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
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
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.
Embargo
Virtual reality to reduce pain, fatigue, and emotional distress in people with cancer: a scoping review
(Lippincott, Williams & Wilkins, 2024-09-02) Cuñado Pradales, Rebeca; Soto Ruiz, María Nelia; Escalada Hernández, Paula; San Martín Rodríguez, Leticia; García Vivar, Cristina; Ciencias de la Salud; Osasun Zientziak
Background: cancer and its treatments cause symptoms such as pain, fatigue, and emotional distress, which affect the quality of life of patients at different stages of cancer. Virtual reality (VR) has emerged as a promising alternative for addressing these symptoms by immersing patients in a virtual environment that isolates them from reality. Objective: to describe the existing evidence on the use of VR to improve pain, fatigue, and emotional distress in people with cancer at different stages of the cancer trajectory. Methods: a scoping review was conducted following the PRISMA-ScR (Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews) guidelines. Search was conducted in PubMed and CINAHL until October 2023. Results: twenty-three primary studies related to the study topic were identified, and the following information was collected: type of VR (immersive vs nonimmersive) used in oncology services, purpose (distraction, training, or relaxation), devices used (head-mounted display, headset, or virtual controller), and the environment simulated (natural environment, skill games, or educational environment). The effects of VR on pain, fatigue, and emotional distress are described, highlighting its ability to mitigate these symptoms in the short term.
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
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
Transcultural adaptation and theoretical models validation of the Spanish version of the Self-Care of Diabetes Inventory
(Frontiers Media, 2024-09-10) Martínez Tofé, Jesús; Ausili, Davide; Soto Ruiz, María Nelia; Santolalla-Arnedo, Iván; Durante, Ángela; Di Nitto, Marco; Lysanets, Yuliia; Ruiz de Viñaspre-Hernández, Regina; Tejada Garrido, Clara Isabel; Sánchez Barba, Mercedes; Gea-Caballero, Vicente; Juárez-Vela, Raúl; Ciencias de la Salud; Osasun Zientziak
Background: for patients with diabetes mellitus, self-care is crucial because it prevents complications and helps preserve quality of life. Clinicians and researchers require effective tools for assessing self-care behaviors across various dimensions to identify individual needs and maximize resource allocation. The aim of this study was to evaluate the validity and reliability of the Spanish version of the Self-Care of Diabetes Inventory (SCODI). Methods: two hundred eighteen participants with DMT1 and DMT2 who were recruited through convenience sampling from a university hospital participated in our cross-sectional study. After translation and cultural adaptation, the enrolled patients answered the questions. We performed an exploratory factor analysis (EFA) on each of the SCODI scales and Confirmatory factor analysis (CFA) was performed using our models which appropriate fit indices. Results: the original structure of the four-dimensions tool was confirmed. The overall consistency across the four scales was assessed by Cronbach's alpha: self-care maintenance (0.766), self-care monitoring (0.790), self-care management (0.771), and self-care confidence (0.936). The model fit yielded a chi-square index of 1.028 with 773 degrees of freedom. Confirmatory factor analysis showed a good fit, thereby affirming the reliability of the model. Conclusion: the internal consistency and reliability of the SCODI Spanish version are deemed adequate. This tool is appropriate when it is desired to evaluate the self-care practices of Spanish persons suffering from diabetes due to its good psychometric qualities.
Open Access
A themed game to learn about nursing theories and models: a descriptive study
(Elsevier, 2020) San Martín Rodríguez, Leticia; Escalada Hernández, Paula; Soto Ruiz, María Nelia; Ciencias de la Salud; Osasun Zientziak
One of the most demanding challenges for teachers in undergraduate nursing programmes is teaching the intangible aspects of the discipline, such as its conceptual and theoretical bases. This study aimed to evaluate nursing students' satisfaction and knowledge acquisition after taking part in a specific themed game to learn about nursing theories and models. A descriptive, cross-sectional, quantitative, interventional study was undertaken involving 105 nursing degree students. After taking part in a themed game called 'The Nurse Theorist game', the knowledge acquired by the students was assessed plus their satisfaction with the game. The data was analysed using descriptive statistics. The results indicated that the average score for knowledge was 8.28 points (on a scale of 0–10); the overall average score for satisfaction was 7.60 points out of 10. The scores obtained for satisfaction with each aspect of the game ranged from 2.90 to 3.90 out of 5. All the students recommended using this game for this subject in the years to come. To conclude, the proposal for a themed game specifically for learning nursing theories and models has been revealed to be effective in terms of knowledge acquisition and student satisfaction.