Artículos (Enfermería)

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Application of the objective structured clinical examination in undergraduate nursing students: A systematic review with meta-synthesis
(Elsevier, 2025-09-11) Garrido-Bueno, Miguel; Romero Castillo, Rocío; Pabón Carrasco, Manuel; Enfermería; CTS1050: Cuidados Complejos, Cronicidad y Resultados en Salud
Objectives: Clinical simulation enables students to replicate healthcare scenarios in a safe setting. The Objective Structured Clinical Examination (OSCE) is the gold standard for assessing clinical competence in nursing education. This study aimed to review the characteristics and applications of OSCE with nursing students and to explore their perceptions of it. Design: Systematic review with meta-synthesis. Data sources: PubMed, Scopus, Embase, Web of Science, and CINAHL. Review methods: Studies were selected based on inclusion criteria such as nursing student focus, mention of OSCE, and discussion of competencies and perceptions. Searches were conducted from December 2024 to March 2025. Risk of bias was assessed, and data were synthesized using Microsoft Excel. Results: Twenty-five studies including 3,605 students were included. OSCE designs varied widely. Students described OSCE as objective and beneficial, though anxiety-inducing due to realism and time pressure. Conclusion: A consensus model recommends in-person OSCEs of brief duration, with debriefing and broad competency assessment. Findings support improved simulation strategies for nursing students, enhancing clinical judgment and confidence.
Measuring the Science of Caring: A Patient-Centred Predictive Model for the Caring Interaction
(WILEY, 2025-09-01) Allande Cussó, Regina; Pinero de Plaza, María Alejandra; Gómez‐Salgado, Juan; Porcel Gálvez, Ana María; Enfermería; Instituto de Salud Carlos III; CTS1050: Cuidados Complejos, Cronicidad y Resultados en Salud
Background: The nurse–patient relationship is central to quality nursing care, yet its impact remains difficult to quantify. While existing models assess caring competencies from the perspective of nursing students and professionals, there is a lack of validated instruments incorporating direct patient feedback. Objective: This study aimed to develop and validate the Nursing Interaction in Caring_Competence Assessment—Patient (NIC_CA-Patient) tool, a patient-centred instrument designed to measure caring interaction in nursing practice and establish a predictive model of its development from the patient's perspective. Methods: A cross-sectional study was conducted in eight hospitals within the Andalusian Health Care System, involving 1060 patients admitted to internal medicine units. The NIC_CA-Patient tool was adapted from the Caring Nurse–Patient Interactions (CNPI) scale and validated through exploratory factor analysis (EFA) and partial least squares structural equation modelling (PLS-SEM). Results: The final model identified three key dimensions—therapeutic relationship, problem management and adaptation—ex- plaining 79% of the variance in patient-reported experiences. The predictive model demonstrated strong reliability (Cronbach's α = 0.97) and excellent model fit indices (SRMR = 0.03, AVE > 0.7). Conclusion: The NIC_CA-Patient tool provides a quantifiable and predictive measure of caring interaction from the patient's perspective. Its implementation in clinical practice and research can enhance patient-centred care by identifying relational fac- tors that improve health outcomes and patient experience.
Satisfacción con el proceso del parto en mujeres sometidas a inducción del Parto
(Health Sciences Research Unit: Nursing, 2025) Ruiz-Moreno, Sandra; Hidalgo-Lopezosa, Pedro; Guerra Martín, María Dolores; Enfermería
Marco contextual: La inducción del parto suele ocasionar partos complicados y mayor intervencionismo, lo que puede conllevar frustración y ansiedad.Objetivo: Analizar la satisfacción del proceso de parto en mujeres sometidas a inducción. Metodología: Estudio observacional. Muestreo no probabilístico por conveniencia. Se establecieron criterios de inclusión y exclusión. La muestra fue de 46 participantes. Se utilizó un cuestionario sociodemográfico, obstétrico y la versión española de la Mackey Childbirth Satisfaction Rating Scale. Resultados: La satisfacción global fue buena. La subescala mejor valorada fue la relacionada con el recién nacido, las peor valoradas las relacionadas con las fases dilatación y expulsivo. La satisfacción del acompañante y confort de las mujeres entre 30-34 años fue mayor que en ≥ 40 años. La satisfacción global fue mayor en mujeres que recibieron información previa sobre el proceso de inducción y que habían cumplido sus expectativas. Conclusión: La satisfacción global y por subescalas fue alta. Los resultados aportan evidencia para una atención eficaz de calidad que mejore los niveles de satisfacción de mujeres inducidas.
Prognostic factors affecting return to work in cancer patients: A systematic review
(BMJ, 2025-08-12) López-Faneca, Lydia; Ruiz-Frutos, Carlos; Gómez-Salgado, Juan; Fagundo-Rivera, Javier; Palomo-Gómez, Rocío; Allande Cussó, Regina; Ruger-Navarrete, Azahara; Macías-Toronjo, Israel; García-Iglesias, Juan Jesús; Enfermería; CTS1050: Cuidados Complejos, Cronicidad y Resultados en Salud
Return-to-work rates among working-age cancer survivors present a complex challenge, varying by cancer type and individual characteristics. This study aimed to identify prognostic factors influencing return to work in cancer survivors. A systematic review was conducted following Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines. Searches in PubMed, Scopus and Web of Science databases in December 2024 used keywords based on the Population, Prognostic Factors, Outcomes framework to identify relevant studies. Study quality was evaluated using Joanna Briggs Institute tools and the protocol was registered in PROSPERO (CRD42024596102).Twenty studies were selected. Identified factors included sociodemographic: older age, educational level, marital status and sex; clinical: aggressive treatments, comorbidities and physical sequelae; psychological: anxiety, stress, fear of relapse and social support; occupational: flexible work schedules and tasks versus rigid conditions. Multiple factors influence return-to-work outcomes for cancer survivors.Individualised intervention programmes addressing specific patient needs and fostering adapted work environments are essential to promote successful reintegration.
Beyond Pain Management:
(2025-06-02) Guerra Martín, María Dolores; Pérez Jiménez, José Miguel; Coheña Jiménez, Manuel; Borrallo Riego, Álvaro; Luque Oliveros, Manuel; Pedro Jiménez, Domingo de; Bonilla Sierra, Patricia; Enfermería; Podología; MDPI; CTS1149: Salud Integral y Sostenible: Enfoque Bio-Psico-Social, Cultural y Espiritual para el Desarrollo Humano
Background: Postoperative pain management after a cesarean section remains a significant challenge, as inadequate control can delay maternal recovery and hinder early bonding and breastfeeding. While multimodal analgesia is the standard approach, non–pharmacological strategies like immediate skin–to–skin contact (SSC) are often underused despite their potential benefits in reducing pain, improving uterine contractions, and increasing maternal satisfaction. Objective: To evaluate the effects of immediate SSC on postoperative pain perception, uterine contraction quality, and maternal satisfaction, and to explore ways to incorporate SSC into routine post–cesarean care to promote recovery and humanized care. Method: A randomized clinical trial was conducted with 80 women undergoing elective cesarean sections, divided into two groups: SSC (40 women) and control (40 women). Postoperative pain was measured using the Visual Analog Scale (VAS) at various intervals, while uterine contraction quality and maternal satisfaction were assessed through clinical observation and a Likert scale, respectively. Results: We found that women in the SSC group experienced significantly lower pain scores (VAS2 and VAS3, p < 0.001), stronger infraumbilical uterine contractions (92.5%, p < 0.001), and higher satisfaction levels (average 9.98 vs. 6.50, p < 0.001). An inverse correlation was observed between pain intensity and satisfaction, indicating that SSC enhances both physiological and psychological recovery. Conclusions: Immediate SSC after cesarean is an effective, humanizing intervention that reduces pain, supports uterine contractions, and boosts maternal satisfaction. These findings advocate for integrating SSC into standard postoperative care, aligning with ethical principles of beneficence and autonomy. Further research with larger samples is necessary to confirm these benefits and facilitate widespread adoption in maternity protocols
Diaphragmatic breathing for referred pain after total laparoscopic hysterectomy: a randomized clinical trial
(Springer, 2025-08-18) Partida Márquez Antonio Luis; Fernández Domínguez, Juan Carlos; Martínez Fernández, José Antonio; Pabón Carrasco, Manuel; Melero Cortes Lidia; Oliva Pascual-Vaca, Ángel; Fisioterapia; Enfermería; Universidad de Sevilla; CTS1050: Cuidados Complejos, Cronicidad y Resultados en Salud; CTS1043: Salud, Fisioterapia y Actividad Física
Background: Referred cervicoscapular pain is common after laparoscopic surgery. This pain has different characteristics from incisional pain and requires a different approach. Method: A blinded, randomized, controlled trial was conducted. Women reporting referred pain with an intensity of 7 points or higher on the visual analogue scale after total laparoscopic hysterectomy (TLH) were randomly assigned to a diaphragmatic breathing group (DBG) or a neck exercise group (NEG). Both groups performed the exercises three times daily, and the usual medical care was maintained. Pain intensity and location were assessed using the McGill questionnaire. Specific self-reported questionnaires were used to assess the evolution of functional disability in the head (HIT-6), shoulder and neck (NDI), or upper limbs (QuickDASH). Follow-up was conducted weekly for 4 weeks after surgery. Results: Seventy-four women (43.7 ± 9,5 years; 26.6 ± 4.9 body mass index) were recruited. The most common area of referred pain was the shoulder and neck (n = 55), followed by the head (n = 48) and upper limbs (n = 14), with four women showing pain in all three areas and thirty-five in two areas. Both groups showed improvement over time in pain intensity and functional disability in all the locations (p < 0,001). However, DBG demonstrated a faster recovery for pain intensity, NDI, and HIT-6 (p < 0,001), while no between-group difference was found for QuickDASH (p > 0,05). No adverse effects were reported for any of the tested interventions. Conclusions: Referred pain in TLH tends to become self-limiting over time, but diaphragmatic breathing exercises resulted in a faster reduction in pain intensity and craniocervical disability when compared with gentle cervical stretching exercises. Thus, abdominodiaphragmatic breathing might be a simple and safe complementary intervention to be taught to patients suffering from referred pain after TLH.
Exploring Psychosocial Risk Factors Among Spanish Nurses: Links to Health and Professional Variables
(Wiley, 2025-08-27) Narbona-Gálvez, Ángela; Gómez‐Salgado, Juan; Allande Cussó, Regina; Ruiz‐Frutos, Carlos; Ayuso-Murillo, Diego; Fontán-Vinagre, Guadalupe; Goniewicz, Krzysztof; Fagundo-Rivera, Javier; Castaño Seiquer, Antonio Luis; Enfermería; Estomatología; CTS1050: Cuidados Complejos, Cronicidad y Resultados en Salud
Objective: To identify factors associated with the perception of psychosocial risks among practising nurses in Spain and to examine their relationship with personal, professional and health-related characteristics. Design: Observational, cross-sectional and correlational study. Participants: A total of 2765 nurses completed an online questionnaire between March and June 2023. The survey was distributed via professional networks and the General Nursing Council of Spain. Methods: Descriptive and bivariate analyses were conducted, along with a categorical regression to identify factors associated with perceived psychosocial risk (measured using the ISTAS_Enfermería scale). Model assumptions were tested and multicollinearity was assessed. The model included self-reported sociodemographic, occupational and mental health variables. Results: Female sex, being under 41 years of age, working night or rotating shifts, recent use of psychotropic medication and symptoms of anxiety or depression were all associated with higher levels of perceived psychosocial risks. These variables explained 29.6% of the variance. Due to the cross-sectional design, no causal relationships can be inferred. Conclusions: Certain professional profiles appear to be more vulnerable to perceived psychosocial risks that are associated with their personal, occupational and health characteristics. These associations are likely to be bidirectional and context-dependent. Longitudinal research is needed to better understand causal mechanisms and to guide personalised preventive interventions.
E-Cigarette Use Among University Students: A Structured Literature Review of Health Risks, Behavioral and Social Determinants, and Nursing Implications
(MDPI, 2025-08-28) Rocha-Ávila, Luis-Rodrigo; Nuñez Baila, María de los Ángeles; González López, José Rafael; Enfermería; CTS284: Promoción de la Salud
Background/Objectives: E-cigarette use has increased substantially among university students in recent years, coinciding with a broader shift in nicotine consumption patterns globally. Despite initial perceptions of e-cigarettes as harm-reduction tools, growing evidence indicates significant health risks, misinformation, and limited awareness—especially within higher education environments. This structured literature review aims to synthesize peer-reviewed evidence on the health impacts, behavioral determinants, and the role of nursing in addressing e-cigarette use among university students. Methods: A literature search was conducted across five databases (PubMed, CINAHL, Scopus, Embase, Dialnet) between February and March 2025. Eligible studies were published between January 2020 and January 2025 in English or Spanish. A total of 43 studies were included. Data were synthesized narratively, and methodological quality was assessed using Joanna Briggs Institute checklists and The Scale for the Assessment of Narrative Reviews Articles. Results: E-cigarette use among university students showed wide variability in prevalence, with higher rates among males, students in non-health disciplines, and users of disposable devices. Key behavioral and social determinants included peer influence, curiosity, stress management, and social media exposure. Despite documented health risks—such as nicotine dependence, respiratory and cardiovascular impairment, and mental health concerns—misconceptions about safety and cessation efficacy were common, even among health science students. Nursing-led interventions hold great potential for prevention but remain underdeveloped within university settings. Conclusions: The findings underscore the urgent need for evidence-based prevention strategies—particularly those led by nurses—to reduce e-cigarette use, bridge knowledge gaps, and mitigate associated health risks in higher education. Future efforts should prioritize institutional policy reinforcement, improved health communication, and the integration of vaping-related education into nursing curricula and public health campaigns targeting emerging adults.
Assessment of anxiety and fear of COVID-19 in the prison population: Psychometric properties of the AMICO_Inmates scale
(Ovid Technologies (Wolters Kluwer Health), 2025) González-Riera, Francisco Javier; Allande Cussó, Regina; López-López, Daniel; Castaño Seiquer, Antonio Luis; Macías-Toronjo, Israel; Fagundo-Rivera, Javier; Gómez‐Salgado, Juan; Enfermería; Estomatología; CTS1050: Cuidados Complejos, Cronicidad y Resultados en Salud
The COVID-19 disease has entailed a public health challenge and an increased sense of uncertainty for the prison population, who have experienced restrictions on access to social contacts, communal areas, and information for a longer and more recent period than the general population, as well as increased levels of anxiety and fear associated with the COVID-19 disease. The objective of this study was the validation of the Anxiety and Fear of COVID-19 (AMICO) Assessment Scale to measure both anxiety and fear constructs in Spanish prison inmates. A descriptive psychometric validation study was carried out. A field study was conducted to perform univariate analyses, in addition to the exploratory and confirmatory factor analysis of the scale. The study sample consisted of 711 subjects over 18 years of age, inmates in Spanish prisons, 14.1% of whom were women with a mean age of 40.35 years (SD = 2.62). The construct validity study reported 2 factors and 16 items, with a Cronbach alpha value of 0.95, confirmed by McDonald Omega coefficient, with a value of 0.951. The AMICO scale is a valid and reliable tool for assessing the level of anxiety and fear of COVID-19 in the Spanish adult prison population and shows high sensitivity.
Creencias y prácticas culturales sobre comportamientos de lactancia materna en mujeres: una Revisión Sistemática Exploratoria
(Servicio de Publicaciones, Universidad de Murcia, 2025-08) Badanta Romero, Bárbara; Suarez-Reina, Paola; Álvarez-Pérez, Isabel; Lucchetti, Giancarlo; Guerra-Martín, María Dolores; Vega-Escaño, Juan; Diego Cordero, Rocío de; Enfermería
Introducción. Las cuestiones culturales están fuertemente relacionadas con los hábitos de vida de las mujeres. Se recomienda la lactancia materna exclusiva en los primeros seis meses de vida y la lactancia materna complementaria hasta los 2 años. Según la Organización Mundial de la Salud solo 4 de cada 10 lactantes menores de 6 meses de edad han recibido lactancia materna exclusiva en el mundo. Objetivo. Explorar el papel de las creencias y prácticas culturales en las conductas de lactancia materna de las mujeres. Método. Se realizó una revisión sistemática exploratoria en seis bases de datos: PubMed, Scopus, CINAHL, PsycINFO, Web of Science y Cochrane Database of Systematic Reviews. Resultados. Se localizaron 3.078 estudios, de los cuales 37 fueron finalmente seleccionados. Se propusieron dos categorías temáticas: 1. Percepciones y creencias sobre la lactancia materna en las mujeres. 2. Influencia de las normas sociales en la lactancia materna en las mujeres. Discusión: Los resultados destacan las creencias de que el calostro se considera “leche sucia” y que la leche materna tiene un bajo valor nutricional, lo que se asocia a algunas prácticas religiosas, imposiciones familiares, barreras sociales, noticias sensacionalistas y falsas y el retorno temprano al trabajo, lo que resulta en bajas tasas de lactancia materna en todo el mundo. Conclusión. Esta revisión ha avanzado en la comprensión de que las cuestiones culturales están fuertemente asociadas con la lactancia materna entre las mujeres. Se deben ofrecer programas educativos, asesoramiento y capacitación de profesionales de la salud para aumentar la lactancia materna
Sense of coherence in Spanish-speaking countries during the COVID-19 pandemic: A systematic review
(LIPPINCOTT WILLIAMS & WILKINS, 2024) Escobar Segovia, Kenny; Domínguez Salas, Sara; García Iglesias, Juan Jesús; López López, Daniel; Allande Cussó, Regina; Romero Ruiz, Adolfo; Gómez Salgado, Juan; Psicología Experimental; Enfermería
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.
Sleep Characteristics, Insomnia and Hypersomnolence Prevalence and Associated Factors in Emerging Adults With Type 1 Diabetes in Andalusia: A Cross-Sectional Study
(Sage Journals, 2025-07-27) Nuñez Baila, María de los Ángeles; Gómez Aragón, Anjhara; González López, José Rafael; Enfermería; CTS284: Promoción de la Salud
Background: Emerging adulthood (aged 18-29 years) is a critical period marked by social, academic, and work transitions. During this life stage, sleep patterns are easily changed, especially for those who live with type 1 diabetes mellitus, which increases the likelihood of sleep disorders. Objectives: We sought to (1) describe sleep characteristics in emerging adults with type 1 diabetes mellitus in Andalusia, Spain; (2) determine the prevalence of insomnia and hypersomnolence using Diagnostic and Statistical Manual of Mental Disorders (DSM-5) diagnostic criteria; and (3) examine the relationship between sociodemographic factors and diabetes-related factors with sleep satisfaction and symptoms of insomnia and hypersomnolence while controlling for potential confounders such as coexisting health conditions and the use of sleep aids. Methods: We conducted a cross-sectional study in Andalusia, Spain, from October 2021 to July 2022, involving 362 emerging adults aged 18 to 29 (67.4% female) with type 1 diabetes mellitus. Participants completed online forms for sociodemographic questions and the Oviedo Sleep Questionnaire. Results: The average sleep duration was 6.8 hours, with half of the participants expressing dissatisfaction. Sleep duration and biological sex predicted insomnia and hypersomnolence, while only sleep duration predicted sleep satisfaction. Common nocturnal awakenings were due to urination, noise, and hyper/hypoglycemia. Notably, 47.5% met DSM-5 criteria for insomnia and 6.9% for hypersomnolence. Conclusions: Emerging adults with type 1 diabetes mellitus in Andalusia frequently faced significant sleep challenges, including sleep dissatisfaction, insufficient sleep duration, insomnia, and hypersomnolence. These findings highlight the need for comprehensive sleep assessments in diabetes care, using DSM-5 criteria that can guide interventions to improve sleep quality and glycemic stability.
Nursing Care to Reduce Suicide Risk in Cancer Patients: A Narrative Review of the Literature
(MDPI, 2025-07-24) Borrallo Riego, Álvaro; García Mayo, María; Gil Ordóñez, Irene; Domínguez Sánchez, Isabel; Guerra Martín, María Dolores; Enfermería; CTS969: Innovación en Cuidados y Determinantes Sociales en Salud
Background: Cancer is one of the leading causes of morbidity and mortality worldwide and in Spain. Individuals with cancer are at a higher risk of suicide compared to the general population due to both general and disease-specific risk factors. Objective: To update knowledge on nursing care measures to address the risk of suicide in cancer patients. Methods: A narrative review was conducted by searching PubMed, WOS, Scopus, and CINAHL during February and March 2025. The inclusion criteria comprised original qualitative, quantitative, and/or mixed-methods studies related to the topic of the review. Results: Of the 289 identified studies, 23 were selected. Twelve studies of cancer patients, ten studies of healthcare professionals, and one study of caregivers and survivors were included. Regarding suicide risk factors, eight studies addressed demographic aspects, fifteen socio-economic factors, twenty-one psycho-emotional factors, and seventeen physical factors. Key risk factors included male sex, advanced age, social isolation, lack of social support, hopelessness, and physical deterioration. Seventeen studies highlighted the need for continuous and comprehensive nursing care using validated tools for systematic assessment of suicide risk. Eight emphasised the importance of ongoing training in suicide prevention, which is essential for developing communication skills and improving therapeutic relationships. Five studies underscored the relevance of a holistic approach that addresses the physical, emotional, social, and spiritual dimensions of patient care. Six extended this approach to include family members and caregivers. Conclusions: Suicide risk in cancer patients is associated with multiple risk factors. Emotional support and a comprehensive, continuous nursing approach—based on systematic assessments, specialised training, and a holistic focus—are key to effective suicide prevention.
Con E de Esperanza, de Enfermería y de Espiritualidad
(FUDEN. Fundación para el Desarrollo de la Enfermería, 2025-06-01) Diego Cordero, Rocío de; Enfermería; CTS1149: Salud Integral y Sostenible: Enfoque Bio-Psico-Social, Cultural y Espiritual para el Desarrollo Humano
Con motivo del año jubilar y de su lema “la esperanza no defrauda” la iglesia católica nos invita a caminar para avanzar juntos hacia un futuro mejor, basado en la esperanza, la misericordia y la fraternidad. Estudios recientes han apuntado que la esperanza está positivamente asociada con el bienestar, y la salud mental actuando como mediador en esta relación, sugiriendo que una mejor salud mental fomenta la esperanza. Las acciones de enfermería que fomentan la esperanza incluyen crear un ambiente de cuidado abierto, proporcionar alivio del dolor y facilitar la participación de los pacientes en su tratamiento.
Telehealth as a Care Solution for Homebound People: Systematic Review and Meta‐Analysis of Healthcare Utilization, Quality of Life, and Well‐Being Outcomes
(Wiley, 2025) Pinero de Plaza, Maria Alejandra; Gulyani, Aarti; Bulto, Lemma N.; Allande Cussó, Regina; Pearson, Vincent; Lange, Belinda; Marin, Tania; Wesley, Hannah; Enfermería; CTS1050: Cuidados Complejos, Cronicidad y Resultados en Salud
Homebound individuals residing in community settings with severe health conditions and disabilities could arguably benefit from telehealth interventions. However, the effectiveness of telehealth compared to in-person care remains underexplored, considering the diversity of these groups. This systematic review and meta-analysis aimed to evaluate the effectiveness of telehealth in reducing healthcare utilization and improving health-related quality of life (HRQOL) and well-being in homebound populations. Adhering and expanding on a published protocol, we conducted comprehensive search across multiple databases: MEDLINE, Embase, PsycINFO, CINAHL, Cochrane Central Register of Controlled Trials (CENTRAL), Scopus, LILACS, and the Web of Science, with no restrictions on language or publication date, and experimental and quasiexperimental studies considered. Eleven independent reviewers were responsible for study selection, and three for data extraction. The methodological quality of the included studies was assessed using JBI checklists. A meta-analysis was then performed using Stata software, which reported standardized mean differences (SMDs) as the effect measure, with the quality of evidence evaluated using the GRADE approach. From an initial screening of 3289 articles, ten studies met our inclusion criteria, with eight suitable for meta-analysis. These studies encompassed data from 2245 participants. Our findings revealed that telehealth interventions significantly reduced healthcare utilization (SMD: −0.49; 95% CI: −0.76 to −0.22; p < 0.01, GRADE: low certainty), significantly enhanced HRQOL (SMD: 0.18; 95% CI: 0.01 to 0.35; p = 0.04, GRADE: moderate certainty), and significantly improved well-being (SMD: −0.31; 95% CI: −0.47 to −0.15; p < 0.01, GRADE: moderate certainty) compared to in-person care. Thus, telehealth emerges as a viable alternative to conventional care, significantly reducing healthcare utilization and enhancing both HRQOL and well-being for homebound people. These findings underscore the potential of telehealth to mitigate healthcare disparities and emphasize the need for accessible, equitable telehealth services codeveloped with end users and relevant stakeholders to save resources and maximize health outcomes for vulnerable populations in community settings.
Shaping current European mitochondrial haplogroup frequency in response to infection: the case of SARS-CoV-2 severity
(Nature Briefing, 2025-01) Cabrera Alarcón, José Luis; Cruz, Raquel; Rosa-Moreno, Marina; Latorre-Pellicer, Ana; Diz de Almeida, Silvia; SCOURGE cohort group; Medrano Ortega, Francisco Javier; Rodríguez Hernández, María A.; Morilla Romero de la Osa, Rubén; Valido Morales, Agustín S.; Enríquez, José Antonio; Medicina; Biología Celular; Enfermería; Instituto de Biomedicina de Sevilla (IBIS)
The frequency of mitochondrial DNA haplogroups (mtDNA-HG) in humans is known to be shaped by migration and repopulation. Mounting evidence indicates that mtDNA-HG are not phenotypically neutral, and selection may contribute to its distribution. Haplogroup H, the most abundant in Europe, improved survival in sepsis. Here we developed a random forest trained model for mitochondrial haplogroup calling using data procured from GWAS arrays. Our results reveal that in the context of the SARS-CoV-2 pandemic, HV branch were found to represent protective factors against the development of critical SARS-CoV-2 in an analysis of 14,349 patients. These results highlight the role of mtDNA in the response to infectious diseases and support the proposal that its expansion and population proportion has been influenced by selection through successive pandemics.
Importance Assigned to Breastfeeding by Spanish Pregnant Women and Associated Factors: A Survey-Based Multivariate Linear Correlation Study
(MDPI, 2024) Arnedillo Sánchez, Mª del Socorro; Suffo Aboza, José Antonio; Carmona Rodríguez, Miguel Ángel; Morilla Romero de la Osa, Rubén; Arnedillo Sánchez, Inmculada; Enfermería; Instituto de Biomedicina de Sevilla (IBIS); CTS1141: Investigación Clínica Aplicada a los Cuidados y Nuevos Paradigmas Asistenciales; CTS969: Innovación en Cuidados y Determinantes Sociales en Salud
Breastfeeding education, across all disciplines, is often inconsistent and lacking in expertise and confidence. However, recommendations from health professionals, the sociocultural environment, and previous knowledge and experiences significantly influence women’s decision to breastfeed. This study aimed to identify factors that promote the assignment of greater importance to breastfeeding and associated practical benefits. This retrospective cross-sectional study included 276 participants who completed a self-administered questionnaire. Descriptive and bivariate analyses were performed, and multivariate linear models were applied to identify factors influencing the importance assigned to breastfeeding. Most participants were married or in a relationship, were native Spaniards, had secondary or higher education, and had an average age of 32.6 years. Seventy percent met the physical activity recommendations, and 91% felt comfortable with their body image during pregnancy. The importance assigned to breastfeeding was high across various aspects, except for postpartum weight loss and body image. Group prenatal care was only significantly associated with the importance assigned to the breastfeeding technique (how to breastfeed). The obesogenic environment and the importance assigned to nutritional aspects and physical activity also turned out to be predictors, although not for all models. In our region, the educational strategy of antenatal care groups could contain gaps regarding the mother’s health, which should be addressed in the future to improve results regarding the initiation and continuation of breastfeeding.
Nurse-Related Complexity of Care Perceived by Critical Care Nurses: A Multicentre Qualitative Study
(Wiley, 2025-06-19) Reguera Carrasco, Cristina; Fernández García, Elena; Prada-Rizoto, Marina; Jiménez García, Victor Manuel; Naharro-Álvarez, Alonso; Corral-Cortés, Ángela; Barrientos Trigo, Sergio; Enfermería; CTS1141: Investigación Clínica Aplicada a los Cuidados y Nuevos Paradigmas Asistenciales
Background: Nurse-related complexity of care encompasses intrinsic elements derived from the professionals and their professional practice that influence the complexity of care delivery. These elements include aspects such as gender, professional experience, effective communication or the application of complex techniques, all of which play a significant role in shaping the complexity of nursing care. Aim: To explore the nurses' perceptions of the complexity of care related to nursing professionals in adult intensive care units. Study Design: A multicentre qualitative descriptive study was conducted using focus group discussions from January to June 2024. Data were transcribed verbatim and subjected to thematic analysis. Trustworthiness was also ensured using Lincoln and Guba's criteria. Therefore, the current manuscript was reported following the Consolidated Criteria for Reporting Qualitative Research checklist. Results: Five focus groups were conducted with 32 nurses from four different hospitals in Spain. Of them, 75% (n = 24) were women, and 25% (n = 8) were men. Participants had an average age of 42 years and 19 years of work experience. Four themes were identified: professional activity, professional background, multidisciplinary work and emotional management. Conclusions: Nurses perceive the complexity of care as a multifaceted interplay of qualitative and quantitative elements. The study's findings, which highlight the influence of technological advances, years of experience, level of training and workload on this perception, are crucial for future efforts to improve the quality of care and the well-being of nurses. Relevance to Clinical Practice: Clarifying the complexity of care in intensive care units through nursing narratives will elucidate the key aspects that influence nurses' work. Assessing workload through this lens will facilitate holistic, patient-centred adjustments, enhance the quality of care and improve resource allocation.
Comparative Effectiveness of Iontophoresis vs. Low Dye Taping in Plantar Fasciitis: A Systematic Review
(Springer Science and Business Media LLC, 2025-07-03) Castro Méndez, Aurora; Roldán-Fernández, Lucía; Tovaruela Carrión, Natalia; Pabón Carrasco, Manuel; Álvarez-Cordero, Juan; Vázquez‐Castro, M. A.; Podología; Enfermería; CTS601: Hermes; CTS1050: Cuidados Complejos, Cronicidad y Resultados en Salud
Background Plantar fasciitis (PF) is a frequent cause of heel pain, affecting approximately 10% of the population. Conserva tive treatments such as iontophoresis and low-dye taping (LDT) are widely used to alleviate symptoms, often providing short-term pain relief. Objective This systematic review aims to compare the efficacy of iontophoresis (with 5% acetic acid, 0.4% dexamethasone, dexamethasone and lidocaine, or placebo) versus low-dye taping (LDT) in treating plantar fasciitis. Additionally, it evaluates the combined effect of iontophoresis and LDT application. Methods A systematic search was conducted in Scopus, PubMed, Web of Science, CINAHL, and the Cochrane Library databases, following PRISMA guidelines and the Cochrane Handbook for Systematic Reviews of Interventions. Inclusion and exclusion criteria were predefined. Two independent reviewers screened and extracted data from eligible studies, assessing their quality. Included studies comprised randomized controlled trials, non-randomized clinical trials, case–control studies, systematic reviews, and meta-analyses. The review protocol was registered with PROSPERO (registration number: [blind for review]). Results Eight studies published between 1997 and 2018 were included, providing a moderate level of evidence. Both ion tophoresis (with the specified agents) and low-dye taping, alone or combined, were associated with statistically significant reductions in pain scores compared to baseline. Conclusion Iontophoresis and low-dye taping are effective conservative interventions for plantar fasciitis, with their com bined use also showing beneficial effects. These treatments can be considered viable options to reduce pain in patients with plantar fasciitis.
Impact of chemical interventions on reducing dengue, Zika, and chikungunya: a systematic review
(Pan American Health Organization, 2025-04-03) Tortosa-La Osa, Silvia; Roldán-Coronel, Sandra; Martín Ruiz, Eva María; Galán‐Relaño, Ángela; Olry de Labry Lima, Antonio; Enfermería
Objective: Given that vector control represents the primary strategy for preventing these diseases, the objec tive of this systematic review is to ascertain the efficacy of chemical interventions in reducing their burden. Methods: The PRISMA guidelines were followed to search for experimental studies published between 1987 and 2024 in English, Portuguese, and Spanish. Medline, Embase, WOS-Core Collection, Scopus, Lilacs, Cochrane Library, and Biological Science Database were consulted to identify studies using incidence or prevalence as outcome variables of interest. Results: Of the 2 232 references initially retrieved, 8 articles were included in the review. All studies used ento mological indices along with disease burden indices to measure intervention impact. Three studies evaluated the use of insecticide-impregnated curtains alone, one combined those with residual insecticide treatment in dwellings, one evaluated the use of insecticide-impregnated school uniforms, and the remaining three evaluated household insecticide application. Only four of the eight articles showed some level of efficacy of chemical interventions in reducing dengue prevalence or incidence. Conclusion: The chemical interventions under examination did not result in a notable reduction in the burden of these diseases within the population, which would appear contradictory given the prominent role of chemi cal interventions in vector-borne disease control programs.

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