adults, and integrated national strategies. These findings offer key insights for policymakers to develop equitable, sustainable solutions for aging populations.Artículo Leadership in a hospital of the Andalusian Public Health System(Elsevier, 2023-10) Bárcenas Villegas, Daniel; Vázquez Santiago, María Soledad; Universidad de Sevilla. Departamento de Enfermería; Universidad de Sevilla. CTS-1050: Cuidados Complejos, Cronicidad y Resultados en SaludObjective: To analyse, from a gender perspective, the characteristics and perception of the effects of leadership of nurses in a hospital of the Andalusian Public Health System. Methodology: Qualitative study with a phenomenological approach. The participants were nurses in care and intermediate positions with a contract of more than 6 months. A qualitative content analysis was carried out. Four phases were established for data analysis, from which 5 categories resulted. NVivo 11 software was used to analyse the dialogues. Results: The participants’ discourses endow the leader with characteristics that define him as a reference person. The contribution of middle management is necessary for the achievement of the objectives of the care units and the cohesion of the group, although this group perceives it only in relation to the management of resources. Access to management positions is not linked to gender. Conclusions: The participants’ discourses endow the leader with characteristics that define him as a reference person. The contribution of middle management is necessary for the achievement of the objectives of the care units and the cohesion of the group, although this group perceives it only in relation to the management of resources. Access to management positions is not linked to gender.Artículo Socio‐healthcare for older people in the Mediterranean basin: an integrative review and quality appraisal600933319(Wiley, 2024-10-15) Porcel Gálvez, Ana María; Allande Cussó, Regina; Fadden, Isotta Mac; Ferentinou, Eleni; Zafiropoulou, Maria; Lima Serrano, Marta; Universidad de Sevilla. Departamento de EnfermeríaObjectives: The aging Mediterranean Basin population presents complex challenges for healthcare systems, which require innovative care approaches. The study aimed to critically assess 19 socio-healthcare practices in the Mediterranean Basin that target the elderly population by analyzing their theoretical foundations, integration of care services, ethical considerations, gender-specific approaches, and use of technology. Design: An integrative literature review was conducted using a structured methodology. Sample: Diverse sources across multiple languages were searched, with the inclusion criteria focusing on the alignment of socio- healthcare practices with the components of the nursing metaparadigm, the incorporation of transversal values, and relevance to the elderly population. Results: The socio-healthcare practices exhibited common themes, such as person-centered care, interdisciplinary collaboration, and incorporation of technology for coordinated care delivery. Ethical principles of autonomy, dignity, and respect were central, with some socio-healthcare practices addressing gender-specific care needs. Evidence-based findings emphasized holistic care, integration, ethics, and innovation in elderly socio-healthcare. Conclusions: New eldercare frameworks should integrate these aspects, which offer a comprehensive approach to addressing the complex needs of elderly patients. Managers should design systems prioritizing patient well-being, whereas policymakers should develop equitable and high-quality care policies that collectively improve the well-being of the elderly population in the Mediterranean Basin.Artículo Evaluation of red blood cell biochemical markers and coagulation profiles following cell salvage in cardiac surgery: a systematic review and meta-analysis(MDPI, 2024-10-11) Cáceres Matos, Rocío; Luque Oliveros, Manuel; Pabón Carrasco, Manuel; Universidad de Sevilla. Departamento de EnfermeríaBackground: Individuals undergoing cardiac surgery face an increased risk of bleeding, as well as alterations in biochemical and coagulation patterns. Therefore, assessing the effectiveness of systems such as Cell Salvage is necessary to prevent potential surgical complications. Objective: To evaluate the efficacy of Cell Salvage in relation to the biochemical parameters of the red blood series and coagulation, as well as the risk of hemorrhage. Methods: A systematic review, accompanied by a meta-analysis, was executed via an extensive literature exploration encompassing Medline, CINAHL, Scopus, Web of Science, and the Cochrane Library. The inclusion criteria comprised studies in English or Spanish, without year restrictions, conducted in adults and with a randomized controlled trial design. Results: Twenty-six studies were included in the systematic review, involving a total of 2850 patients (experimental group = 1415; control group = 1435). Cell Salvage did not demonstrate superior outcomes compared to allogeneic transfusions in the management of post-surgical hemorrhage, as well as in total blood loss, platelet count, fresh frozen plasma, and fibrinogen. However, Cell Salvage showed a greater effectiveness for hemoglobin (moderate evidence), hematocrit (low evidence), post intervention D-dimer (low evidence), and some coagulation-related parameters (low evidence) compared to allogeneic transfusions. Finally, better results were found in the control group for INR parameters. Conclusions: The use of the Cell Salvage system holds high potential to improve the postoperative levels of biochemical and coagulation parameters. However, the results do not provide definitive evidence regarding its effectiveness for hemorrhage control, platelet count, fresh frozen plasma, and fibrinogen. Therefore, it is recommended to increase the number of studies to assess the impact of the Cell Salvage system on improvements in the red blood cell count and patient coagulation patterns. In addition, protocols should be homogenized, and variables such as the sex of the participants should be taken into account.Artículo Effect of foot orthoses and footwear in people with rheumatoid arthritis: an updated systematic review(MDPI, 2024-10-11) Cabrera-Sánchez, José Manuel; Reina Bueno, María; Palomo Toucedo, Inmaculada Concepción; Vázquez-Bautista, Carmen; Nuñez Baila, María de los Ángeles; González López, José Rafael; Universidad de Sevilla. Departamento de Enfermería; Universidad de Sevilla. Departamento de Podología; Universidad de Sevilla. CTS-1136: Patología y función del pie.; Universidad de Sevilla. CTS-601: HERMES; Universidad de Sevilla. CTS-284: Promoción de la saludBackground/Objectives: Rheumatoid arthritis is a chronic, systemic, inflammatory disease of an autoimmune nature that causes pain and disability in affected patients. Foot pain has become a challenge due to its negative impact on physical function. The objective of this updated systematic review is to describe the effect of foot orthoses and/or footwear in patients with rheumatoid arthritis and foot problems. Methods: Scopus, PubMed, CINALH, WOS, and Dialnet were searched for all articles published from January 2013 to September 2024. Inclusion criteria included randomised clinical trials and crossover trials (level of evidence I), published within the last 10 years, involving adults with a diagnosis of rheumatoid arthritis, with no restrictions on gender, race, or ethnicity. All studies that addressed the use of foot orthoses and/or shoe therapy in any type of comparison between these interventions were considered relevant. Review Manager was used to carry out the bias analysis of the selected studies. The reporting was based on the new PRISMA guidelines. Results: A total of 9 relevant articles were selected from an initial sample of 438. These articles analyse and compare the effectiveness of various types of foot orthoses in reducing pain, functional limitation, and disability, as well as improving balance and kinetic and kinematic parameters affected by rheumatoid arthritis. Conclusions: Foot orthoses reduce pain and disability in rheumatoid arthritis, improving balance and kinematic parameters. However, no significant improvements in the patients’ functionality and walking ability have been demonstrated. Customised ones with good arch control, heel reinforcement, and metatarsal pad are more effective. No results on the impact of footwear on patients with rheumatoid arthritis have been found in the last 10 years. This systematic review was registered in PROSPERO (CRD42023405645).Artículo High prevalence of tobacco consumption among pregnant women in a southern European city (Seville): a challenge for the health system(MDPI, 2024-10-09) Mendoza Berjano, Ramón; León Larios, Fátima; Corrales-Gutiérrez, Isabel; Gomez-Baya, Diego; Medero-Canela, Rocío; Baena-Antequera, Francisca; Universidad de Sevilla. Departamento de Cirugía; Universidad de Sevilla. Departamento de EnfermeríaThe prevalence of prenatal tobacco exposure remains high in many countries, particularly in southern Europe. The aims of this study were to estimate the prevalence of smoking among pregnant women in a southern Spanish city (Seville) and to identify the associated sociodemographic and obstetric characteristics. In a descriptive, cross-sectional study, a random sample of pregnant women who were scheduled to undergo a morphology scan at their public referral hospital in their 20th week of gestation were interviewed in person. At the start of pregnancy, 38.2% of the pregnant women were smokers. In the twentieth week, 19.1% continued to smoke, and the same percentage had quit. The prevalence of smoking in pregnant women was higher among those with a low level of education (60% among pregnant women with no studies and 30.4% in those with primary education) and among those who had had abortions (38.5%). Pregnant smokers with obesity were the least likely to have given up smoking during pregnancy. Women with a lower educational level should be a prime target for cross-sectoral interventions aimed at preventing prenatal tobacco exposure. Implementation of support measures for providing effective clinical advice in preconception and prenatal care regarding healthy lifestyles is particularly needed.