Open Access
Validación de contenido del diagnóstico de enfermería “trastorno de los procesos de pensamiento”
(2015) Escalada Hernández, Paula; Marín Fernández, Blanca; Martín Carrasco, Manuel; Ciencias de la Salud; Osasun Zientziak
El objetivo general de esta investigación es elaborar una nueva versión del diagnóstico de enfermería “trastorno de los procesos de pensamiento” y llevar a cabo su validación de contenido por un panel de expertos. La versión validada del diagnóstico es presentada a la NANDA-I para su inclusión de nuevo en la clasificación de diagnósticos de enfermería. Este proyecto se basa en la hipótesis de trabajo de que el trastorno de los procesos de pensamiento, entendido como la alteración de la capacidad para procesar la información, valorar las alternativas y tomar decisiones, es un problema real experimentado por los pacientes, y que dicha respuesta es susceptible de actuación por parte de los profesionales de enfermería dentro de su práctica autónoma, por lo que constituye un diagnóstico de enfermería.
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
Effectiveness of digital health on the quality of life of long-term breast cancer survivors: a systematic review
(Elsevier, 2023) Pimentel Parra, Gustavo Adolfo; Soto Ruiz, María Nelia; San Martín Rodríguez, Leticia; Escalada Hernández, Paula; García Vivar, Cristina; Ciencias de la Salud; Osasun Zientziak
Objectives: To identify, critically appraise, and synthesize the available evidence on the effectiveness of digital health interventions to improve the quality of life or any of its four dimensions (physical, psychological, social, and spiritual) in women survivors of breast cancer who are in the extended or permanent survival stage. Data Sources: Systematic review—Four databases were searched: PubMed, CINAHL, PsycINFO, and Web of Science. Conclusion: The clinical evidence shows a positive relationship or association between eHealth use and improved quality of life in breast cancer survivors at extended or permanent survival stage. However, the findings point to a deficit in the assessment of the social and spiritual domains that play a fundamental role in the quality of life of survivors. Implication for Nursing Practice: The findings found reflect implications of great value for nursing practice because these professionals are the main users of digital health tools to provide them to patients. Using these digital tools contributes to improving evidence-based practice and providing greater efficiency and effectiveness in the care of long-term cancer survivors.
Open Access
Calidad de vida relacionada con la salud en pacientes con enfermedad inflamatoria intestinal
(Gobierno de Navarra. Departamento de Salud, 2016) López Cortés, R.; Marín Fernández, Blanca; Hueso Montoro, C.; Escalada Hernández, Paula; Sanz Aznárez, A. C.; Rodríguez Gutiérrez, C.; Ciencias de la Salud; Osasun Zientziak
Fundamento. Determinar la calidad de vida relacionada con la salud en pacientes con enfermedad de Crohn y colitis ulcerosa, así como evaluar las diferencias en función del sexo, tipo de enfermedad y otras variables sociodemográficas. Método. Estudio observacional, descriptivo y transversal en 100 pacientes atendidos en el servicio de Digestivo del Complejo Hospitalario de Navarra. Se empleó un cuestionario con variables sociodemográficas y clínicas, además del Inflammatory Bowel Disease Questionnaire-32, en su versión adaptada al castellano, para medir la calidad de vida. Resultados. La media de la puntuación total del cuestionario de calidad vida es de 166 puntos (D.T.=40,06) sobre un máximo de 232. Se han hallado diferencias estadísticamente significativas en función del tipo de enfermedad (p=0,005) y el sexo (p=0,001). Conclusiones. Las personas con enfermedad de Crohn o sexo femenino perciben peor calidad de vida relacionada con la salud respecto a pacientes con colitis ulcerosa u hombres
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
Efficacy of educational interventions in adolescent population with feeding and eating disorders: a systematic review
(Springer, 2023) Ladrón Arana, Sergio; Orzanco Garralda, María Rosario; Escalada Hernández, Paula; Aguilera-Serrano, Carlos; Gutiérrez Valencia, Marta; Urbiola-Castillo, Jordi; Ciencias de la Salud; Osasun Zientziak; Universidad Pública de Navarra / Nafarroako Unibertsitate Publikoa
Background: Educational interventions are a key element in the care of young patients with feeding and eating disorders, forming part of the majority of therapeutic approaches. The aim of this review is to evaluate the impact of educational interventions in adolescents with feeding and eating disorders. Methods: Following the PRISMA recommendations electronic databases were searched up to 29 June 2023. Studies related to educational interventions in young population diagnosed with feeding and eating disorders (anorexia nervosa, avoidant/ restrictive food intake disorder, bulimia nervosa, pica and ruminative disorders and binge- eating disorder) in Spanish and English language, without temporal limitation, were located in the databases: PubMed, Scopus, CINAHL, Cochrane Library, PsycINFO, CUIDEN, DIALNET, and ENFISPO. A search in the databases of grey literature was performed in OpenGrey and Teseo. The review protocol was registered in PROSPERO (CRD42020167736). Results: A total of 191 articles were selected from the 9744 citations screened. Ten publications were included. The results indicated variability between educational programs, including individual and group interventions, learning techniques and various research methodologies. Variables such as learning, attitudinal and perceptual changes, anthropometric parameters, symptom improvement, normalization of eating patterns, evaluation of the program and cognitive fexibility were identifed. The risk of bias was high due to the low methodological quality of a large number of studies analyzed. Conclusion: The results indicate that educational interventions can infuence the improvement of knowledge level and have a positive efect on health outcomes. Although education is a common practice in the treatment of these pathologies, highquality studies were not identifed. Thus, this review concludes that additional evidence is needed to evaluate the efectiveness of educational programs, with further research studies, especially randomized controlled trials, to confrm these results. Level of evidence: Level I: Systematic review.
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
Validation of nursing activities in a material and sterilization center
(Associação Brasileira de Enfermeiros de Centro Cirúrgico, Recuperação Anestésica e Centro de Material e Esterilização (SOBECC), 2022-06-15) Gonçalves, Raquel Calado da Silva; Sento Sé, Aline Coutinho; Escalada Hernández, Paula; Marín Fernández, Blanca; Cardoso, Rosane Barreto; Tonini, Teresa; Ciencias de la Salud; Osasun Zientziak; Institute of Smart Cities - ISC
Objetivo: validar las actividades de enfermería del diagnóstico 'Riesgo por contaminación de productos sanitarios'. Método: se trata de un estudio exploratorio, descriptivo, metodológico, de validación, utilizando el modelo adaptado de Fehring. Participaron 128 enfermeras especialistas del centro quirúrgico y del centro de material y esterilización, según criterios predefinidos. Se utilizó un instrumento compuesto por preguntas cerradas, donde a cada actividad se le asignó un valor según la escala de Likert. En este estudio, se consideraron validadas las actividades que presentaron un índice de validez de contenido de 0,95. Estudio aprobado por el Comité de Ética en Investigación. Resultados: 20 actividades de enfermería fueron validadas para 12 factores de riesgo y cinco intervenciones. El factor de riesgo que no fue representativo en sus actividades fue 'Esterilización de cargas sin utilizar el paquete de prueba de desafío'. Conclusión: se concluye que la provisión de actividades de enfermería relacionadas con los factores de riesgo es adecuada, una vez que fueron validadas con un índice de validez de contenido de 0,95. El conocimiento producido ayuda en la implementación de actividades validadas, promoviendo indirectamente una atención de calidad, basada en los principios de seguridad del paciente.
Open Access
Content validation of the nursing diagnosis "Adult Disuse Syndrome": a quantitative study
(Wiley, 2025-01-06) Ardila Suárez, Edinson Fabian; Sánchez-Martínez, Vanessa; Escalada Hernández, Paula; Ciencias de la Salud; Osasun Zientziak
Purpose: This study aimed to establish the content validity of the proposed nursingdiagnosis (ND) “Adult Disuse Syndrome” and all its components. Method: This is an exploratory descriptive study of diagnostic content validation underFehring’s proposal. Forty three expert nurses with clinical, teaching, and research experi-ence analyzed the components of the diagnosis. The representativeness and relevance ofthe components of the diagnosis under study were evaluated through a Likert-type questionnaire. Data distribution analysis was carried out, and the components were validatedif their content validity index (CVI) was over 0.80. The overall CVI was obtained for the clinical indicators. Findings: A total of 12 defining characteristics (DCs) were validated, 3 etiological factors were highly related, 6 risk populations were confirmed, and 11 conditions were consid-ered associated. Most validated DCs refer to the physical dimension, but those focusingon the psychological and social dimensions were also validated. The etiological factorswere related to the effects of immobility. The risk populations were validated in different contexts or situations, and associated conditions were mainly oriented toward chronic conditions. Conclusions: This study validated the content of the elements of the proposed ND “AdultDisuse Syndrome.” These were considered relevant and appropriate by both academicand clinical experts. Implications for nursing practice: The content validation by experts of the componentsof the ND “Adult Disuse Syndrome” provides nurses with a tool for the identification ofthe phenomenon that exceeds the risk and occurs frequently in patients exposed to theeffects of immobility. At the same time, it will guide the results pursued in the care planand the application of the respective nursing and interdisciplinary interventions that favor the reduction of the complications derived from disuse.
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.