Open Access
The role of resilience and coping strategies as predictors of well-being in breast cancer patients
(Elsevier, 2024) Ulibarri Ochoa, Ainhoa; Macía, Patricia; Ruiz de Alegría, Begoña; García Vivar, Cristina; Iraurgi, Ioseba; Ciencias de la Salud; Osasun Zientziak
Purpose: This study investigated the role of resilience and coping strategies on breast cancer patients’ well-being using a structural equation model. To achieve this objective, a model previously developed by Mayordomo’s group was partially replicated using a longitudinal study design in an oncological sample. Methods: The study was a longitudinal observational survey. Patients with breast cancer were recruited (N = 166). Resilience was measured with the Mexican Resilience Measurement Scale, coping strategies with the Forms of Coping and Dimensions Scale and perception of the psychological well-being with a short-form of Ryff’s Scales of Psychological Well-Being at the start and end of adjuvant chemotherapy (T1 and T2 respectively). Results: The results showed stability in the variables over time and revealed differences with respect to Mayordomo’s model. The best predictor of well-being at T2 was well-being at T1. In addition, the model indicated that resilience had a direct impact on well-being through problem-focused coping. Indeed, resilience and problem-focused coping best explained well-being at T2. Conclusions: Both at the start and end of adjuvant chemotherapy for breast cancer, problem-focused coping positively predicted resilience, which in turn was a positive predictor of well-being. On the other hand, emotionfocused coping showed no association with resilience or well-being. As part of the multidisciplinary cancer team, oncology nurses have a key role to play in promoting resilience and problem-focused coping as an important goal of psychosocial interventions in breast cancer patients.
Open Access
Differences in quality of life and emotional well-being in breast, colon, and lung cancer patients during outpatient adjuvant chemotherapy: a longitudinal study
(Wolters Kluwer, 2022) Ulibarri Ochoa, Ainhoa; Ruiz de Alegría, Begoña; López Vivanco, Guillermo; García Vivar, Cristina; Iraurgi, Ioseba; Ciencias de la Salud; Osasun Zientziak
Adjuvant chemotherapy used at each cancer site may affect quality of life (QoL) and emotional well-being (affect) of cancer patients differently; however, these differences between groups have not been studied. Objectives. The aim of this study was to assess differences in QoL and affect by cancer site at the start of outpatient adjuvant chemotherapy, whether QoL and affect change during this treatment, and whether adverse effects influence these variables. Methods. A multicenter longitudinal descriptive study was conducted with 247 participants with breast, colon, or lung cancer at the beginning (T1) and end of treatment (T2). We used the SF-12 Health Survey, Positive and Negative Affect Scale, and an ¿ad hoc¿ adverse effects questionnaire. Results. At the start of chemotherapy, the lung group had poorer Physical Component Summary and poorer positive and negative affect (P < .05) scores. In the end-of-treatment comparisons, breast and colon cancer patients¿ status had worsened, whereas lung cancer patients had tended to stabilize, although they remained the most vulnerable. Adverse effect severity was significant for Physical Component Summary (r = -0.13, P = .035), with decreases in positive affect (r = -0.17, β= -.16) and increases in negative affect (r = 0.15, β= .14). Conclusions. Changes in QoL and emotional state differ between groups, implying a need for varying levels of follow-up and emotional support. Patients with lung cancer seem particularly vulnerable. Implications for Practice Cancer nurses could strengthen the assessment of patients undergoing chemotherapy using more sensitive instruments such as the Positive and Negative Affect Scale and considering differences by cancer site, to provide care tailored to individual patient needs and preferences.
Embargo
Quality of life of adolescents and young adult survivors of childhood cancer: a qualitative study
(Wiley, 2024-11-11) Neris, Rhyquelle Rhibna; Papathanassoglou, Elizabeth; Leite, Ana Carolina Andrade Biaggi; García Vivar, Cristina; Nascimento, Lucila; Ciencias de la Salud; Osasun Zientziak; Institute of Smart Cities - ISC
Aims: to analyse how adolescents and young adults who survived childhood cancer experience their quality of life and to ex-plore their meanings and conceptualisations of quality of life. Design: narrative design following Squire's method. Methods: in-person and virtual recruitment, due to the global COVID-19 pandemic, was carried out in Brazil between May and November 2021. Eighteen semi-structured virtual interviews were conducted with childhood cancer survivors. These data wereanalysed using reflexive thematic analysis and employing a triangulation of investigators. Results: four subthemes were identified, encompassing participants' perceptions and meanings of quality of life. Through thereflection and synthesis of these subthemes, a central theme emerged entitled "New self", capturing the profound impact of thecancer and survival experience on every aspect of the self, along with participants' sense of having gained "a new life" and a "sec-ond chance". Conclusion: the study provides a rich and nuanced understanding of quality of life for childhood cancer survivors. The results highlight that after all the changes in life due to cancer, integrating the new self becomes a central aspect of quality of life forsurvivors. Implications for the Profession and/or Patient Care: recognising the profound shifts in self-perception that survivors of childhood cancer undergo, nurses should engage early in empowering patients and families, offering education, space and sup-port to help adolescents and young adults grow throughout their journey. Impact: the richness and depth inherent in qualitative data on quality of life can inform the development of care standards and health policies for survivors, guide the allocation of strategic resources and shape the development of plans and interventions focusing on childhood cancer survivors. Reporting method: the COREQ checklist was used. Patient or Public: no patient or public contribution.
Open Access
'Opportunistic care': a focus group study of nurses' perspective on caring for long-term cancer survivors and their families
(Lippincott, Williams & Wilkins, 2024) Elizondo Rodríguez, Nerea; La Rosa-Salas, Virginia; Leite, Ana Carolina Andrade Biaggi; Domingo-Oslé, Marta; Nascimento, Lucila; García Vivar, Cristina; Ciencias de la Salud; Osasun Zientziak
Background: The global population of long-term cancer survivors is increasing, thanks to advances in treatments and care. Healthcare systems are working to address the unique needs of these individuals. However, there remains a knowledge gap concerning nurses' view on cancer survivorship care. Objective: To identify nurses' perspective of care for long-term cancer survivors and their families. Methods: This qualitative descriptive study used 5 focus groups comprising 33 nurses from primary healthcare and specialized oncology care. Data analysis was conducted through thematic analysis, and the study received ethical approval. Results: Long-term cancer survivors and their families often remained unrecognized as a distinct group within the healthcare system. Consequently, nurses provide what can be termed as opportunistic care during nurse-survivor encounters, addressing health needs beyond the purpose of the initial healthcare visit. This absence of a systematic or structured approach for this patient group has prompted nurses to seek the establishment of a comprehensive framework through survivorship care plans, thus ensuring a continuum of care for this specific population. Conclusion: The lack of a structured approach to caring for long-term cancer survivors and their families, often invisible as a distinct population group, results in nurses providing care on an opportunistic basis. Implications for practice: It is crucial to develop and implement survivorship care plans tailored to this population's needs. Simultaneously, it is important to advance research in this area and establish an educational framework for nurses, enabling them to effectively address the care of long-term cancer survivors and their families.
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
Nurses' attitudes towards family importance in nursing care across Europe
(Wiley, 2022) Shamali, Mahdi; Esandi Larramendi, Nuria; Østergaard, Birte; Barbieri-Figueiredo, María; Brødsgaard, Anne; Canga Armayor, Ana; Dieperink, Karin Brochstedt; García Vivar, Cristina; Konradsen, Hanne; Nordtug, Bente; Lambert, Veronica; Mahrer-Imhof, Romy; Metzing, Sabine; Nagl-Cupal, Martin; Imhof, Lorenz; Svavarsdottir, Erla Kolbrun; Swallow, Veronica; Luttik, Marie Louise; Ciencias de la Salud; Osasun Zientziak
Aims and Objective To explore differences in nurses' attitudes regarding the importance of family in nursing care and factors associated with nurses' attitudes across 11 European countries. Background Family involvement in healthcare has received attention in many European healthcare systems. Nurses have a unique opportunity to promote family involvement in healthcare; however, their attitudes and beliefs may facilitate or impede this practice. Design A cross-sectional survey across European countries. Method A broad convenience sample of 8112 nurses across 11 European countries was recruited from October 2017 to December 2019. Data were collected using the Families' Importance in Nursing Care-Nurses' Attitudes (FINC-NA) questionnaire. We used the STROBE checklist to report the results. Results There were significant differences in nurses' attitudes about families' importance in nursing care across Europe. Country was the factor with the strongest association with the total scores of the FINC-NA. Older age, higher level of education, increased years since graduation, having a strategy for the care of families in the workplace, and having experience of illness within one's own family were associated with a higher total FINC-NA score. Being male and working in a hospital or other clinical settings were associated with a lower total FINC-NA score. Conclusion Nurses' attitudes regarding the importance of family in nursing care vary across 11 European countries. This study highlights multiple factors associated with nurses' attitudes. Further research is necessary to gain a deeper understanding of the reasons for nurses' different attitudes and to develop a strong theoretical framework across Europe to support family involvement in patient care. The inclusion of family healthcare programs in the baccalaureate curriculum may improve nurses' attitudes.
Open Access
Impact of individual and job characteristics on nurses' scope of practice in spanish hospital units
(Wiley, 2024) Saralegui Gainza, Amaia; Escalada Hernández, Paula; García Vivar, Cristina; San Martín Rodríguez, Leticia; Soto Ruiz, María Nelia; Ciencias de la Salud; Osasun Zientziak
Background. Nurses are one of the largest and costliest groups in healthcare organizations; therefore, it is important to comprehend their scope of practice. Aim. To contribute to the improvement of nursing resource management in medical-surgical and Intensive Care Units by identifying factors that influence the scope of nursing practice. The hypothesis was that the activities carried out by nurses in medical-surgical units and intensive care units are influenced by individual and job-related factors, with job characteristics having an additive and moderating effect on individual characteristics. Materials and Methods. Cross-sectional correlational design to test the relationship between the individual and job characteristics on the nursing scope of practice measured by the Actual Scope of Nursing Practice (ASCOP) questionnaire. The sample consisted of 270 nurses. Linear mixed effects models analysis (LME) was used with the aleatory effect of the intensive care unit (ICU). Results. Belonging to the ICU decreased the scope of practice of nurses. We found a statistically significant effect of psychological demand, practice environment, role ambiguity, and growth need strength on the scope of nursing practice. The models explained a variance up to 24%. Conclusions. Although the survey results revealed the existence of broader scope of practice levels in Spanish hospital units than in the original Canadian study, the use of scope of nursing practice remains suboptimal. Higher levels on the psychological demand, the practice environment and in the individual growth need strength were related with a broader scope of practice. Otherwise, role ambiguity negatively affected the scope of practice. Implications for Nursing Management. This article provides an analysis of the impact of individual and job-related characteristics on the nursing scope of practice. It serves as a valuable resource for both managers and nurses, offering insights to improve nurses' working conditions and obtain more efficient workforces.
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
Modelo de gestión para la investigación en enfermería: experiencia de la Universidad de Navarra
(Conferencia Nacional de Decanos y Decanas de Enfermería, 2015) García Vivar, Cristina; Canga Armayor, Ana; López de Dicastillo Sáinz de Murieta, Olga; Pérez Díez del Corral, Mercedes; Rumeu Casares, Carmen; Saracibar Razquin, María Isabel; Ciencias de la Salud; Osasun Zientziak; Institute of Smart Cities - ISC
Introducción. Las nuevas demandas universitarias están obligando a redefinir el modelo de gestión de la investigación en enfermería con el objeto de consolidar su calidad e impacto socio-sanitario. Objetivo. Presentar las estrategias utilizadas en la implantación de un modelo de gestión para el desarrollo de la investigación en enfermería en la Universidad de Navarra (UN). Metodología. Las cuatro fases de Marchette (simulación, individualista, unificada, equilibrio) son el marco para presentar el modelo de gestión llevado a cabo por la UN para potenciar la investigación en Enfermería. Resultados. Se describen las siguientes estrategias: organización de jornadas y reuniones sobre investigación; inversión en capacitación investigadora de los profesores; aprobación de las líneas de investigación como estructuras organizativas para el desarrollo del conocimiento en enfermería; creación de la Cátedra María Egea para la investigación; implantación del Plan Estratégico en investigación 2013-2018; aprobación del Programa de Doctorado en Ciencias de la Enfermería. Conclusiones. Existe la necesidad de adoptar y adaptar nuevas estructuras de gestión de la investigación que fomenten la creación de conocimiento disciplinar, el desarrollo de equipos de investigación competitivos, la interdisciplinariedad, el trabajo en equipo, y la formación de nuevos investigadores. Asimismo, estas estructuras deben dar respuesta a las nuevas demandas sociosanitarias, y promover la práctica clínica de enfermería de excelencia.
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.