Open Access
Infant mortality in the European Union: a time trend analysis of the 1994-2015 period
(Elsevier España, 2019) Onambele, Luc; San Martín Rodríguez, Leticia; Niu, Hao; Álvarez Álvarez, Ismael; Arnedo Pena, Alberto; Guillén Grima, Francisco; Aguinaga Ontoso, Inés; Ciencias de la Salud; Osasun Zientziak
Introducción: La mortalidad infantil es un indicador de la salud infantil y una variable explicativa del desarrollo socioeconómico. Nuestro objetivo fue examinar los cambios y tendencias de la mortalidad infantil en la Unión Europea (UE) y sus 28 países miembros en el período 1994-2015. Métodos: Se recopilaron datos de muertes de niños menores de un año entre 1994 y 2015 de la base de datos Eurostat. Estudiamos las tendencias en la UE, por países y regiones, utilizando elanálisis de regresión joinpoint. Se condujeron análisis adicionales para estudiar las tendencias de mortalidad neonatal y neonatal precoz. Resultados: La mortalidad infantil en la UE ha disminuido significativamente de 8.3 a 3.6 por 1.000 (porcentaje de cambio anual = −3.8%, intervalos de confianza del 95% −4.1; −3.6). Las tasas de mortalidad más altas se registraron en Rumanía y Bulgaria, y las tasas más bajas en países escandinavos (Finlandia, Suecia). Se encontraron tendencias descendentes significativas en los países de la UE, más pronunciadas en los países bálticos exsoviéticos y países de Europa oriental, mientras que los países de Europa occidental mostraron los descensos menos pronunciados. La mortalidad infantil ha aumentado significativamente en Grecia en los últimos años,mientras que en el Reino Unido e Irlanda las tasas se han estabilizado. Conclusiones: La mortalidad infantil ha disminuido en la UE y sus países en las últimas décadas, más pronunciadamente en los países de Europa oriental y los países bálticos exsoviéticos, mientras que en varios países de Europa occidental las tasas aumentaron o se han estabilizado enlos últimos años.
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
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
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
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
Guía del Programa Health-Friendly. Intervención para la disminución del miedo al entorno sanitario en niños y niñas de edad escolar
(2021) Escalada Hernández, Paula; Ferraz Torres, Marta; San Martín Rodríguez, Leticia; Saralegui Gainza, Amaia; Soto Ruiz, María Nelia; Ciencias de la Salud; Osasun Zientziak; Gobierno de Navarra / Nafarroako Gobernua
El programa Health-Friendly tiene como objetivo reducir el miedo al entorno sanitario de los niños y niñas entre 5 y 9 años. Es un programa de inmersión basado en una intervención en la que los niños y niñas, a través de un entorno sanitario simulado, toman contacto con distintos escenarios, como una consulta de enfermería o una habitación de hospitalización quirúrgica. En el proyecto de diseño y evaluación del programa Health-Friendly participaron niños y niñas de distintos colegios de Navarra. La intervención se llevó a cabo en el Espacio de Habilidades Clínicas y Simulación de la Facultad de Ciencias de la Salud de la Universidad Pública de Navarra (UPNA).
Open Access
How did COVID-19 lockdown impact the health of older adults in nursing homes?: a scoping review
(BMC, 2024) San Martín Erice, María 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
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.