Person: Pumar Méndez, María Jesús
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Pumar Méndez
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María Jesús
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Ciencias de la Salud
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0000-0003-3284-5588
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812013
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Publication Open Access Theory based capacity building intervention for intersectoral action for health at local governments: an exploratory pilot study(Wiley, 2022) Hernantes Colias, Naia; Bermejo-Martins, Elena; Øvergård, Kjell Ivar; Pumar Méndez, María Jesús; López de Dicastillo Sáinz de Murieta, Olga; Iriarte Roteta, Andrea; Antoñanzas Baztán, Elena; Mujika Zabaleta, Agurtzane; Ciencias de la Salud; Osasun ZientziakAim: To design, implement and evaluate a nurse- led capacity building intervention (PromoGOB) for intersectoral action for health at local governments. Design: The programme was based on theories of the policy process and organizational change and facilitated by a nurse developing a health broker role. A complex intervention perspective was adopted in carrying out the study. The intervention was evaluated using a mixed method embedded design. Methods: Quantitative component relied on a specific questionnaire. This tool, designed and piloted ad hoc, measured the capacity in terms of knowledge, awareness, resources, skills, and commitment, both at sectoral and government levels. For the qualitative component, semi-structured interviews were conducted. These explored the perceived capacity and feasibility and acceptability issues. The programme was initiated at the end of October 2019, and it lasted a total of 5 weeks. Nineteen individuals representing various sectors at a local government in northern Spain participated in the study. The data analysis was concluded by the end of March 2020. Findings: PromoGOB positively influenced participants' capacity for addressing health promotion. Awareness component, intersectoral work and the nurse as health broker were essential in the programme. The necessity of political participation was identified as an issue to be prioritized in future studies. Conclusion: This study highlights the relevance of capacity building at local governments and the role that nurses can play in it. Further work should be undertaken to continue developing Health in All Policies approach at local level. Impact: This study offers a starting point for nurses to get involved in the policy process of health promotion, performing a specific role as health brokers, building capacity at local governments for addressing social determinants of health, and delving into theories and concepts of the Health in All Policies field.Publication 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 ZientziakAim(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.Publication 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 ZientziakAim: 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.Publication 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 GobernuaAim: 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.Publication 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 ZientziakObjeto: 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.Publication 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 ZientziakBackground: 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.Publication Open Access Parental self-efficacy to promote children's healthy lifestyles: a pilot and feasibility study(MDPI, 2021) Ruiz-Zaldíbar, Cayetana; Serrano-Monzó, Inmaculada; López de Dicastillo Sáinz de Murieta, Olga; Pumar Méndez, María Jesús; Iriarte Roteta, Andrea; Bermejo-Martins, Elena; Mujika Zabaleta, Agurtzane; Ciencias de la Salud; Osasun ZientziakPositive parenting programs are a key strategy to promote the development of parental competence. We designed a pilot study based on parental self-efficacy to promote healthy lifestyles in their children aged between 2 to 5 years old. In this pilot study, we aimed to assess the effects of a parenting program on parental self-efficacy and parenting styles. Twenty-five parents were allocated into intervention (N = 15) and control group (N = 10). Parents from the intervention group received four group sessions (120 mi per session) to develop a positive parenting, parenting styles and parenting skills regarding to children's diet, exercise, and screen time, and two additional sessions about child development and family games. Parents from the control group received these two latter sessions. Parental self-efficacy, parenting styles, and meal-related parenting practices were measured before and after the intervention and at 3-month follow-up. Acceptability and feasibility of the program was also measured. Quantitative data were analyzed using the repeat measures ANOVA and ANCOVA tests and the effect size calculation. Content analysis was used to analyse open questions. Positive trends were found regarding parental self-efficacy and the use of authoritative parenting style. Parents also reported a great acceptability of the program getting high satisfaction. According to the feasibility barriers and facilitators aspects were identified. The positive trends founded in this study support the development of parenting programs to promote healthy lifestyle in children.Publication Open Access Mapping health promotion practices across key sectors and its intersectoral approach at the local level: study protocol(Wiley, 2024) Pumar Méndez, María Jesús; López de Dicastillo Sáinz de Murieta, Olga; Hernantes Colias, Naia; Antón-Solanas, Isabel; Zabaleta del Olmo, Edurne; Rodríguez- Roca, Beatriz; Subirón-Valera, Ana Belén; Juvinyà-Canal, Dolors; Mujika Zabaleta, Agurtzane; Ciencias de la Salud; Osasun Zientziak; Universidad Pública de Navarra / Nafarroako Unibertsitate PublikoaAims: This study outlines a protocol aimed at identifying and mapping health promotion practices in need of development from the perspectives of key sectors responsible for it at the local level and from an intersectoral perspective across four Spanish regions. Design: A complementary multi-method study combining survey methods and qualitative interviews will be adopted. Methods: Purposive snowball sampling will be employed to select potentially rich informants from city councils, primary care centres, primary and secondary schools, and public health and civil society organizations in 12 municipalities sensitive to local health. Data on the degree of execution of health promotion activities, the level of intersectorality in their implementation, and their origins will be collected using PromoACTIVA questionnaires, an intersectoral typology model and an interview protocol. A parallel mixed analysis encompassing descriptive statistics and a ‘framework analysis’ will be performed. Discussion: This study is expected to yield thorough and reliable insights into health promotion practices and omissions at the local level by focusing on key stakeholders, both individually and collaboratively. This information can enhance health promotion planning and improve its effectiveness, efficiency and contextual relevance. The development and testing of a methodology for the integration and interpretation of these data will ensure sustainable capacity building. Impact: Managers and practitioners interested in health promotion planning in the researched settings can benefit from a comprehensive map of the current state of their practices and insights into the starting points of collaboration. In addition, planners from other local settings will gain access to tools and methodologies to replicate and expand these maps to their own contexts. Stakeholder Engagement: Engaging key stakeholders with experience working in or with primary care centres, public health organizations, primary and secondary schools, civil society organizations, and city councils was vital to ensure the study's relevance and feasibility.Publication Open Access Nurses' role in health promotion and prevention: a critical interpretive synthesis(Wiley, 2020) Iriarte Roteta, Andrea; López de Dicastillo Sáinz de Murieta, Olga; Mujika Zabaleta, Agurtzane; Ruiz-Zaldíbar, Cayetana; Hernantes Colias, Naia; Bermejo-Martins, Elena; Pumar Méndez, María Jesús; Ciencias de la Salud; Osasun ZientziakBackground: Role confusion is hampering the development of nurses' capacity for health promotion and prevention. Addressing this requires discussion to reach agree-ment among nurses, managers, co-workers, professional associations, academics and organisations about the nursing activities in this field. Forming a sound basis for this discussion is essential. Aims and objectives: To provide a description of the state of nursing health promo-tion and prevention practice expressed in terms of activities classifiable under the Ottawa Charter and to reveal the misalignments between this portrayal and the ideal one proposed by the Ottawa Charter. Methods: A critical interpretive synthesis was conducted between December 2018 and May 2019. The PubMed, CINAHL, Scopus, PsychINFO, Web of Science and Dialnet databases were searched. Sixty-two papers were identified. The relevant data were extracted using a pro-forma, and the reviewers performed an integrative synthesis. The ENTREQ reporting guidelines were used for this review. Results: Thirty synthetic constructs were developed into the following synthesising arguments: (a) addressing individuals' lifestyles versus developing their personal skills; (b) focusing on environmental hazards versus creating supportive environments; (c) action on families versus strengthening communities; (d) promoting community part-nerships versus strengthening community action; and (e) influencing policies versus building healthy public policy. Conclusions: There are notable misalignments between nurses' current practice in health promotion and prevention and the Ottawa Charter's actions and strategies. This may be explained by the nurses' lack of understanding of health promotion and prevention and political will, research methodological flaws, the predominance of a biomedical perspective within organisations and the lack of organisational prioritisa-tion for health promotion and prevention.Publication Open Access A reliable and valid parent self-report tool to assess children's global health needs(Elsevier, 2021) Pumar Méndez, María Jesús; Lozano-Ochoa, Cristina; Mujika Zabaleta, Agurtzane; Bermejo-Martins, Elena; Carrasco, José Miguel; Tricas-Sauras, Sandra; López de Dicastillo Sáinz de Murieta, Olga; Ciencias de la Salud; Osasun ZientziakPurpose: This study aimed to develop and validate a parent self-report questionnaire to explore global health needs in 2- to 6-year-old children. Design and methods: The development of the tool started with a conceptualization phase, followed by the design, pilot testing and psychometric validation of the questionnaire. The construct validity was assessed. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were carried out to explore the construct validity of the questionnaire. The normed fit index (NFI), root mean square error of approximation (RMSEA), chi square test and comparative fit index (CFI) were used to test the goodness-of-fit. Reliability was explored through Cronbach's alpha for internal consistency. Results: A total of 973 parents completed the 119 items of the Necesidades de salud de la Población Infantil (NPI) questionnaire for the psychometric validation stage. The EFA identified seven factors: Lifestyles, Promotion of healthy lifestyles and influence of significant persons, Children's socioemotional aspects, Parents' socioemotional aspects, Parental self-efficacy, Situational influences, Professional advice. All the factors showed good internal consistency (Cronbach's alpha N0.7). The CFA showed good adjustment to the model (RMSEA = 0.048). The values of NFI and CFI were 0.741 and 0.779 respectively. Conclusions: The NPI questionnaire is a reliable and valid instrument. Practice implications: The seven-factor questionnaire will be useful for analyzing children's global health needs, designing health promotion programs according to identified needs and assessing related interventions.