Open Access
Social determinants of health in post-treatment cancer survivors: scoping review
(Elsevier, 2024) Lara-Morales, Alfredo; Soto Ruiz, María Nelia; Agudelo-Suárez, Andrés A.; García Vivar, Cristina; Ciencias de la Salud; Osasun Zientziak; Universidad Pública de Navarra / Nafarroako Unibertsitate Publikoa
Purpose: To identify, analyze and describe the available scientific evidence about the influence of social determinants of health on cancer survivors. Methods: A scoping review was outlined according to the steps described by the Joanna Brigs Institute Reviewer¿s Manual: selection of studies, data mapping, and results grouping, synthesis and report, was conducted. PubMed, CINAHL, Scopus and LILACS databases were searched from 2011 to 2023. Results: Out of a total of 1783 papers initially screened, only 19 studies met the inclusion criteria for the scoping review, focusing on the primary social determinants impacting the health of cancer survivors. These studies were categorized into six main themes: a) employment (challenges in work reintegration and work-place difficulties); b) variations among different ethnic groups; c) disparities based on sex; d) barriers and facilitators in accessing health and social security services; e) the role of support networks and social environments; and f) socioeconomic lever (influence of income and socioeconomic status). Conclusions: Understanding the impact of social determinants on the post-treatment quality of life for cancer survivors is crucial. Comprehensive survivorship care should address not just medical needs but also holistic aspects like social support, education, overall well-being, and improvements in physical and social environments. This multifaceted approach ensures the well-rounded support needed for optimal survivorship outcomes.
Open Access
Educación interprofesional en ciencias de la salud con la colaboración de pacientes
(Elsevier, 2022) Soto Ruiz, María Nelia; Escalada Hernández, Paula; Ortega Moneo, María; Viscarret Garro, Juan Jesús; San Martín Rodríguez, Leticia; Ciencias de la Salud; Osasun Zientziak; Sociología y Trabajo Social; Soziologia eta Gizarte Lana
Introducción: la educación interprofesional en las ciencias de la salud es un enfoque muy efectivo tanto para la formación general del estudiante como para abordar diferentes aspectos específicos. Un nuevo paradigma aboga por la transformación de la filosofía de la atención sanitaria, cambiando el enfoque de cuidado centrado en el paciente a «cuidado en asociación con el paciente. El objetivo de este estudio fue evaluar una actividad de educación interprofesional con la integración del paciente con una enfermedad crónica, en los grados de Enfermería, Fisioterapia y Trabajo Social de una universidad pública española. Métodos: para dar respuesta al objetivo se aplicó un diseño paralelo convergente de metodología mixta. Diecisiete estudiantes de los grados de Enfermería, Fisioterapia y Trabajo Social evaluaron una actividad formativa, denominada ¿Integración de la Perspectiva del Paciente en la Atención Multidisciplinar, mediante un cuestionario. Se recogieron datos sobre la adquisición de conocimiento y las competencias, y su satisfacción con la actividad. Además, los 2 pacientes implicados evaluaron la actividad mediante entrevistas semiestructuradas y los docentes, con un breve cuestionario. Resultados: en la evaluación objetiva de las competencias, los estudiantes obtuvieron una puntuación global media de 7,63 puntos (DE: 2,33) sobre 10. Los estudiantes valoraron su satisfacción con la actividad con una nota media global de 4,49 (DE: 0,61) sobre 5. Tanto los pacientes como los docentes valoraron de forma muy positiva la actividad. Conclusión: los resultados presentados muestran cómo esta experiencia de aprendizaje ha sido altamente satisfactoria para todos los participantes, y cómo los estudiantes han logrado adquirir las competencias previstas
Open Access
HIV Incidence Among Women in Sub-Saharan Africa: a time trend Aanalysis of the 2000-2017 Period
(Wolters Kluwer Health, 2021) Soto Ruiz, María Nelia; Arregui Azagra, Adriana; San Martín Rodríguez, Leticia; Elizalde Beiras, Itsaso; Saralegui Gainza, Amaia; Escalada Hernández, Paula; Ciencias de la Salud; Osasun Zientziak; Institute of Smart Cities - ISC
ABSTRACT: The aim of this study was to use data from the United Nations Global Indicators Database to analyze the trends in the HIV incidence rate among women in sub-Saharan African countries between 2000 and 2017. The HIV incidence rate is defined as the number of new HIV infections per 1,000 uninfected population, aged 15 to 49 years old. Joinpoint regression analysis was applied to identify periods when there were significant changes in the HIV incidence rate. The results show that there was a global decrease trend in the HIV incidence rates among women in sub-Saharan Africa, decreasing in all sub-Saharan African countries, except in Angola, Equatorial Guinea, and Sudan, which have remained the same, and Madagascar, where the overall trend is increasing. The joinpoint regression statistical method offers an in-depth analysis of the incidence of HIV among women in sub-Saharan Africa. Copyright © 2021 Association of Nurses in AIDS Care.
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.
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
Intención de abandono de la profesión enfermera por salud mental en Navarra (España) durante la pandemia de COVID-19
(Gobierno de Navarra, 2025-04-30) García Vivar, Cristina; Ferraz Torres, Marta; Escalada Hernández, Paula; Soto Ruiz, María Nelia; Ciencias de la Salud; Osasun Zientziak; Gobierno de Navarra / Nafarroako Gobernua
Fundamento. El objetivo es estimar la intención de abandono de la profesión enfermera o del puesto de trabajo en la comunidad foral de Navarra (España) durante la sexta ola de la pandemia por COVID-19 (octubre 2021-marzo 2022) y analizar su relación con el estado de salud mental de las enfermeras y sus características socio-demográficas. Metodología. Estudio descriptivo y transversal con enfermeras que trabajaron durante la pandemia de COVID-19 en instituciones sanitarias de Navarra. Se diseñó un cuestionario con escalas validadas para evaluar depresión, ansiedad, insomnio, estrés postraumático y la intención de abandonar el puesto de trabajo o la profesión enfermera. El cuestionario se envió por correo electrónico a las enfermeras colegiadas, cerrando la recogida de datos al alcanzar el tamaño muestral requerido. Resultados. Se recibieron 691 cuestionario completos. El 43% de las enfermeras manifestaron intención de abandonar la profesión y, de ellas, el 52% también consideraron la posibilidad de cambiar de puesto de trabajo. Las enfermeras con niveles moderados de ansiedad y estrés postraumático mostraron mayor intencionalidad de abandono de la profesión, así como aquellas con menor experiencia profesional. Conclusiones. La intención de abandono de la profesión enfermera en Navarra durante la sexta ola de la pandemia por COVID-19 se asocia significativamente con niveles moderados de ansiedad y estrés postraumático, y menor experiencia profesional. Es necesario implementar estrategias para mejorar las condiciones laborales, promover el bienestar mental y reducir el riesgo de abandono profesional de las enfermeras, especialmente en contextos de crisis sanitaria.
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.
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
Modificación de la actividad física durante los tres primeros años de universidad
(ARAN Ediciones, 2019) Soto Ruiz, María Nelia; Aguinaga Ontoso, Inés; Guillén Grima, Francisco; Marín Fernández, Blanca; Ciencias de la Salud; Osasun Zientziak
Introducción: la inactividad física constituye el cuarto factor de riesgo más importante de mortalidad en todo el mundo y los estudiantes universitarios presentan en un alto nivel este factor de riesgo. Objetivos: determinar la modificación de la actividad física de los estudiantes universitarios en Navarra durante los tres primeros años de universidad. Métodos: estudio observacional prospectivo de una cohorte de universitarios que participaron en el estudio en primer curso y dos años después, en tercer curso. Las cohortes fueron constituidas por 454 estudiantes que respondieron a un cuestionario de autocumplimentación voluntario y anónimo con variables sociodemográficas y relacionadas con la actividad física. Los datos se analizaron con el SPSS v21.0. Resultados: un 67,4% (n = 306) fueron mujeres y un 32,6% (n = 148) fueron hombres. El 61,6% de los estudiantes de primer curso realizaban más de 150 minutos a la semana de actividad física y se incrementó el porcentaje de estudiantes activos físicamente en un 2,7%. Entre quienes realizaban actividad física mínimo tres veces a la semana se observó un incremento del 6,1%, hasta alcanzar el 30,5% de estudiantes. Conclusiones: el periodo universitario no desempeña un papel significativo en la promoción de la actividad física, ya que se observan modificaciones mínimas en su práctica. A futuro, convendría plantearse los motivos que dificultan la actividad física y diseñar programas según las recomendaciones actuales.