Open Access
How did COVID-19 lockdown impact the health of older adults in nursing homes?: a scoping review
(BMC, 2024) San Martín-Erice, Isabel; Escalada Hernández, Paula; García Vivar, Cristina; Furtado Eraso, Sara; San Martín Rodríguez, Leticia; Soto Ruiz, María Nelia; Ciencias de la Salud; Osasun Zientziak; Universidad Pública de Navarra / Nafarroako Unibertsitate Publikoa
Background. The impact of the COVID-19 pandemic on older adults in nursing homes is signifcant, with high death rates, disrupted care, isolation measures, and inadequate treatment. Social isolation has increased risks of cognitive disorders, anxiety, and depression. While many studies have examined the pandemic’s efects on nursing home staf and residents’ families, less is known about the health consequences for the residents themselves. This review aims to synthesize literature on the COVID-19 lockdown’s impact on the functional, cognitive, and psycho-emotional states of older adults in nursing homes. Methods. A scoping review was conducted following the Joanna Briggs Institute guidelines and the PRISMA exten sion for Scoping Reviews (PRISMA-ScR). Four databases were searched: CINAHL, PubMed, Web of Science, and Psy cINFO. The eligibility criteria included studies on older adults in nursing homes during the COVID-19 pandemic, with data that could be disaggregated for this population and results on the lockdown’s impact on physical, cognitive, and psycho-emotional levels. Results. Seventeen articles met the criteria for data extraction The synthesis was categorized into four main areas: functional, cognitive and psycho-emotional status, and isolation measures. Key fndings included decreased func tional abilities, lower cognitive test scores during the pandemic’s frst waves, development of psychological symp toms, and increased negative feelings among residents. Conclusions. Highlighting the consequences of confnement for nursing home residents is essential for updating evidence, developing efective strategies, and establishing protocols to mitigate the impact and prevent health issues in future pandemics.
Open Access
Web-based personalized intervention to improve quality of life and self-efficacy of long-term breast cancer survivors: study protocol for a randomized controlled trial
(MDPI, 2022) Soto Ruiz, María Nelia; Escalada Hernández, Paula; San Martín Rodríguez, Leticia; Ferraz Torres, Marta; García Vivar, Cristina; Ciencias de la Salud; Osasun Zientziak
Long-term breast cancer survivors (>5 years free of disease) may suffer late sequelae of cancer that impact on their quality of life. The use of telehealth for cancer care is recommended but little is known about the effectiveness of digital interventions for long-term cancer survivors. This study aims to evaluate the effectiveness of a web-based personalized intervention based on artificial intelligence instead of usual primary health care to improve the quality of life of long-term survivors of breast cancer and self-efficacy for the management of late sequelae. A randomized controlled trial will be conducted. The sample will consist of long-term breast cancer survivors recruited from primary health centers. Women will be randomly assigned to the intervention group to receive a web-based personalized intervention or to the control group to receive standard primary health care by nurses. Data on quality of life of cancer survivors and self-efficacy for the management of late sequelae of cancer will be collected and assessed at preintervention, and at 3, 6, and 9 months. It is expected that, at the end of the programme, the experimental group will have improved quality of life and improved self-efficacy for the management of late sequelae of cancer.
Open Access
Passive or interactive virtual reality? The effectiveness for pain and anxiety reduction in pediatric patients
(Springer, 2022) Ferraz Torres, Marta; San Martín Rodríguez, Leticia; García Vivar, Cristina; Soto Ruiz, María Nelia; Escalada Hernández, Paula; Ciencias de la Salud; Osasun Zientziak
Invasive techniques such as venipuncture are painful procedures causing stress and anxiety, both in pediatric patients and in their carers. For this reason, efforts are being made to develop mitigating strategies for the patient's pain and anxiety during the performance. To analyze and evaluate the effectiveness of the use of Virtual Reality distraction techniques as a measure of pain and anxiety reduction in pediatric patients and their parents. In addition, the effects of two modes of Virtual Reality (passive vs. interactive) were compared. A quasi-experimental study was carried out in the pediatric emergency department of a tertiary referral hospital in north Spain. The participants were children who underwent venipuncture for blood extraction and vascular cannulation. From the 124 patients, 51.6% (n = 64) were girls and 48.4% (n = 60) were boys (p = 0.574). The mean age was 8.4 years (SD: 4.1). The mean level of pain experienced was 2.33 (SD: 0.76) in the interactive VR group (n = 88) versus 2.67 (SD: 1.35) in patients with passive VR (n = 36) (p = 0.008); being the presence of anxiety in 27.3% (n = 24) of the cases treated with interactive Virtual Reality and in 88.9% (n = 32) of the patients with passive Virtual Reality (p = 0.000). The virtual reality is an effective method to reduce pain and anxiety levels in pediatric patients, with the effectiveness of interactive virtual reality and its use in the population aged 7-15 years being greater.
Embargo
Virtual reality to reduce pain, fatigue, and emotional distress in people with cancer: a scoping review
(Lippincott, Williams & Wilkins, 2024-09-02) Cuñado Pradales, Rebeca; Soto Ruiz, María Nelia; Escalada Hernández, Paula; San Martín Rodríguez, Leticia; García Vivar, Cristina; Ciencias de la Salud; Osasun Zientziak
Background: cancer and its treatments cause symptoms such as pain, fatigue, and emotional distress, which affect the quality of life of patients at different stages of cancer. Virtual reality (VR) has emerged as a promising alternative for addressing these symptoms by immersing patients in a virtual environment that isolates them from reality. Objective: to describe the existing evidence on the use of VR to improve pain, fatigue, and emotional distress in people with cancer at different stages of the cancer trajectory. Methods: a scoping review was conducted following the PRISMA-ScR (Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews) guidelines. Search was conducted in PubMed and CINAHL until October 2023. Results: twenty-three primary studies related to the study topic were identified, and the following information was collected: type of VR (immersive vs nonimmersive) used in oncology services, purpose (distraction, training, or relaxation), devices used (head-mounted display, headset, or virtual controller), and the environment simulated (natural environment, skill games, or educational environment). The effects of VR on pain, fatigue, and emotional distress are described, highlighting its ability to mitigate these symptoms in the short term.
Open Access
Quality of life of male breast cancer survivors: a systematic review
(Wiley, 2025-04-30) López Wilson, Arleen; Leite, Ana Carolina Andrade Biaggi; Soto Ruiz, María Nelia; Escalada Hernández, Paula; García Vivar, Cristina; Ciencias de la Salud; Osasun Zientziak
Introduction: Breast cancer treatments signifcantly infuence the quality of life of cancer survivors. While most studies havefocused on female breast cancer survivors, data on the quality of life of men who have undergone medical, surgical or radiologicaltreatments for breast cancer are limited. Objective: To evaluate the quality of life of male breast cancer survivors. Methods: A systematic review was conducted according to the PRISMA statement with a search in four databases: PubMed,Embase, Cochrane and Web of Science. We screened and extracted data and assessed the methodological quality of the studies viathe Cochrane RoB-2 and ROBINS-I tools for randomised clinical trials and follow-up studies, respectively. Te data werepresented in a narrative synthesis format. Results: In total, 993 records were identifed, of which three studies were included for analysis: two randomised clinical trials andone cohort study. Te interventions in the randomised clinical trials involved evaluating the impact of endocrine therapy and theimplementation of online physical training. Although there was a reduction in the overall quality of life during cancer treatment,patients who received tamoxifen monotherapy did not report a clinically signifcant change in their sexual function. Additionally,moderate exercise was shown to improve physical health and enhance social well-being. In the cohort study, quality of life andsymptom burden were evaluated in men with breast cancer treated with endocrine therapies at the time of diagnosis via symptomassessment scales. Conclusions: Male breast cancer survivors experience a decrease in quality of life during and after treatment. While tamoxifenmonotherapy preserves sexual function, moderate-intensity physical rehabilitation signifcantly improves both quality of life andsocial functioning. Te limited number of studies included in this review highlights the need for further research to address thephysical, psychological and social needs of male breast cancer survivors.
Open Access
Impact of individual and job characteristics on nurses' scope of practice in spanish hospital units
(Wiley, 2024) Saralegui Gainza, Amaia; Escalada Hernández, Paula; García Vivar, Cristina; San Martín Rodríguez, Leticia; Soto Ruiz, María Nelia; Ciencias de la Salud; Osasun Zientziak
Background. Nurses are one of the largest and costliest groups in healthcare organizations; therefore, it is important to comprehend their scope of practice. Aim. To contribute to the improvement of nursing resource management in medical-surgical and Intensive Care Units by identifying factors that influence the scope of nursing practice. The hypothesis was that the activities carried out by nurses in medical-surgical units and intensive care units are influenced by individual and job-related factors, with job characteristics having an additive and moderating effect on individual characteristics. Materials and Methods. Cross-sectional correlational design to test the relationship between the individual and job characteristics on the nursing scope of practice measured by the Actual Scope of Nursing Practice (ASCOP) questionnaire. The sample consisted of 270 nurses. Linear mixed effects models analysis (LME) was used with the aleatory effect of the intensive care unit (ICU). Results. Belonging to the ICU decreased the scope of practice of nurses. We found a statistically significant effect of psychological demand, practice environment, role ambiguity, and growth need strength on the scope of nursing practice. The models explained a variance up to 24%. Conclusions. Although the survey results revealed the existence of broader scope of practice levels in Spanish hospital units than in the original Canadian study, the use of scope of nursing practice remains suboptimal. Higher levels on the psychological demand, the practice environment and in the individual growth need strength were related with a broader scope of practice. Otherwise, role ambiguity negatively affected the scope of practice. Implications for Nursing Management. This article provides an analysis of the impact of individual and job-related characteristics on the nursing scope of practice. It serves as a valuable resource for both managers and nurses, offering insights to improve nurses' working conditions and obtain more efficient workforces.
Open Access
Impacto de la dotación de enfermeras en la calidad de la atención en centros residenciales para personas mayores
(Colegio Oficial de Enfermeras de Navarra, 2024) Escalada Hernández, Paula; Pimentel Parra, Gustavo Adolfo; Soto Ruiz, María Nelia; García Vivar, Cristina
Informe elaborado por el Grupo de Investigación Inno-CARE de la Universidad Pública de Navarra, a petición del Colegio Oficial de Enfermeras de Navarra. El objetivo del informe es conocer el impacto de la dotación de enfermeras en la calidad de la atención en los centros residenciales para personas mayores. El informe se estructura en tres partes. La primera parte describe la regulación del personal sanitario de atención directa en centros residenciales en España. La segunda parte presenta una síntesis de la evidencia científica sobre la relación entre la dotación de enfermeras y la calidad de la atención. Finalmente, la tercera parte muestra un posicionamiento sobre la figura de la enfermera en las residencias de personas mayores en España.
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
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.
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.