Open Access
Building capacity for health promotion by addressing nurses' role confusion: study protocol of a pilot clustered randomised controlled trial
(Wiley, 2021) Iriarte Roteta, Andrea; López de Dicastillo Sáinz de Murieta, Olga; Mujika Zabaleta, Agurtzane; Antoñanzas Baztán, Elena; Hernantes Colias, Naia; Galán Espinilla, María José; Pumar Méndez, María Jesús; Ciencias de la Salud; Osasun Zientziak; Gobierno de Navarra / Nafarroako Gobernua
Aim: To describe the protocol for the pilot phase of a complex intervention, designed to address primary care nurses' role confusion in health promotion. Design: A pilot clustered randomized controlled trial, with control and intervention groups. Methods: The study will be conducted in a primary care setting. Participants will be nurses from the primary care health service working in a primary care team (PCT, 15 control group; 15 intervention group). Nurses in the experimental group will receive the ROLE-AP programme over a 3-week period. The control group will continue with the normal routine. The pilot will help determine the intervention's feasibility, acceptability, fidelity and quality of the programme components. Data collected preintervention, postintervention and 3 months after intervention will provide estimates of the intervention's preliminary effects on the main variable, nurses' degree of agreement concerning their expected role in health promotion. The study received funding from the local government in December 2019. Discussion: Role confusion is promoting primary care nurses' omissions in their health-promoting practice, which is far from the ideal portrayed by the Ottawa Charter. Interventions are needed that reveal the most appropriate mechanisms for addressing role confusion, which requires reaching an intraprofessional agreement about the expectations for role activities. Healthcare organisations could benefit from the incorporation of a programme of these characteristics into standard practice. Impact: This study will produce a novel and comprehensive complex intervention that is expected to build nurses' capacity in primary healthcare organizations for health promotion, which is key to increasing the quality, efficiency and sustainability of the National Health System. The programme evaluation and feasibility study will reveal how to better use existing resources in a full-scale clinical trial.
Open Access
Urge capacitar a los gobiernos locales para la intersectorialidad por la salud: un policy brief
(Gobierno de Navarra. Departamento de Salud, 2020) Hernantes Colias, Naia; Bermejo-Martins, Elena; Pumar Méndez, María Jesús; López de Dicastillo Sáinz de Murieta, Olga; Iriarte Roteta, Olga; Fernández-Unanue, S.; Mujika Zabaleta, Agurtzane; Ciencias de la Salud; Osasun Zientziak
Los enfoques que integran la salud en todos los sectores y sus políticas están llamados a la acción; sin embargo, la colaboración entre los sectores y el convencimiento de la parte política y de la estructura administrativa continúa siendo la principal barrera para poder implementarlos. En muchos casos, fomentar la colaboración puede requerir mecanismos de financiación e incentivos, o institucionalizar herramientas que evalúen las consecuencias en salud de las políticas y decisiones de todos los sectores. Las autoras, como paso previo a estas medidas, recomiendan la capacitación de los sectores para fomentar una visión compartida en torno a la salud como elemento esencial para establecer objetivos comunes. Esta capacitación debe ser liderada por el sector salud. Ello permitirá avanzar en el establecimiento de la salud como un eje trasversal en los gobiernos locales para promover la salud de las poblaciones sobre las cuales gobiernan.
Open Access
Development of a taxonomy of activities in health prevention and promotion for primary care
(Wiley, 2022) Pumar Méndez, María Jesús; López de Dicastillo Sáinz de Murieta, Olga; Hernantes Colias, Naia; Iriarte Roteta, Andrea; Belintxon, Maider; García-Iriarte, Antonio; Mujika Zabaleta, Agurtzane; Ciencias de la Salud; Osasun Zientziak
Aim: To develop a taxonomy of activities in health prevention and promotion for primary care. Background: Despite health promotion being considered a keystone for popula-tion health and health care sustainability, its implementation remains insufficient. Customized evaluation tools are needed to address prevention and promotion omis-sions in primary care. Method: A taxonomy was designed using documentary analysis. Documents describ-ing frontline primary care professionals' health prevention and promotion activities or omissions were identified and analysed using framework analysis. Results: The ‘Taxonomy of Activities in Health Prevention and Promotion for Primary Care’ (TaxoPromo) includes 43 activities grouped into eight categories: planification, situational analysis, capacity building, development of awareness/public opinion, advocacy, development of networks, development of partnerships and intervention strategies. Conclusion: By contrasting the usual practices with the activities collected in the TaxoPromo, opportunities for improvement can be unveiled. Implications for Nursing Management: The TaxoPromo can be used at organisational and system levels to identify actions to integrate health prevention and promotion activities into a systematic, data-driven process; design implementation plans and tailor-made strategies for capacity building; enable benchmarking; and address omis-sions. The TaxoPromo can serve as a catalyst tool for the clarification and expansion of the nursing role in health prevention and promotion.
Open Access
Six-month breastfeeding maintenance after a self-efficacy promoting programme: an exploratory trial
(Wiley, 2021) Antoñanzas Baztán, Elena; Belintxon, Maider; Marín Fernández, Blanca; Redín Areta, María Dolores; Mujika Zabaleta, Agurtzane; Pumar Méndez, María Jesús; López de Dicastillo Sáinz de Murieta, Olga; Ciencias de la Salud; Osasun Zientziak
Background: Breastfeeding care plays a fundamental role in establishing breastfeeding and longer duration after discharge. Practices though vary among professionals involved and are often inconsistent with good practices recommended, being a threat to women’s breastfeeding self-efficacy. Breastfeeding self-efficacy is considered a predictor for successful breastfeeding and a significant variable amenable to intervention for promoting lactation Aim: To evaluate the efficacy, feasibility and acceptability of a new breastfeeding self-efficacy promoting programme (SIALAC) on 6-month breastfeeding maintenance. Methods: In this exploratory multi-centre controlled trial, participants were allocated into control and intervention groups sequentially. Professionals in charge of the treatment groups were trained in between, with an especial focus on reducing practice variability. Control and intervention group women received usual care, and the intervention group received in addition SIALAC, a three-stage breastfeeding self-efficacy promoting programme. Primary outcome was breastfeeding maintenance up to 6 months analysed by Kaplan–Meier and Cox proportional hazard regression analysis. Student’s t-test or chi-square tests were also used for continuous and categorical variables. Data on breastfeeding status and breastfeeding self-efficacy were collected at baseline, and 4, 8 and 24 weeks after birth. Results: From May 2014 through November 2015, participants were enrolled. The sample consisted of 112 women. No relevant socio-demographic or obstetric difference was found between groups. The intervention achieved a significant difference between groups in breastfeeding survival (X2 = 4.94, p = 0.026). Six-month breastfeeding maintenance was significantly higher in the intervention group (67% vs. 55%; X2 = 5.384, p = 0.020). Breastfeeding dropout in the control group was 3.3 (CI 1.1, 10.1) times higher than that of the intervention group at 6 months. Breastfeeding self-efficacy scores were higher in the intervention group although without significant statistical difference. The programme showed good acceptability. Conclusion: Breastfeeding self-efficacy promoting programme SIALAC was beneficial in fostering 6-month breastfeeding survival. Full-scale trial should consider feasibility-related issues identified.
Open Access
"Missed nursing care" in health promotion: raising awareness
(Wiley, 2020) López de Dicastillo Sáinz de Murieta, Olga; Zabaleta del Olmo, Edurne; Mujika Zabaleta, Agurtzane; Antoñanzas Baztán, Elena; Hernantes Colias, Naia; Pumar Méndez, María Jesús; Ciencias de la Salud; Osasun Zientziak
Aim(s): This commentary aims to raise awareness of the possible causes of “missed nursing care” in health promotion and to propose possible solutions. Background: Although health promotion is an essential function of nursing practice, “missed nursing care” has been scarcely studied in this area. It is crucial to know both its causes and possible strategies to prevent it. Evaluation: We used evidence to identify possible causes of “missed nursing care” in health promotion, and we classified them into categories. We suggested the concept of capacity building to address its underlying causes. Key issue(s): Four main factors are involved in “missed nursing care” in health promo-tion, that is intrapersonal, interpersonal, organisational and cultural. Capacity build-ing, including the development of knowledge, skills, commitment, structures, systems and leadership, could reduce missed care. Conclusion(s): “Missed nursing care” in health promotion is complex and is multifac-torial in its origins. Capacity building could be a way to address its causes. Implications for Nursing Management: Nursing care in health promotion is para-mount and a long-term investment that can contribute to the sustainability of the health system. Organisations and managers could view capacity building processes as a tool to prevent “missed nursing care” in health promotion.
Open Access
Volunteerism as adolescent health promotion asset: a scoping review
(Oxford University Press, 2020) Hernantes Colias, Naia; Pumar Méndez, María Jesús; López de Dicastillo Sáinz de Murieta, Olga; Iriarte Roteta, Andrea; Mujika Zabaleta, Agurtzane; Ciencias de la Salud; Osasun Zientziak
The Aim of this scoping review was to explore the available literature on volunteerism in adolescence and the benefits that this activity may report in their healthy development, from a salutogenic perspective. Searches were conducted in Pubmed, Cinahl, PsycINFO and Cochrane Library home databases; 15 articles were selected. Almost all of the studies were conducted in the United States between 1990 and 2000, primarily developed by psychologists and sociologists. The impact of volunteering was reflected in aspects that can be classified based on Lerner's dimensions of the PYD model. Volunteer activities promote an Improved academic, social, cognitive, and vocational competence in adolescents. An increase in conflict resolution capacity, leadership and personal agency, as well as improved pro-social attitudes and relationships with adults and peers, all of which contributed to their self-identification with the community. Moreover, increased positive development of adolescents reduces the rates of risky behaviors. Volunteerism may represent an opportunity for health promotion in adolescence. The concept of volunteering as an asset for health promotion during adolescence evokes the need to adopt and favor this view with regard to key areas of study associated with this stage such as education and health. Teams that work in community health, especially those in primary care, should recognize and value existing volunteer groups as an asset to promote the healthy development of adolescents. Friendlier health services should be encouraged that include comprehensive services from within educational institutions to community actions.
Open Access
Health professionals' personal behaviours hindering health promotion: a study of nurses who smoke
(Wiley, 2017) Mujika Zabaleta, Agurtzane; Arantzamendi, María; López de Dicastillo Sáinz de Murieta, Olga; Forbes, Angus; Ciencias de la Salud; Osasun Zientziak
Aim: To explore the views of current and ex-smoker nurses on their role in sup-porting patients to stop smoking. Background: Long-term conditions are closely linked to harmful lifestyle behaviours, including smoking and overeating. Health professionals have an important role toplay in promoting healthier lifestyles. It has been described that nurses’ health beha-viours may be a barrier to their health promotion practice. There is a need to gainfurther understanding on why nurses’ health promotion activity is influenced bytheir own health behaviour. Design: A secondary analysis of qualitative data gathered in 2010 in the context ofa project that aimed to develop a smoking cessation intervention for nurses. Methods: Eleven transcripts of semi-structured interviews conducted with nurses (current and ex-smokers) working in one university hospital in Spain. Data wereanalysed using framework analysis. Findings: Nurses who smoked engaged in social justification in terms of socialnorms and work stress. Only nurses who had quit smoking were able to identify thenegative feelings it generated and the effect that it had on their past health promotion practice. This was expressed by ex-smokers as an internal conflict that prevented them from supporting patients with their own habit. Conclusion: Nurses who smoke may be inhibited as health promoters withoutbeing aware of it. Interventions that focus on helping these professionals dealwith the challenges associated with these encounters are necessary if health promotion practices are to be enhanced. Targeting this conflict might also work toimprove their lifestyle, which would expand the potential impact to professionals’ own health.
Open Access
Placing myself in a new normalized life: the process of becoming a first-time father. A grounded theory study
(Wiley, 2021) Vidaurreta, Marta; López de Dicastillo Sáinz de Murieta, Olga; Serrano-Monzó, Inmaculada; Belintxon, Maider; Bermejo-Martins, Elena; Mujika Zabaleta, Agurtzane; Ciencias de la Salud; Osasun Zientziak
Becoming a first-time father is an important transition period in men's lives that is frequently accompanied by joy and happiness. Engaging fathers has a broader impact on family and community and on fathers' own well-being. This study explores the process of men becoming first-time fathers and the experiences and challenges involved. Seventeen interviews with men in different stages of pregnancy, childbirth, and the postpartum period were conducted. Through a grounded theory design, a novel four-stage theoretical model emerged that represents the journey to first-time fatherhood. These stages are beginning the journey, fatherhood in limbo, facing reality, and settling down. Participants suggested that achieving a new normality was the final stage where they finally felt located with a sense of mastery in their journey to fatherhood. The novel theoretical approach of addressing the process of men's transition allowed more complete access to their perspectives. Men's needs are different at every phase of the transition to fatherhood, and the use of these findings can help care providers in caring for every man according to the stage he is facing.
Open Access
Estrategias para impulsar la implementación de promoción de salud en Atención Primaria: dos grupos nominales
(Asociación de Enfermería Comunitaria, 2020) Mujika Zabaleta, Agurtzane; Pumar Méndez, María Jesús; Bermejo-Martins, Elena; Hernantes Colias, Naia; Antoñanzas Baztán, Elena; López de Dicastillo Sáinz de Murieta, Olga; Ciencias de la Salud; Osasun Zientziak
Objeto: identificar recomendaciones para impulsar la implementación de la promoción de salud en Atención Primaria. Método: se realizaron dos grupos nominales, con la participación de 15 expertos en promoción de la salud, Salud Pública, Atención Primaria y seguridad del paciente. Se llevaron a cabo dos rondas de trabajo, combinando trabajo personal, puesta en común y discusión entre panelistas sobre los elementos identificados, así como su puntuación. Este proceso dio lugar a una lista de ítems priorizados por los participantes. Resultados: consenso alcanzado por expertos sobre estrategias para implementar una taxonomía de actividades de prevención y promoción de salud dirigida a identificar omisiones en este campo; y a elementos críticos para implementar estrategias de promoción de salud en Atención Primaria. Entre ellos, destacan la consideración de la implementación de la promoción de salud como proceso; la interpelación a otros agentes; y la necesidad de una apuesta clara y firme por la promoción de salud en el ámbito institucional. Conclusión: el impulso de la promoción de salud en Atención Primaria requiere de una apuesta clara y firme, acompañada de la adopción de un enfoque de creación de capacidad y de un marco de implementación.
Open Access
Lessons learned from the COVID-19 pandemic on the global health needs of young children: a cross-sectional study
(Gobierno de Navarra, 2025-01-31) Elizalde Beiras, Itsaso; López de Dicastillo Sáinz de Murieta, Olga; Andueza-Wood, Hazel Helen; Sola Cía, Sara; Lozano-Ochoa, Cristina; Mujika Zabaleta, Agurtzane; Hernantes Colias, Naia; Pereda Goikoetxea, Beatriz; Antoñanzas Baztán, Elena; Pumar Méndez, María Jesús; Ciencias de la Salud; Osasun Zientziak; Gobierno de Navarra / Nafarroako Gobernua
Fundamento. Este estudio transversal tiene como objetivo eva-luar las necesidades globales de salud de la población infantil de 2 a 6 años y determinar si las características sociodemográficas producen diferencias en las necesidades de salud de los niños observadas después de la pandemia de COVID-19.Métodos. Estudio transversal realizado en tres regiones del nor-te de España con ingresos similares. Los participantes se selec-cionaron mediante muestreo cluster de un paso. El cuestionario auto respondido por los padres Necesidades de salud de la Pobla-ción Infantil evaluó las necesidades de salud mediante siete di-mensiones y 125 ítems.Resultados. Un total de 301 progenitores/cuidadores completa-ron el cuestionario. Las dimensiones autoeficacia parental, aseso-ramiento profesional, aspectos socioemocionales del niño e influencia situacional alcanzaron las puntuaciones más altas, mientras que aspectos socioemocionales de los padres, estilo de vida, promoción de estilos de vida saludables e influencia de personas significativas re-cibieron las puntuaciones más bajas (mayores necesidades). Las necesidades relacionadas con el estilo de vida se vieron afecta-das por la falta de acceso a profesionales de la salud y con mayor intensidad cuando los niños tenían una discapacidad.Conclusiones. El resultado de este estudio podría enriquecer la planificación de estrategias, programas e intervenciones para pro-mover la salud infantil, cubriendo las necesidades identificadas.