Artículos (Enfermería)

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Estudio de prevalencia de disfagia e intervención con consejo dietético, en residencias de mayores de Sevilla
(Grupo Arán, 2009-08) Irles Rocamora, José Antonio; Sánchez-Duque, M. J.; Valle Galindo, P. B. de; Bernal López, E.; Fernández Palacín, Ana; Almeida González, Carmen V.; Torres Enamorado, Dolores; Universidad de Sevilla. Departamento de Medicina Preventiva y Salud Pública; Universidad de Sevilla. Departamento de Enfermería; Universidad de Sevilla. CTS312: Análisis de la Demanda Sanitaria; Universidad de Sevilla. SEJ066: Mujeres, Bienestar y Ciudadanía
Introducción: La prevalencia de las alteraciones de la deglución varia ampliamente según la edad y comorbilidad . Objetivos: Determinar la prevalencia de disfagia y alteraciones de la alimentación en personas mayores que viven en residencias de la provincia de Sevilla, valorando la efectividad del consejo dietético. Métodos: Se realizó un estudio descriptivo transversal sobre una población de 3.921 residentes distribuidos en 86 residencias. En una primera fase del estudio se pretendía estimar la prevalencia de disfagia, para lo cual se seleccio- naron 373 residentes en 23 residencias. En una segunda fase se seleccionó una muestra de residentes con disfagia, siendo reevaluados un mes después tras recibir consejo dietético y medidas básicas para control de disfagia . Resultados: La mediana de edad fue 80 (73-86) años, presentaron disfagia 60 (17,3%), y dificultades de alimentación 50 (13,4%). Ambas se asociaron de forma significativa (p < 0,05) con enfermedades neurológicas. Presentaron accidente cerebrovascular (AVC ) 40 (11,3%), y demencia 123 (34,8%). En la segunda parte se estudiaron 12 pacientes con disfagia, de edad media 80,6 ± 11,9 años, MNA 19 ± 3, Barthel 24 ± 27, y grado de disfagia Karnell 3-4, en un 75% de los casos. Estos pacientes a los que se sometió a consejo dietético y medidas básicas para control de disfagia no mejoraron el nivel de ingesta, disfagia o dependencia. Conclusiones: La prevalencia de disfagia y dificultades de la alimentación es muy elevada en residencias. Las medidas estándar para el control de la disfagia son poco efectivas en pacientes con dependencia severa o demencia avanzada.
Is Spirituality Included in Spanish Language Pain Assessment Scales? A Scoping Review of Instruments Available
(Springer Science and Business Media LLC, 2025-06-05) Diego Cordero, Rocío de; Martin-Palomino, Emilio; Aranda-Jerez, Alicia; Pérez Jiménez, José Miguel; Lucchetti, Giancarlo; Universidad de Sevilla. Departamento de Enfermería; Universidad de Sevilla. CTS1149: Salud Integral y Sostenible: Enfoque Bio-Psico-Social, Cultural y Espiritual para el Desarrollo Humano
The subjective and biopsychosocial–spiritual nature of pain makes its assessment difficult. Although multidimensional scales exist, few pain instruments have included spiritual aspects in their development, so our purpose is to investigate the inclusion of spirituality in pain assessment scales available in Spanish. A review of the scientific literature was carried out in the PubMed, SCOPUS and Web of Science databases. To make the search more exhaustive, Internet databases were searched, and the Spanish Pain Society was consulted. For each instrument, items were rated and classified according to a broader (i.e., family, nature, transcendence, meaning) or narrower (i.e., deity or higher power) definition of spirituality. Out of a total of 838 items searched in the databases, 8 multidimensional pain scales were found in Spanish, and 5 included items related to spirituality and/or religiosity. Most of the scales do not focus directly on the assessment of spiritual pain. Although the Coping with Chronic Pain Questionnaire has clear items related to prayer, God, faith and seeking religious leaders, the other scales only touch on spiritual definitions and most of these would lead to “contaminated” results due to poor design. It seems that these scales were not originally designed to assess the spiritual dimension of pain but, instead, have some existential items that are linked to a broader definition of spirituality, such as hope, suffering, emptiness and meaning. The present review has revealed that most pain scales available in Spanish were not originally designed to investigate spiritual pain, assessing indirectly items related to spirituality. These findings highlight that, although spirituality is an important aspect of pain, its assessment is still scarce in clinical practice and research. Future instruments should include a more holistic view of pain, which includes aspects related to spirituality and religiousness.
Understanding the Predisposing Factors of Nurse‐to‐Nurse Horizontal Violence in Hospital Settings: An Integrative Review
(Wiley, 2025-06-02) Reguera Carrasco, Cristina; Santana Berlanga, Nicia del Rocío; Barrientos Trigo, Sergio; Universidad de Sevilla. Departamento de Enfermería; Universidad de Sevilla. CTS1141: Investigación Clínica Aplicada a los Cuidados y Nuevos Paradigmas Asistenciales
Introduction: Nurse-to-nurse horizontal violence is a highly prevalent issue in healthcare, significantly affecting nurses' well-being, job satisfaction and professional performance. Despite its widespread occurrence, it remains largely invisible due to organisational culture, normalisation and underreporting. Recognising and addressing this phenomenon is a priority to improve workplace environments and safeguard both nurses and patient care. Aim: The aim was to synthesise the existing evidence on the main predisposing factors of nurse-to-nurse horizontal violence in a hospital setting. Design: An integrative review. Data Source. Four databases: PubMed, CINAHL, Scopus and Web of Science. Methods: This integrative review followed Whittemore and Knafl's approach and was reported according to SWiM checklist. Database searches occurred from September 2022 to February 2023, including studies published between 2013 and 2023. Articles were screened by title, abstract and full text based on set criteria. Additional articles were identified through backward citation searching. Quality was appraised using Joanna Briggs instruments, and a narrative synthesis summarised the findings. Results: Fifteen articles were reviewed, focusing on nurse-to-nurse horizontal violence. Most studies used the Revised Negative Acts Questionnaire and were rated as ‘good quality’. The predisposing factors identified were grouped into three categories: organisational, professional and work related. Conclusion: The findings highlight that the predisposing factors of nurse-to-nurse horizontal violence are multidimensional and interrelated. Addressing this issue requires a comprehensive and coordinated approach that strengthens leadership and implements standardised early detection and measurement tools to develop effective preventive strategies. Implications for the Professional Practice and Patient Care: Horizontal violence promotes disruptive work environments. Management-related issues, professional hierarchies and unhealthy working conditions contribute to its occurrence. Therefore, strengthening leadership, promoting peer support and improving work environments are key to mitigating its impact and enhancing nurse well-being and care quality. Trial Registration: PROSPERO: CRD42023396684
Psychosocial Risks in Spanish Nursing: Relationship With Stability and Working Conditions
(Frontiers Media SA, 2025-05-20) Narbona-Gálvez, Ángela; Gómez‐Salgado, Juan; Ruiz‐Frutos, Carlos; Ayuso-Murillo, Diego; Fontán-Vinagre, Guadalupe; Fagundo-Rivera, Javier; Palomo-Gómez, Rocío; Rúger-Navarrete, Azahara; Rúger-Navarrete, Azahara; Allande Cussó, Regina; Universidad de Sevilla. Departamento de Enfermería; Universidad de Sevilla. CTS10: Cuidados Complejos, Cronicidad y Resultados en Salud
Objectives: Psychosocial risks significantly affect the physical and mental health of workers, especially in the healthcare sector. This study assesses psychosocial risks in a sample of Spanish nurses by applying the ISTAS_ENFERMERÍA questionnaire. Methods: A descriptive cross-sectional study was conducted with 2,765 nurses working in Spain. Sociodemographic, occupational, and psychosocial variables were assessed using the ISTAS_ENFERMERÍA questionnaire. Data were collected through a digital form distributed through social networks and professional channels. Results: Significant differences were found in ISTAS_ENFERMERÍA scores according to socio-demographic and employment variables. Younger age and job instability were associated with higher levels of stress, while stable contracts were correlated with lower perceived risks. Conclusion: The study highlights the relationship between psychosocial risks and sociodemographic and occupational factors. Youth and job instability are linked to higher levels of stress, while job stability reduces these risks. Interventions to improve working conditions and support younger professionals are recommended.
Gradual dose reduction versus abrupt deprescription of antipsychotic in patients with dementia: A systematic review
(Universidad de Granada, 2025-03-18) Oyarzo Cuevas, Alex; Martín Ruiz, Eva María; Olry de Labry Lima, Antonio; Universidad de Sevilla. Departamento de Enfermería
Objective: To synthesize the available evidence on antipsychotic gradual dose reduction or abrupt deprescription in the older people population with dementia. Methods: A systematic review of intervention studies. PubMed, Embase, Web of Science-Core Collection, Cochrane Library, Scopus, MEDLINE(Ovid), and PsycINFO databases were consulted. Articles were eligible for inclusion if they were intervention studies (randomized or quasi-experimental trials) evaluating the effectiveness of dose reduction or complete withdrawal antipsychotic deprescribing strategies in people with dementia. The screening process, data extraction, data analysis and bias risk assessment were performed by two independent reviewers and any discrepancies were triangulated with a third reviewer. Results: Eight clinical trials were ultimately included in the systematic review, two of which were quasi experimental. Over 60% of participants came from nursing or care homes. There is evidence of several strategies for depre scribing antipsychotics. Five studies used an abrupt withdrawal schedule and three studies used a gradual dose reduction. Deprescription through abrupt and gradual withdrawal schedules showed no significant differences in the management of behavioral symptoms, although abrupt withdrawals showed significantly higher rates of relapse and/or adverse events. Conclusion: Deprescribing antipsychotics is feasible in those people with dementia, and it is associated with benefits in terms of survival, and with potential improved outcomes in the management and relapse of behavioral and psychological symptoms of dementia. It seems reasonable that tapering off antipsychotic medication should be assessed after 12 weeks of treatment or when behavioural symptoms are under control.
Role of proton pump inhibitors dosage and duration in Helicobacter pylori eradication treatment: Results from the European Registry on H. pylori management
(Sage publications inc; John wiley & sons LTD; Wiley, 2024-02) Pabón Carrasco, Manuel; Keco‐Huerga, Alma; Castro Fernández, Manuel; Saracino, Ilaria Maria; Fiorini, Giulia; Vaira, Dino; Pérez‐Aísa, Ángeles; Gisbert, Javier P.; Hp-EuReg Investigators; Universidad de Sevilla. Departamento de Enfermería; Centro de Investigacion Biomedica en Red de Enfermedades Hepaticas y Digestivas (CIBERehd); Grupo Europeo de Estudio de Helicobacter y Microbiota (EHMSG); Programa de la Unión Europea EU4Health; Programa de la Unión Europea HORIZON; Asociación Española de Gastroenterología
BACKGROUND: Management of Helicobacter pylori (H. pylori) infection requires co-treatment with proton pump inhibitors (PPIs) and the use of antibiotics to achieve successful eradication. AIM: To evaluate the role of dosage of PPIs and the duration of therapy in the effectiveness of H. pylori eradication treatments based on the 'European Registry on Helicobacter pylori management' (Hp-EuReg). METHODS: Hp-EuReg is a multicentre, prospective, non-interventionist, international registry on the routine clinical practice of H. pylori management by European gastroenterologists. All infected adult patients were systematically registered from 2013 to 2022. RESULTS: Overall, 36,579 patients from five countries with more than 1000 patients were analysed. Optimal (≥90%) first-line-modified intention-to-treat effectiveness was achieved with the following treatments: (1) 14-day therapies with clarithromycin-amoxicillin-bismuth and metronidazole-tetracycline-bismuth, both independently of the PPI dose prescribed; (2) All 10-day (except 10-day standard triple therapy) and 14-day therapies with high-dose PPIs; and (3) 10-day quadruple therapies with clarithromycin-amoxicillin-bismuth, metronidazole-tetracycline-bismuth, and clarithromycin-amoxicillin-metronidazole (sequential), all with standard-dose PPIs. In first-line treatment, optimal effectiveness was obtained with high-dose PPIs in all 14-day treatments, in 10- and 14-day bismuth quadruple therapies and in 10-day sequential with standard-dose PPIs. Optimal second-line effectiveness was achieved with (1) metronidazole-tetracycline-bismuth quadruple therapy for 14- and 10days with standard and high-dose PPIs, respectively; and (2) levofloxacin-amoxicillin triple therapy for 14days with high-dose PPIs. None of the 7-day therapies in both treatment lines achieved optimal effectiveness. CONCLUSIONS: We recommend, in first-line treatment, the use of high-dose PPIs in 14-day triple therapy and in 10-or 14-day quadruple concomitant therapy in first-line treatment, while standard-dose PPIs would be sufficient in 10-day bismuth quadruple therapies. On the other hand, in second-line treatment, high-dose PPIs would be more beneficial in 14-day triple therapy with levofloxacin and amoxicillin or in 10-day bismuth quadruple therapy either as a three-in-one single capsule or in the traditional scheme.
Author Correction: Comparison of the management of Helicobacter pylori infection between the older and younger European populations (Scientific Reports, (2023), 13, 1, (17235), 10.1038/s41598-023-43287-4)
(Nature publishing group; Nature portfolio, 2023-11-01) Jonaitis, Paulius; Nyssen, Olga P.; Saracino, Ilaria Maria; Fiorini, Giulia; Vaira, Dino; Pérez-Aisa, Ángeles; Castro Fernández, Manuel; Pabón Carrasco, Manuel; Huguet, Jose M.; Universidad de Sevilla. Departamento de Enfermería; Universidad de Sevilla. CTS1050: Cuidados Complejos, Cronicidad y Resultados en Salud
Comparison of the management of Helicobacter pylori infection between the older and younger European populations
(Nature publishing group; Nature portfolio, 2023-10-11) Jonaitis, Paulius; Nyssen, Olga P.; Saracino, Ilaria Maria; Fiorini, Giulia; Vaira, Dino; Pérez-Aisa, Ángeles; Castro Fernández, Manuel; Pabón Carrasco, Manuel; Jonaitis, Laimas; Universidad de Sevilla. Departamento de Enfermería; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd); Grupo Europeo de Estudio de Helicobacter y Microbiota (EHMSG); Programa de la Unión Europea EU4Health; Programa de la Unión Europea HORIZON; Asociación Española de Gastroenterología (AEG); Universidad de Sevilla. CTS1050: Cuidados Complejos, Cronicidad y Resultados en Salud
The prevalence of Helicobacter pylori remains high in the older population. Specific age-related peculiarities may impact the outcomes of H. pylori treatment. The aim of the study was to evaluate the diagnostics and effectiveness of H. pylori eradication between the younger and older European populations. “European Registry on H. pylori Management (Hp-EuReg)” data from 2013 to 2022 were analyzed. Patients were divided into older (≥ 60 years) and younger (18–59 years) groups. Modified intention-to-treat (mITT) and per-protocol (PP) analysis was performed. 49,461 patients included of which 14,467 (29%) were older-aged. Concomitant medications and penicillin allergy were more frequent among the older patients. Differences between younger and older populations were observed in treatment duration in first-line treatment and in proton pump inhibitors (PPIs) doses in second-line treatment. The overall incidence of adverse events was lower in the older adults group. The overall first-line treatment mITT effectiveness was 88% in younger and 90% in the older patients (p < 0.05). The overall second-line mITT treatment effectiveness was 84% in both groups. The effectiveness of the most frequent first- and second-line triple therapies was suboptimal (< 90%) in both groups. Optimal efficacy (≥ 90%) was achieved by using bismuth and non-bismuth-based quadruple therapies. In conclusion, the approach to the diagnostics and treatment of H. pylori infection did not generally differ between younger and older patients. Main differences were reported in the concurrent medications, allergy to penicillin and adverse events both in first- and second-line treatment. Optimal effectiveness rates were mostly achieved by using bismuth and non-bismuth-based quadruple therapies. No clinically relevant differences in the effectiveness between the age groups were observed.
Analysis of Clinical Phenotypes through Machine Learning of First-Line H. pylori Treatment in Europe during the Period 2013–2022: Data from the European Registry on H. pylori Management (Hp-EuReg)
(MDPI, 2023-09-10) Nyssen, Olga P.; Pratesi, Pietro; Spínola, Miguel A.; Jonaitis, Laimas; Pérez-Aísa, Ángeles; Vaira, Dino; Saracino, Ilaria Maria; Pabón Carrasco, Manuel; Gisbert, Javier P.; European Registry on H. pylori Management; Universidad de Sevilla. Departamento de Enfermería; Asociación Española de Gastroenterología (AEG); Universidad de Sevilla. CTS1050: Cuidados Complejos, Cronicidad y Resultados en Salud
The segmentation of patients into homogeneous groups could help to improve eradication therapy effectiveness. Our aim was to determine the most important treatment strategies used in Europe, to evaluate first-line treatment effectiveness according to year and country. Data collection: All first-line empirical treatments registered at AEGREDCap in the European Registry on Helicobacter pylori management (Hp-EuReg) from June 2013 to November 2022. A Boruta method determined the “most important” variables related to treatment effectiveness. Data clustering was performed through multi-correspondence analysis of the resulting six most important variables for every year in the 2013–2022 period. Based on 35,852 patients, the average overall treatment effectiveness increased from 87% in 2013 to 93% in 2022. The lowest effectiveness (80%) was obtained in 2016 in cluster #3 encompassing Slovenia, Lithuania, Latvia, and Russia, treated with 7-day triple therapy with amoxicillin–clarithromycin (92% of cases). The highest effectiveness (95%) was achieved in 2022, mostly in Spain (81%), with the bismuth–quadruple therapy, including the single-capsule (64%) and the concomitant treatment with clarithromycin–amoxicillin–metronidazole/tinidazole (34%) with 10 (69%) and 14 (32%) days. Cluster analysis allowed for the identification of patients in homogeneous treatment groups assessing the effectiveness of different first-line treatments depending on therapy scheme, adherence, country, and prescription year.
Testing the TEC-MED-Integrated Transcultural Social–Ethical-Care Model for Older People in the Mediterranean Basin: A Mixed-Method Quasiexperimental Study Protocol
(Ubiquity Press, 2025-05-09) Lima Serrano, Marta; Allande Cussó, Regina; Vargas Martínez, Ana Magdalena; Karam, Georges; El-Korh, Lea; Porcel Gálvez, Ana María; Universidad de Sevilla. Departamento de Enfermería
Background: The global shift toward aging populations, driven by advancements in the economy, healthcare, and society, has transformed once-lethal diseases into chronic conditions. Complex patient management scenarios emerge through this trend, coupled with demographic changes, given that multiple chronic diseases coexist within an individual. The TEC-MED project, which spans multiple countries, aims to evaluate whether the TEC-MED model can improve the quality of life and reduce care dependency among older adults in the Mediterranean region. Methods: This study employs a mixed-method approach including a longitudinal analytical quasiexperimental design, economic evaluation, and qualitative techniques such as interviews and focus groups. The sample includes at least 20,000 older adults and their caregivers from the Mediterranean basin countries. Quantitative data analysis encompasses descriptive and bivariate statistical analyses, regression models, and economic evaluation, whereas qualitative analysis involves discourse analysis and thematic categorization. Discussion: The TEC-MED project’s focus on integrating social and health care is expected to improve health outcomes and quality of life for older people and their caregivers. The anticipated outcomes will contribute valuable insights into the TEC-MED model’s effectiveness in promoting person-centered care and addressing global challenges posed by aging populations.
Assessing COVID-19-related psychological distress: validation of the AMICO scale in Spanish nursing University Students
(MDPI, 2025-05-04) Badillo-Sánchez, Nadine; Morgado-Toscano, Cristina; Allande Cussó, Regina; Gómez-Salgado, Juan; Yıldırım, Murat; Goniewicz, Krzysztof; Macías-Toronjo, Israel; Fagundo-Rivera, Javier; Universidad de Sevilla. Departamento de Enfermería; Universidad de Sevilla. CTS1050: Cuidados Complejos, Cronicidad y Resultados en Salud
Background: The COVID-19 pandemic had a significant impact on nursing students by intertwining academic demands with health concerns, a situation that had effects on their emotional well-being and academic engagement. Factors such as sociodemographic characteristics and health status determined their experiences. Understanding these dynamics is crucial, especially in the context of the Spanish health and education systems. The present study aimed to adapt and assess the psychometric properties of the AMICO scale in the context of nursing students in Spain. Methods: Cross-sectional descriptive study. The study was carried out in University Nursing Centers in Spain using a non-probabilistic snowball sampling method. The total sample consisted of 1197 nursing students. Sociodemographic variables were included, as well as questions related to general health and some more specific questions about COVID-19. For the reliability study, Cronbach’s alpha was calculated. An exploratory factor analysis using principal components and varimax rotation was applied, excluding items with loadings below 0.05. Results: In this study, 1197 nursing students residing in Spain participated, of whom 85% were female, with a mean age of 22.35 years. Despite 73.9% of the students being isolated due to exposure to COVID-19, they rated their general health positively (7.86). Females reported higher levels of anxiety. The AMICO scale revealed significant differences according to gender, health, and vaccination history, showing high reliability (Cronbach’s alpha = 0.913). Conclusions: The two-factor structure of the AMICO scale was validated, confirming its suitability for assessing anxiety and fear among nursing students in Spain. The study revealed significant emotional distress during the COVID-19 pandemic, particularly among women, high-risk individuals, and those fully vaccinated. These findings accentuate the need for higher education institutions to implement targeted mental health interventions during public health emergencies. Future longitudinal research should examine the evolving psychological impact of such crises and the mitigating roles of quality of life, sleep, and physical activity.
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 Salud
The 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)
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 Mujer
Pneumocystis 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.
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 Humano
The 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.
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 Salud
Objective: 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.
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 Salud
Objetivo: 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.
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 Salud
El 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.
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 Salud
Objetivo: 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.
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 Salud
Introduction: 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.
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 Salud
Background: 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.

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