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
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
Analysis of mental health effects among nurses working during the COVID-19 pandemic: a systematic review
(Wiley, 2022) García Vivar, Cristina; Rodríguez Matesanz, Irati; San Martín Rodríguez, Leticia; Soto Ruiz, María Nelia; Ferraz Torres, Marta; Escalada Hernández, Paula; Ciencias de la Salud; Osasun Zientziak; Gobierno de Navarra / Nafarroako Gobernua; Universidad Pública de Navarra / Nafarroako Unibertsitate Publikoa
Introduction: Health professionals have suffered negative consequences during the COVID-19 pandemic. No review has specifically addressed the impact of the pandemic on the mental health of nurses exclusively according to the work context. Aim: To analyse the impact of the COVID-19 pandemic on the mental health of nurses who have worked in hospitals, primary care centres and social health centres. Method: PubMed, CINAHL, PsychINFO and Cochrane databases were searched (Prospero number: CRD42021249513). Out of 706 papers, 31 studies (2020–2021) were included in the systematic review. A qualitative synthesis method was used to analyse the data. Results: Most studies were conducted in hospitals or frontline settings. The prevalence of moderate-to-severe symptoms was for anxiety 29.55%, depression 38.79%, posttraumatic stress disorder 29.8%, and insomnia 40.66%. Discussion: This review highlights the mental health effects among nurses working in acute hospital settings. It also evidences a data gap on mental health effects among nurses working in primary health care and in nursing homes. Implications for practice: In the post phase of the pandemic, there is an urgent need to assess and respond to the impact on the mental well-being of nurses, and to monitor international policies for the improvement of nurses’ working conditions.
Open Access
Augmented reality for intramuscular injection training: a cluster randomized controlled trial
(Elsevier, 2025-07-01) Soto Ruiz, María Nelia; Escalada Hernández, Paula; Bujanda Sainz de Murieta, Arantxa; Ballesteros Egüés, Tomás; Larráyoz Jiménez, Ana; San Martín Rodríguez, Leticia; Ciencias de la Salud; Osasun Zientziak; Institute of Smart Cities - ISC
Background: The acquisition of clinical skills, such as intramuscular injection, is crucial in nursing education, traditionally taught through theory and practice. Recent studies suggest that augmented reality (AR) enhances students' learning. Aim: To evaluate the effect of an augmented reality application (ARSim2care) for training intramuscular injections technique among undergraduate nursing students. Methods: A cluster randomized controlled trial was conducted. A total of 72 nursing students participated in the study (32 in the intervention group and 40 in the control group). Sociodemographic variables and dependent variables such as knowledge, skills, satisfaction and self-confidence with learning were measured. Results: The groups showed statistically significant differences in age. Knowledge acquisition in the intervention group was 0.56 points higher, this difference was statistically significant. No significant differences were found in technical skills, satisfaction and self-confidence although both groups showed positive results. Conclusions: The ARSim2care application enhanced nursing students' theoretical knowledge of intramuscular injections, although no significant improvements in technical skills were observed. Augmented reality shows potential as an educational tool; however, further research is required to evaluate its long-term effectiveness.
Open Access
Extended and long-term cancer survivorship of childhood survivors: a scoping review of nursing evidence with bibliometric analysis
(Lippincott, Williams & Wilkins, 2024-06-10) Leite, Ana Carolina Andrade Biaggi; Nascimento, Lucila; Neris, Rhyquelle Rhibna; Soto Ruiz, María Nelia; Escalada Hernández, Paula; San Martín Rodríguez, Leticia; García Vivar, Cristina; Ciencias de la Salud; Osasun Zientziak
Background: With the increasing survival rates of childhood cancer, nurses' familiarity with published evidence has become crucial to care for this population and their families throughout the survival process. Objective: to systematically identify and conduct a bibliometric analysis of nursing-related evidence concerning extended and long-term survival of childhood survivors. Methods: a scoping review was conducted using bibliometric analysis with searches performed in the PubMed, CINAHL, SCOPUS, and Web of Science databases. A total of 300 studies on childhood cancer survival within the nursing field were included. Results: the first study on this topic was published in 1975. American and Chinese researchers lead study publications, primarily publishing in nursing journals such as Cancer Nursing. Quantitative designs were prevalent, and the majority of the studies focused on physical late effects, overall quality of life, and survivor follow-up care. Conclusions: this study has allowed us to map and synthesize the bibliometric evidence pertaining to the extended and long-term survivorship of childhood cancer survivors in the nursing field. Consequently, it identifies gaps in knowledge, research trends, and areas necessitating further exploration. Implications for practice: the evidence presented in this review can facilitate academic and clinical discussions, offering a comprehensive synthesis of the published knowledge. More research needs to be developed on the topic, particularly in Central and Latin America, Africa, Southern and Eastern Europe, and in some regions of Asia. Furthermore, the scope of studies should extend beyond late effects and quality of life, encompassing the experience of surviving childhood cancer, including psychosocial and spiritual dimensions.
Open Access
Predictive factors for anxiety during blood sampling and insertion of peripheral intravenous catheters in paediatric patients in Spain
(Elsevier, 2021) Ferraz Torres, Marta; Escalada Hernández, Paula; San Martín Rodríguez, Leticia; Delarosa, R.; Sáenz Mendía, Raquel; Soto Ruiz, María Nelia; Ciencias de la Salud; Osasun Zientziak
Introduction: Invasive procedures for diagnosis purposes such as venepuncture and peripheral venous catheter insertion are painful procedures that cause great stress for paediatric patients. The objective of this study is to find out the factors that have an impact on the level of anxiety experienced by children undertaken these procedures. Design and methods: Prospective study, 359 children between 2 and 15 years old were included, treated in a tertiary reference hospital in the region of Navarra (Spain). The impact of the variables recorded was analysed using a regressive analysis, the Wong-Baker and FLACC scales were used to measure the level of pain and the PACBIS scale to measure the level of stress and anxiety. Results: The average age of the participants was 7.93 years (SD: 4.04), with 51.8% (n = 186) boys and 48.2% (n = 173) girls. The mean value of pain recorded was 4.43 (SD:3.10). 45.7% (n = 123) of the venepuncture techniques was associated with minimum level of anxiety, including 11.1% of intravenous catheterization. Variables determining the anxiety has been detected such as age, sex, level of pain, parental conduct and time spent on the procedure. Conclusions: Paediatric patients experience high levels of anxiety when undergoing painful procedures which are conditioned by multifactorial reasons. The increase in stress is directly related to the older age (>6 years old) of the patient, and statistically significant by the female gender, the longer duration of the technique and the parental block. Practice implications: Healthcare professionals should work on some of the variables and apply measures aimed to mitigate anxiety levels. For example, reducing the duration of the procedure, training parents, and distracting techniques.
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
Quality of life in long-term cancer-free breast cancer survivors in Spain: a descriptive study
(Nature, 2025-07-03) Soto Ruiz, María Nelia; Escalada Hernández, Paula; Pimentel Parra, Gustavo Adolfo; García Vivar, Cristina; Ciencias de la Salud; Osasun Zientziak
This study aimed to assess the quality of life (QOL) of long-term breast cancer survivors (LT-BCS), disease-free 5 years after completing primary treatments, and to identify sociodemographic and clinical factors associated with their QOL. A descriptive cross-sectional study was conducted with LT-BCS from the Navarra region in Spain. The QOL was assessed using the Spanish version of the QOL scale for cancer survivors. Sociodemographic and clinical data, time since treatment completion, and lifestyle factors were also collected. Bivariate statistical analysis and multiple regression were used to explore associations between independent variables and QOL and its domains. A total of 188 LT-BCS participated, with a mean age of 57.55 years and a mean survival time of 10.22 years. The overall QOL score was 5.77/10, with physical well-being scoring the highest and spiritual wellbeing the lowest. Age, occupation, and moderate physical activity were associated with better QOL, while total mastectomy, early menopause, and recurrences had a negative impact. Radiotherapy was associated with improved overall QOL. Regression models confirmed these associations, except for spiritual well-being. The study identifies key factors affecting the QOL of LT-BCS, a population that has been relatively underrepresented in scientific literature. It provides valuable insights into their distinct physical and psychological sequelae, contributing to a more comprehensive understanding of their long-term well-being. Sequelae of breast cancer persist, affecting long-term survivors’ wellbeing. Despite the growing importance of supportive care, many women lack proper follow-up. This study underscores the need for strategies such as survivorship care plans to improve coordination and support, addressing both psychological impacts and physical well-being.
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.