Artículos (Enfermería)

URI permanente para esta colecciónhttps://hdl.handle.net/11441/11010

Examinar

Mostrando 1 - 20 de 641

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; Universidad de Sevilla. Departamento de Medicina; Universidad de Sevilla. Departamento de Biología Celular; Universidad de Sevilla. Departamento de 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; Universidad de Sevilla. Departamento de Enfermería; Instituto de Biomedicina de Sevilla (IBIS); Universidad de Sevilla. CTS1141: Investigación Clínica Aplicada a los Cuidados y Nuevos Paradigmas Asistenciales; Universidad de Sevilla. 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; Universidad de Sevilla. Departamento de Enfermería; Universidad de Sevilla. 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.; Universidad de Sevilla. Departamento de Podología; Universidad de Sevilla. Departamento de Enfermería; Universidad de Sevilla. CTS601: Hermes; Universidad de Sevilla. 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; Universidad de Sevilla. Departamento de 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.
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.

Examinar

Envíos recientes