Open Access
Proposal of nursing diagnosis "adult disuse syndrome": a conceptual derivation and integrative review
(Wiley, 2023) Ardila Suárez, Edinson Fabian; Escalada Hernández, Paula; Ciencias de la Salud; Osasun Zientziak
Purpose: To develop a nursing diagnosis proposal derived from the concept of “disuse syndrome” based on an integrative review. Methods: The conceptual derivation technique, proposed by Walker and Avant, was used in the following phases: an integrative review of the literature was carried out, applying the parameters of Whitermore and Knalf, where 43 articles were selected that covered the existence of the concept in the nursing discipline and other health sciences, the concepts were subsequently analyzed, and the new concept was redefined following the middle-range theory of causality and validation of nursing diagnoses proposed by Oliveira-Lopes et al. Findings: The proposal of the new nursing diagnosis was developed, including the following elements: diagnostic label adult disuse syndrome, the corresponding definition, 25 defining characteristics, eight related factors, eight risk populations, and 14 associated problems. Conclusions: The concept of the proposed new diagnosis describes adult disuse syndrome as a phenomenon that transcends the physiological component and should be viewed from a multidimensional view, expressing a clinical judgment related to a series of nursing diagnoses that appear together. Implications for nursing practice: The results of this study will help nursing professionals to identify the phenomenon of adult disuse syndrome in any setting and in turn guide optimal care interventions that decrease the consequences of adult disuse syndrome.
Open Access
Reducción del miedo al entorno sanitario en niños usando espacios simulados: un ensayo controlado aleatorizado
(Elsevier, 2024-04-10) Soto Ruiz, María Nelia; Escalada Hernández, Paula; García Vivar, Cristina; Ferraz Torres, Marta; Saralegui Gainza, Amaia; San Martín Rodríguez, Leticia; Ciencias de la Salud; Osasun Zientziak; Institute of Smart Cities - ISC; Universidad Pública de Navarra / Nafarroako Unibertsitate Publikoa; Gobierno de Navarra / Nafarroako Gobernua
Objetivo: El objetivo de este estudio fue evaluar la efectividad de una intervención que implicó interacciones dentro de un espacio de atención sanitaria simulado para reducir el miedo al entorno sanitario entre los niños de educación infantil. Métodos: Se llevó a cabo un estudio experimental en el que participaron a 86 niños, divididos en los grupos intervención (GI) y control (GC), con medidas antes y después de la intervención. Esta última, denominada Programa Health-Friendly, consistió en enseñar a los niños diversos escenarios que simularon diferentes contextos sanitarios, para que pudieran interactuar en ellos, experimentar con los materiales y realizar preguntas. El miedo al entorno sanitario fue evaluado mediante la versión en español revisada de Child Medical Fear Scale (CMFS-R), que proporciona una puntuación al nivel de miedo al entorno sanitario que fluctúa de 0 a 34 puntos. Los niveles de miedo al entorno sanitario antes y después de la prueba en los grupos intervención y control fueron comparados mediante la prueba t de Student. Resultados: Los niños del GI experimentaron una reducción significativa del miedo de 3,21 puntos (desviación estándar [DE]: 6,50) en comparación con los niños del GC. Dicha reducción del miedo se reflejó en las cuatro dimensiones de la escala: miedos intrapersonales, miedos procedimentales, miedos ambientales y miedos interpersonales. Conclusión: El Programa Health-Friendly proporciona una intervención innovadora para reducir el miedo al entorno sanitario entre los niños, basada en información, estrategias de confrontación y escenarios de simulación. Este estudio sugiere el beneficio potencial de incorporar intervenciones educativas en las escuelas, en colaboración con los centros universitarios y los centros de simulación de la atención sanitaria.
Open Access
Use of online communities among people with type 2 diabetes: a scoping review
(Springer, 2024) Bujanda Sainz de Murieta, Arantxa; Soto Ruiz, María Nelia; García Vivar, Cristina; San Martín Rodríguez, Leticia; Escalada Hernández, Paula; Ciencias de la Salud; Osasun Zientziak; Universidad Pública de Navarra / Nafarroako Unibertsitate Publikoa
Purpose of Review. People with diabetes require continuous self-monitoring and face numerous decisions in their day-today lives. Therefore, on many occasions, they need more support than that provided by health professionals. In this context, peer support in online diabetes communities could be a useful tool. The purpose of the review is to describe, analyze and synthesize the available evidence on the use and health out-comes of online communities for people with type 2 diabetes mellitus. A scoping review was conducted in accordance with the Joanna Briggs Institute guidelines. Searches were performed PubMed, Web of Science, CINHAL, Scopus and Cochrane databases. Recent Findings. From 1821 identifed documents, 6 articles were included. These studies explored the characteristics of diabetes online communities and the population features. Besides, the results were classifed according to whether they were clinical, psychosocial, or addressed people's experiences with the online community. The analysis underscores their value in facilitating communication, improving diabetes management, and enhancing psychosocial well-being. Future investigations should prioritize longitudinal assessments to elucidate the sustained impact of community engagement and optimize user participation for enhanced patient outcomes. Summary. The growing relevance of new technologies has led to a signifcant number of individuals with chronic illnesses seeking peer support. Online health communities have emerged as virtual spaces where individuals with shared health interests interact and form relationships. Within these digital spaces, individuals can engage in peer interaction, observe behaviors, and mutually beneft, potentially leading to improved attitudes toward the disease.
Open Access
Propuesta de plan de cuidados de enfermería para mujeres que sufren pérdidas perinatales, según la teoría de Watson
(Elsevier, 2024-10-21) Furtado Eraso, Sara; Marín Fernández, Blanca; Escalada Hernández, Paula; Ciencias de la Salud; Osasun Zientziak; Institute of Smart Cities - ISC; Universidad Pública de Navarra / Nafarroako Unibertsitate Publikoa
Perder a un recién nacido es para muchas madres un final doloroso en el que acontece la muerte cuando se espera la vida, que les hace vivir un tiempo de soledad, duda personal y sentimiento de fracaso. Tras realizar un estudio cualitativo previo analizando las vivencias de 25 mujeres que sufrieron una pérdida perinatal espontánea en cualquier momento del embarazo y una revisión sistemática de los factores que afectan a la respuesta emocional tras las pérdidas perinatales, se presenta una propuesta de cuidados de enfermería basada en la teoría del cuidado humano transpersonal de Jean Watson para dar respuesta a las necesidades de las mujeres que experimentan dicho proceso de pérdida. Con esta propuesta de plan cuidados se pretende proporcionar un cuidado individualizado a las mujeres que sufren pérdidas perinatales adaptado a sus necesidades, no solo físicas, sino también emocionales.
Open Access
Quality of life in long-term cancer-free breast cancer survivors in Spain: a descriptive study
(Nature, 2025-07-03) Soto Ruiz, María Nelia; Escalada Hernández, Paula; Pimentel Parra, Gustavo Adolfo; García Vivar, Cristina; Ciencias de la Salud; Osasun Zientziak
This study aimed to assess the quality of life (QOL) of long-term breast cancer survivors (LT-BCS), disease-free 5 years after completing primary treatments, and to identify sociodemographic and clinical factors associated with their QOL. A descriptive cross-sectional study was conducted with LT-BCS from the Navarra region in Spain. The QOL was assessed using the Spanish version of the QOL scale for cancer survivors. Sociodemographic and clinical data, time since treatment completion, and lifestyle factors were also collected. Bivariate statistical analysis and multiple regression were used to explore associations between independent variables and QOL and its domains. A total of 188 LT-BCS participated, with a mean age of 57.55 years and a mean survival time of 10.22 years. The overall QOL score was 5.77/10, with physical well-being scoring the highest and spiritual wellbeing the lowest. Age, occupation, and moderate physical activity were associated with better QOL, while total mastectomy, early menopause, and recurrences had a negative impact. Radiotherapy was associated with improved overall QOL. Regression models confirmed these associations, except for spiritual well-being. The study identifies key factors affecting the QOL of LT-BCS, a population that has been relatively underrepresented in scientific literature. It provides valuable insights into their distinct physical and psychological sequelae, contributing to a more comprehensive understanding of their long-term well-being. Sequelae of breast cancer persist, affecting long-term survivors’ wellbeing. Despite the growing importance of supportive care, many women lack proper follow-up. This study underscores the need for strategies such as survivorship care plans to improve coordination and support, addressing both psychological impacts and physical well-being.
Open Access
The Spanish version of the child medical fear questionnaire: cross-cultural adaptation and validation
(MDPI, 2021) San Martín Rodríguez, Leticia; Soto Ruiz, María Nelia; Ferraz Torres, Marta; García Vivar, Cristina; Saralegui Gainza, Amaia; Escalada Hernández, Paula; Ciencias de la Salud; Osasun Zientziak; Gobierno de Navarra / Nafarroako Gobernua
Having valid and reliable tools that help health professionals to assess fear in children undergoing medical procedures is essential to offer humanised and quality of care in the paediatric population. The aim of this study was to develop the cross-cultural adaptation and the evaluation of the psychometric properties of the Spanish version of the 'Child Medical Fear Scale' in its shortened version (CMFS-R). The design consisted of two phases: first, of cross-cultural adaptation and second, of the psychometric validation of the CMFS-R with a sample of 262 children from Spain, applying a cross-sectional design. Confirmatory factor analysis was conducted to assess construct validity and the Cronbach's alpha and the adjusted item-total score correlation coefficients were performed to study reliability. The results confirmed internal consistency and construct validity of the Spanish version of the CMFS-R, indicating that the scale has an acceptable level of validity and reliability. Therefore, this study brings a new version of the scale to assess fear related to medical procedures for use in the Spanish paediatric population.
Open Access
Use of telehealth among cancer survivors: a scoping review
(Mary Ann Liebert, Inc., 2023) Irurita Morales, Paula; Soto Ruiz, María Nelia; San Martín Rodríguez, Leticia; Escalada Hernández, Paula; García Vivar, Cristina; Ciencias de la Salud; Osasun Zientziak
Background: Long-term cancer survivors have specific needs that are frequently neglected. Telehealth, as a new form of health care, can benefit this growing population.Objective: To identify, analyze, and synthesize the existing evidence on the use of telehealth in the care of cancer survivors after the end of treatment.Methods: A scoping review was conducted in the databases PubMed, CINAHL, COCHRANE, SCIELO, DIALNET, and LILACS and reference institutions in cancer.Results: The initial search yielded 406 publications with 59 articles meeting the eligibility criteria. There are different types of telehealth (video calls, phone calls, websites, mobile applications, and short message services) used for the care of cancer survivors. Most telehealth interventions focus on improving the physical and mental spheres of quality of life in the extended survival phase (from 1 to 3 years postdiagnosis), with only two articles (3%) on long-term cancer survivors (>5 years postdiagnosis). Survivors are satisfied with telehealth interventions, noting the importance of improving comprehensibility, personalization of the platforms, and the lack of excessive information included.Conclusions: Telehealth is a feasible modality for cancer survival care. The scarcity of interventions aimed at long-term survivors stands out, as does the general neglect of the social and spiritual spheres of quality of life.Implications for Practice: Telehealth platforms must adapt their content, format, and items to the preferences reported by the survivors.
Open Access
Systematic review of clinical practice guidelines for long-term breast cancer survivorship: assessment of quality and evidence-based recommendations
(Springer Nature, 2025-05-17) Pimentel Parra, Gustavo Adolfo; García Vivar, Cristina; Escalada Hernández, Paula; Santos Martín, José Luis; Soto Ruiz, María Nelia; Ciencias de la Salud; Osasun Zientziak; Institute of Smart Cities - ISC
BACKGROUND: Breast cancer is the most common cancer among women, with improved survival rates due to advances in early diagnosis and therapies. However, long-term survivors (≥5 years post-treatment, disease-free) face persistent physical, psychological, and social challenges requiring tailored, evidence-based care. Despite the growing survivor population, no systematic evaluation of Clinical Practice Guidelines (CPGs) for this group has been conducted. This study assesses the quality of CPGs and their evidence-based recommendations. METHODS: A systematic review was conducted in PubMed, CINAHL, and Cochrane Library (2015–2023), including guidelines from major oncology organisations. The AGREE II instrument evaluated CPG quality across six domains, and recommendations were classified using a Primary Care survivorship framework: prevention, surveillance, care coordination, and long-term effect management. RESULTS: Ten CPGs met inclusion criteria, with 7 classified as high quality. Most recommendations focused on prevention (adjuvant therapy, alcohol) and surveillance (follow-up, mammography), while gaps remained in lifestyle guidance, psychosocial support, and management of complications (lymphedema, osteoporosis, cognitive dysfunction). Care coordination and psychosocial interventions were inconsistently addressed. CONCLUSIONS: Current CPGs inadequately cover the complex needs of long-term survivors, particularly in psychosocial care. Evidence-based, patient-centred guidelines are urgently needed to optimise long-term outcomes and quality of life.
Open Access
Mental health of spanish nurses working during the covid-19 pandemic: a cross-sectional study
(Wiley, 2022) San Martín Rodríguez, Leticia; Escalada Hernández, Paula; Soto Ruiz, María Nelia; Ferraz Torres, Marta; Rodríguez Matesanz, Irati; García Vivar, Cristina; Ciencias de la Salud; Osasun Zientziak; Gobierno de Navarra / Nafarroako Gobernua
Aim. To explore the impact of the COVID-19 pandemic on the mental health of nurses working in primary, secondary, and tertiary healthcare centers in Navarre (Spain). Background. Healthcare workers, especially nurses, are at high risk for developing mental health problems during the COVID-19 pandemic. Introduction. Spain ranks among the European countries with the highest incidence of and mortality from COVID-19 and has a 31% deficit in the number of nurses compared with the average for the European Union. Methods. This was a cross-sectional study involving 800 Registered Nurses in Navarre, Spain. Four standardized instruments, along with a self-administered online questionnaire, were used to measure the impact in terms of depression, anxiety, insomnia, and posttraumatic stress disorder. The STROBE checklist for cross-sectional studies was used to report this study. Results. Of the 800 nurses, 68% had some level of depression, anxiety, insomnia, and distress, and of these, 38% had moderate or severe symptoms. Those who worked in hospital COVID units and in nursing homes showed a higher impact on their mental health. Discussion. The sustained pressure that nurses have experienced in their work during the COVID-19 pandemic has negatively affected their mental health. Conclusion. This study found that nurses who worked in hospital COVID units and in nursing homes during the pandemic had worse mental health outcomes. Implications for nursing/policy. Recommendations for nursing policy include the need to implement coaching and emotional programs to support nurses on the frontlines of the pandemic. There is also an urgent need for the implementation of national training programs to strengthen health emergency preparedness, improve response capacity, and increase the resilience of nurses to disasters.
Open Access
Can virtual reality reduce pain and anxiety in pediatric emergency care and promote positive response of parents of children? A quasi-experimental study
(Elsevier, 2023) Ferraz Torres, Marta; Soto Ruiz, María Nelia; Escalada Hernández, Paula; García Vivar, Cristina; San Martín Rodríguez, Leticia; Ciencias de la Salud; Osasun Zientziak; Universidad Pública de Navarra / Nafarroako Unibertsitate Publikoa
Aim: To evaluate the effectiveness of virtual reality to reduce pain and anxiety in pediatric patients during venipuncture procedure in emergency care and the behavioral response of their parents/companions. Background: Virtual reality is being used as a source of distraction in children undergoing invasive procedures. Methods: Quasi-experimental study with 458 children (from 2 to 15 years) who attended a pediatric emergency service from September 2019 to April 2021. An intervention based on virtual reality as a distraction method during venipuncture procedure was applied. The level of pain and anxiety of children and attitude of parents/ companions were assessed. Ordinal and binary logistic regressions were applied. Results: A protective effect of using virtual reality was observed in the intervention group both for the absence of pain (− 4.12; 95 % CI: − 4.85 to − 3.40) and anxiety (− 1.71; 95 % CI: − 2.24 to − 1.17) in children aged between 2 and 15 years. A significant reduction in the blocking response of the accompanying parents (− 2.37; 95 % CI: − 3.017 to − 1.723) was also observed. Conclusions: VR is effective in reducing pain and anxiety in children during venipuncture in emergency care. A positive attitude of the parents during the invasive procedure to their children was found.