Unidad de Investigación en Cuidados de Salud (Investén-isciii)

Permanent URI for this collectionhttps://hdl.handle.net/20.500.12105/19618

La Unidad de investigación en cuidados y servicios de salud (Investén-isciii) se crea en 1996 con el objetivo de fomentar la investigación en cuidados de enfermería y otras disciplinas relacionadas. Investén-isciii incluye profesionales, en su mayor parte de enfermería de todas las comunidades autónomas. Su ámbito de influencia es nacional, en ella están involucradas las diferentes áreas de trabajo de los profesionales de enfermería y disciplinas afines: la atención primaria, la hospitalaria, las instituciones docentes y las diferentes áreas de gestión de la provisión de cuidados. La misión es desarrollar estrategias y promover acciones para el fomento y coordinación de la investigación multidisciplinar y traslacional en cuidados, favoreciendo el vínculo entre la práctica y la investigación, y posibilitando la implantación de cuidados seguros y de calidad que mejoren la salud de la población. Está adscrita a la Subdirección General de Servicios Aplicados, Formación e Investigación.

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Factors modulating the impact of the COVID-19 pandemic on posttraumatic stress symptomatology of the Spanish healthcare workers: A cohort study.
(Public Library of Science (PLOS), 2025-06-16) Arregui-Gallego, Beatriz; Orts-Cortes, Maria Isabel; Moreno-Casbas, Teresa; Abad-Corpa, Eva; Camacho-Bejarano, Rafaela; Cidoncha-Moreno, Mª Ángeles; Feria-Raposo, Isabel; Iruzubieta-Barragán, Javier; Carmona, Montserrat; Cristóbal-Domínguez, Estíbaliz; Bernués-Caudillo, Leticia; Casado-Ramirez, Elvira; Recas-Martin, Alda; Sánchez-López, Dolores; Company-Sancho, M Consuelo; Rascón, Noelia López; Esteban-Sepúlveda, Silvia; Vidal-Thomàs, María Clara; Alonso, Isabel; Muñoz-Jiménez, Daniel; Segura-Heras, José Vicente; Moncho, Joaquín; Rich-Ruiz, Manuel; Fundación BBVA
Introduction: The COVID-19 pandemic generated a global health crisis that significantly impacted healthcare systems and professionals. Healthcare workers were exposed to high levels of psychological distress, including posttraumatic stress symptomatology (PTSS). Aim: Analyse the evolution of PTSS among Spanish healthcare workers during the COVID-19 pandemic, and to identify associated factors. Method: A multicenter prospective cohort study with a 12-month follow-up was conducted. PTSS was the primary outcome. Secondary variables included sociodemographic, occupational, psychological, and coping-related factors. Statistical analyses comprised bivariate comparisons and multivariate modelling, such as generalized linear models and linear mixed models. Results: Of the 428 participants, 180 completed the 12-month follow-up. At baseline, changes in work posts, negative family-work relations, avoidant coping, burnout symptoms, and emotional intelligence were associated with PTSS levels. Linear mixed models showed a significant decrease in PTSS over the 12-month period, regardless of gender, age, household type, occupational role, contract type, job title, level of care or type of service (p < 0.001). The generalised linear model explained 25.5% of the variance in PTSS levels at baseline, highlighting the role of psychological and coping factors over sociodemographic or occupational characteristics. Conclusions: This study highlights the need for early identification and intervention focused on psychological and coping mechanisms. Promoting emotional regulation, reducing burnout, and addressing maladaptive coping may help mitigate long-term psychological effects among healthcare workers during public health crises.
Cognitive Screening Tools in Spanish for Mild Cognitive Impairment: A Systematic Review and Meta-analysis
(2025-05-28) Barderas Manchado, Rodrigo; Ropero-Sánchez, Andrea; Escudero Pérez, Guillermo; Lozano González, Pilar; Alonso-del-Cura, Olatz; Camacho-Montaño, Lucia; Pascual García, Marcos; Sánchez Ruano, Raquel; Martín Saborido, Carlos; Moreno-Casbas, Teresa; Instituto de Salud Carlos III
Mild Cognitive Impairment (MCI) represents the earliest stage of a chronic and degenerative condition, often undetected, impacting individuals, families, and healthcare systems. Early identification is critical. This study evaluates the diagnostic accuracy of MCI screening tools in Spanish-speaking populations, aiming to enhance early detection, reduce misdiagnosis and underdiagnosis, and improve clinical outcomes. This systematic review stems from the Project Dendrite (PMP22/00084 - "Personalized Medicine in the Identification of Preclinical Cognitive Impairment: Development of a Predictive Risk Model") in which it was demonstrated that the five screening tests employed in the study (MMSE, MoCA, Fototest, MiniCog, T@M) lacked consistency and yielded variable results, even in the same participant. This finding highlights the need to evaluate the diagnostic accuracy of the screening tools and their applicability in early cognitive decline detection.
Early detection of cognitive impairment in primary care: a mixed-methods protocol integrating data from multiple sources (DENDRITE study)
(2025-09-16) Almeida-Parra, Ángeles; Ropero-Sánchez, Andrea; Zamora Romero, Javier; Docío-Fernández, Laura; Fatjó-Vilas Mestre, Mar; Campuzano Ruiz, Susana; Lozano González, Pilar; Alonso-del-Cura, Olatz; Montero Calle, Ana; Barderas Manchado, Rodrigo; Moreno-Casbas, Teresa; MedPer_DC Project Working Group; Unión Europea. Comisión Europea. NextGenerationEU
Globally, over half of cognitive impairment cases identified in population-based studies remain undetected, and up to 90% of mild cases go undiagnosed. This represents a major public health challenge with significant implications for ageing populations and health systems. The present protocol outlines the integration of clinical, multiomic, healthcare, social, environmental, voice, and behavioral data, using artificial intelligence and advance statistical modeling, to develop a predictive risk model for the preclinical detection of cognitive impairment in adults aged 55–70 years. This is an observational, multicenter, non-interventional study employing a convergent mixed-methods approach. The design combines a prospective quantitative phase with a qualitative one based on discussion groups. The study will be conducted across six Spanish regions and seven primary healthcare centers located in different geographic areas. Each center will recruit 150 cognitively unimpaired participants, resulting in a total sample of 1050 participants. In addition, a calibration group of 100 participants diagnosed with mild cognitive impairment will be included. This protocol has been developed in accordance with the STROBE guidelines to ensure methodological rigor, transparency, and reproducibility. This research aims to develop a simple, cost-effective, and actionable tool for early preclinical detection of individuals at risk of cognitive impairment, enabling its integration into primary care and supporting timely, targeted interventions. This approach has the potential to reduce diagnostic delays, optimize healthcare resources, and promote equitable access to timely interventions, ultimately improving population health and quality of life.
Medicina Personalizada (MedPer) en la detección precoz del Deterioro Cognitivo (DC) preclínico (DENDRITE). Desarrollo de un modelo predictivo de riesgo. Plan de Gestión de Datos (PGD) v. 2.0
(Instituto de Salud Carlos III (ISCIII). Unidad de Investigación en Cuidados de Salud (Investén), 2025-08-25) Instituto de Salud Carlos III. Unidad de Investigación en Cuidados de Salud (Investén-ISCIII); Instituto de Investigación Biomédica de Salamanca (IBSAL); CIBER de Fragilidad y Envejecimiento Saludable, Instituto de Salud Carlos III (CIBERFES, ISCIII); Alonso-del-Cura, Olatz; Instituto de Salud Carlos III
Plan de Gestión de Datos del proyecto DENDRITE. El objetivo principal del proyecto MedPer_DC es obtener un modelo predictivo para la detección preclínica del deterioro cognitivo en población de 55-70 años de edad, permitiendo así la implantación efectiva de la Medicina Personalizada de Precisión en Atención Primaria. El estudio involucra la participación de 6 Comunidades Autónomas y 7 centros de Atención Primaria en diferentes ubicaciones geográficas. Es una cohorte observacional, multicéntrica y no intervencional con métodos mixtos convergentes. Se desarrollará combinando una fase cuantitativa observacional y prospectiva con una fase cualitativa que involucrará grupos de discusión. Durante el estudio se recogerán datos multi-ómicos (moleculares, proteómicos, genómicos), asistenciales, sociales, ambientales, de voz y de conducta (provenientes de monitorización activa y pasiva) junto con información clínica complementaria. Todos estos datos se analizarán mediante diversas técnicas de análisis basadas en Inteligencia Artificial y en modelos estadísticos para sintetizar un perfil clínico, genético y molecular, de comportamiento y voz, y determinar su potencial para converger en un modelo predictivo global de DC.
Estudio multicéntrico sobre el impacto de la pandemia por SARS-CoV-2 en los cuidados y estado de salud de las personas de 75 años o más y sus cuidadores (Proyecto CUIDAMOS+75): Plan de Gestión de Datos (PGD) v 2.0
(Instituto de Salud Carlos III (ISCIII). Unidad de Investigación en Cuidados de Salud (Investén), 2025-08) Cameselle-Lago, Candela; Moreno-Casbas, Teresa; Rico Blázquez, Milagros; González Chordá, Víctor M.; Pedraz-Marcos, Azucena; Sánchez Ruano, Raquel; Cameselle-Lago, Candela; Instituto de Salud Carlos III; Unión Europea
Este Plan de Gestión de Datos de investigación (PGD) desarrolla el manejo y tratamiento de datos en el Proyecto CUIDAMOS +75: Estudio multicéntrico sobre el impacto de la pandemia por SARS-CoV-2 en los cuidados y estado de salud de las personas de 75 años o más y sus cuidadores. Objetivo: Estudiar el impacto de la pandemia por SARS-CoV-2 en el estado de salud de personas ≥75 en España. Diseño: Estudio con métodos mixtos y tres objetivos secundarios. 1) Estudio longitudinal de cohorte poblacional multipropósito, ambispectiva, con datos de vida real y 6 años de seguimiento; 2) estudio observacional prospectivo de cohortes de 18 meses de seguimiento; 3) estudio cualitativo de abordaje crítico-social. Ámbito: Atención Primaria de 11 Comunidades Autónomas españolas. Población: personas ≥=75 años, adscritas a los centros de salud del ámbito de estudio. Muestra: La cohorte poblacional incluirá el total de la población que cumpla criterios, sobre la estimada de 1.619.620. El tamaño en la cohorte prospectiva estimado es de 1035, reclutados de manera consecutiva por enfermeras clínicas. En el abordaje crítico social la selección será intencional y avanzará hacia muestreo teórico en función del desarrollo emergente. Variables resultado: Cohorte poblacional: diagnósticos e intervenciones enfermeras y uso de servicios; Cohortes prospectivas: mortalidad, calidad de vida (EQ-5D) y capacidad funcional (Barthel). Variable de exposición para cohortes prospectivas: infección positiva registrada en historia clínica por SARS-Cov-2 entre 11/05/2020 y anterior al 01/06/2022. Fuentes: Historia Clínica Electrónica (HCE), entrevista clínica, entrevistas semiestructuradas y grupos de discusión. Análisis: Cohorte poblacional: para estudiar la evolución de diagnósticos e intervenciones se hará un análisis de series temporales. Estudio de cohortes: curvas de supervivencia de Kaplan-Meier para mortalidad y análisis de efectos mixtos para deterioro funcional y calidad de vida. Para estudiar el impacto de la infección sobre las tres variables a los 6, 12 y 18 meses, ajustando por características sociodemográficas y clínicas, se utilizarán modelos de riesgos proporcionales de Cox y modelos mixtos. Estudio cualitativo: análisis temático, semiótico y de posiciones discursivas.
Transcultural Adaptation and Evaluation of the Psychometric Properties of the Spanish Version of the FCR7 Questionnaire for Assessing Fear of Recurrence in Cancer Patients: FCR6/7-SP
(Multidisciplinary Digital Publishing Institute (MDPI), 2025-03-03) Díaz-Periánez, Cristina; Camacho-Bejarano, Rafaela; González-de la Torre, Héctor; Cruickshank, Susanne; Humphris, Gerald Michael; Bayo-Lozano, Eloísa; Merino-Navarro, Dolores
Background/objectives: Fear of recurrence is one of the main issues affecting cancer patients after the completion of treatment. Despite the development of various assessment tools at the international level, there is a lack of validated questionnaires in Spanish. For this reason, the aim of this study is to conduct a transcultural adaptation and evaluate the psychometric properties of the Spanish version of the Fear of Cancer Recurrence (FCR7) questionnaire. Methods: We carried out translation and transcultural adaptation of the FCR7 scale, content validity through expert review, and face validity with a pilot test in the first phase. In the second phase, construct validity was evaluated through confirmatory factor analysis and Rasch analysis, along with reliability (internal consistency), convergent-divergent validation, and known-groups validation in a sample of 315 individuals with a history of cancer. Descriptive and inferential analysis was performed using JAMOVI© v.2.3.24., confirmatory factor analysis with FACTOR© v.12.02.01x64 bits, and Rasch analysis with JMetrik© v.2.0. Results: Aiken's coefficient exceeded 0.75 for all items, indicating acceptable face validity for the instrument. Two unidimensional models were obtained for the instrument, FCR7-SP and FCR6-SP, both showing acceptable fit values and adequate reliability (omega coefficient = 0.933 [95% CI: 0.922-0.944] and 0.942 [95% CI: 0.931-0.951], respectively). Conclusions: The Spanish version of the FCR7 is valid and reliable for assessing fear of cancer recurrence in the Spanish population, with two models available for its application (FCR7-SP and FCR6-SP). The availability of this tool will enable the evaluation of this phenomenon in clinical practice and a more effective approach to addressing its consequences.
Patient and Public Involvement in Malnutrition Disorders Health Research: A Methodological Systematic Review Protocol
(Multidisciplinary Digital Publishing Institute (MDPI), 2025-04-07) Garcia-Garcia, Arturo; Carretero-Randez, Cristina; Camacho-Bejarano, Rafaela; Roldán-Chicano, María Teresa; Castellano-Santana, Pedro Raúl; Camacho-Montaño, Lucia; Montero-Marco, Jesica; Charlo-Bernardos, Marta; Orts-Cortes, Maria Isabel
Background/Objectives: Older adults are particularly susceptible to undernutrition and conditions that can aggravate it, such as frailty and conditions associated with swallowing difficulties or dysphagia. To address these challenges, it is important to consider the perspectives of older adults and their caregivers, especially those with conditions such as frailty or cognitive impairment, as they can provide valuable insights on supporting nutrition in these vulnerable populations. This participatory approach requires structures formed by scientific research committees working together with other stakeholders, involving various actors at all stages of the research process. The aim of this study is to analyze the methodology for involving patients aged 65 and older with malnutrition or at risk of malnutrition as co-investigators in research. Methods: This protocol has been developed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA-P) checklist. A literature search will be carried out in the following electronic databases: PubMed/MEDLINE, EMBASE and CINAHL. Through the COVIDENCE program, the research team will independently review the different screening phases of the identified studies for possible inclusion or exclusion. Expected Results: This systematic review will provide up-to-date evidence on the use of non-scientific actors at different stages of research. The main limitation stems from the use of non-scientific agents in a topic as specific as adults with or at risk of undernutrition, which may make it difficult to extrapolate the results to other settings. The registration number in PROSPERO is CRD42024444374.
Evaluating Tools for Assessing Fear of Cancer Recurrence in Adults for Nursing Practice: A Systematic Review
(Elsevier, 2025-06) Díaz-Periánez, Cristina; Camacho-Bejarano, Rafaela; Cruickshank, Susanne; Humphris, Gerry; Bayo-Lozano, Eloisa; Merino-Navarro, Dolores
Objective: To identify, assess and compare internationally validated tools that measure the fear of recurrence in adult survivors of cancer. Methods: This systematic review was based on the PRISMA reporting guidelines and COSMIN methodology was applied to analyses the psychometric properties and the validation process of the selected assessment tools. The search was conducted on 6 databases: PubMed/Medline, Cochrane Library, CINAHL, Web of Science, Scopus and LILACS, from 2001 to 2023. The descriptors used were: "fear of cancer recurrence," "tools," "validity," "reliability" and "cancer survivors." Studies focused on the design, validation or cultural adaptation of fear of cancer recurrence tools in adult cancer patients were selected. The COSMIN checklist was used to compare the tools measurement properties, including the following dimensions: conceptual suitability, applicability and psychometric features, and also to assess the methodological quality and the risk of bias of the different studies. Results: 18 studies have been included. Three validated tools were identified for measuring fear of cancer recurrence in adults: CARS, FCRI and FCR7, which were also adapted in various languages. Although there are differences in the validation process, most of the tools were validated with acceptable psychometric properties and with a suitable cultural adaptation. Conclusions: The 3 main tools identified are valid to measure fear for cancer recurrence although vary on their level of development, being FCR4/7 the most recent and consistent 1. Despite the availability of these tools, there is a lack of validated instruments in Spanish-speaking contexts. Regular use of these tools in Nursing practice would contribute to early detect fear of cancer recurrence and to effectively manage it, improving the quality of life of cancer patients. Recently, shorter versions have arisen to facilitate its applicability.
Effectiveness of an Early Intervention in Mild Hyponatremia to Prevent Accidental Falls in Hospitalized Older Adults-A Crossover Ecological Clinical Trial
(Multidisciplinary Digital Publishing Institute (MDPI), 2025-04-10) Lobo-Rodríguez, Carmen; Pedraz-Marcos, Azucena; Velarde-García, Juan Francisco; Calderari Fernández, Elena; Gadea-Cedenilla, Carmen; Medina-Torres, Margarita; Moro-Tejedor, Mª Nieves; Sánchez García, Leonor; García-Pozo, Ana Mª; Fundación Mutua Madrileña
Background: Falls in hospitalized patients cause injuries of varying severity and even death. There is a link between falls and low blood sodium levels in older patients. Identifying and treating hyponatremia could help prevent falls and reduce hospital stays. The purpose of this study was to evaluate the effectiveness of the correction of hyponatremia on reducing the incidence of falls and the mean stay of hospitalized patients aged more than 65 years. Methods: A crossover ecological clinical trial was conducted in adult hospitalization units of a hospital in Madrid (Spain) over 12 months. Patients meeting inclusion criteria were divided into two randomized groups. The intervention was applied in two six-month phases, alternating between groups with a 15-day washout period. Early diagnosis and treatment of hyponatremia were implemented in the intervention group, while the control group received standard care. Primary outcomes included fall incidence and length of hospital stay. Data were collected using REDCap and analyzed with SPSS v.21. Statistical significance was set at p < 0.05 (ClinicalTrials identifier of the manuscript: NCT03265691). Results: A total of 1925 patients were included (408 intervention, 1517 control). Fall incidence was significantly lower in the intervention group (6.7 vs. 9.8, p = 0.000). Hyponatremia was corrected in 72% of cases. No significant differences were found in functional scores. The intervention effectively reduced falls compared to standard care. Conclusions: Early hyponatremia treatment reduces falls and hospital stay in older patients, supporting its inclusion in fall prevention strategies.
Rasch and Confirmatory Factor Analysis of the Community Wellbeing Index: A Multicountry Validation Study
(Springer, 2025-04-22) Forjaz, Maria João; Ayala, Alba; Schutte, Lusilda; Wissing, Marie P.; Temane, Qambeshile Michael; Campbell, Timothy C. H.; Carroll, Matthew T. C.; National Research Foundation (Sudáfrica); South African Medical Research Council; National Treasury (Sudáfrica); RETICS-Actividades Preventivas y Promoción de la Salud en Atención Primaria (REDIAPP-ISCIII) (España)
Community wellbeing assessment is of growing interest in governance and policy-making. This study investigated the validity and reliability of the Community Wellbeing Index (CWI), assessing community wellbeing from an individual’s perspective, across independent international datasets. The CWI was translated from the original Spanish into English and Setswana and was administered to participants from established research cohorts in Spain (n = 1,106), Australia (n = 677) and South Africa (n = 400). The CWI was validated within countries using the Rasch model and confirmatory factor analysis. Differential Item Functioning (DIF) by country and Multigroup Confirmatory Factor Analysis was used to evaluate invariance across the samples. Results indicated a three-dimensional construct, good fit of the data to the model, item local independence, PSI ranging 0.668–0.752, and an absence of DIF by sex, age and country. Configural and metric invariance among the three countries were supported, but not scalar invariance, implying that scale and subscale scores could not be compared across the samples. This could potentially be attributed to sample differences on demographic factors including age, urbanicity and socio-economic status. In conclusion, the CWI performed robustly across geographic, cultural, and linguistic settings, indicating the scale can be used in diverse settings. Continued investigation of the CWI across place and culture is warranted, particularly research using samples more closely matched on demographic factors to explore whether the measure can be used to compare community wellbeing levels across countries.
Evolution of Spanish population well-being during the COVID-19 pandemic: Results from the COSMO-Spain study
(Elsevier, 2025-02-15) Santos-Ribeiro, Catarina; Rodriguez-Blazquez, Carmen; Ayala, Alba; Romay-Barja, Maria; Falcón, María; Forjaz, Maria João; Instituto de Salud Carlos III
Introduction: The COVID-19 pandemic affected mental health worldwide. The COSMO-Spain study analyses risk perceptions, behaviours, knowledge and other pandemic related variables, such as well-being. This work aimed to assess the evolution of self-reported well-being in Spain from May 2021 to September 2022 and its association with demographic and COVID-19 related factors. Methods: An online, nationwide cross-sectional panel survey was applied in seven rounds with 1000+ participants each, with a total sample of 7266 participants, representative of the Spanish adult general population. The main variable was well-being, measured with the World Health Organization Well-Being Index (WHO-5) total score, an index with a total score from 0 to 100 (0 = worst well-being, 100 = best well-being). Other variables included in the survey were: sociodemographic data, concern about COVID-19, feelings of depression and fear, COVID-19-related worries, risk perception, self-efficacy, preventive behaviours, pandemic fatigue, health literacy, information search behaviours, and trust in several institutions. A multiple linear regression was run to analyse the associated factors with the WHO-5 total score. Results: The WHO-5 total score showed a significant increase from rounds 6 (May-June 2021) to 8 (September-October 2021). Women (standardized b coefficient (b) = -0.10), youth or people with lower socioeconomic status (worsened financial situation (b = -0.10) or unemployed/furloughs (b = -0.04)) reported lower well-being levels, whereas having a university-level education showed the opposite (b = 0.11). Feeling less depressed was associated with higher well-being (b = 0.31). Conclusions: This study shows rising levels of well-being until a plateau was reached in October 2021. Vulnerable groups may be at higher risk of worsened mental health and should be addressed by policymakers. Further longitudinal studies should evaluate causality and evolution patterns of well-being throughout the COVID-19 pandemic.
Impact of the COVID-19 pandemic on the self-care and health condition of the older adults. CUIDAMOS+75. A mixed methods study protocol
(Frontiers Media, 2024) Rico-Blazquez, Milagros; Esteban-Sepúlveda, Silvia; Sánchez-Ruano, Raquel; Aritztegui-Echenique, Ana María; Artigues-Barbera, Eva María; Brito-Brito, Pedro-Ruymán; Casado-Ramirez, Elvira; Cidoncha-Moreno, María Ángeles; Fabregat-Julve, María Inmaculada; Feria-Raposo, Isabel; Hernandez-Pascual, Montserrat; Lozano-Hernández, Cristina; Moreno-Casbas, Teresa; Otones-Reyes, Pedro; Palmar-Santos, Ana María; Pedraz-Marcos, Azucena; Romero-Rodriguez, Esperanza María; Solé-Agustí, María Cristina; Taltavull-Aparicio, Joana María; Vidal-Thomàs, María Clara; González-Chordá, Víctor M; Cuidamos+75 Group; Instituto de Salud Carlos III; Unión Europea. Fondo Europeo de Desarrollo Regional (FEDER/ERDF)
Aims: To assess the impact of the COVID-19 pandemic on the health condition of people ≥75 years of age and on their family caregivers in Spain. Design: Multicentric, mixed method concurrent study. Methods: This work, which will be conducted within the primary care setting in 11 administrative regions of Spain, will include three coordinated studies with different methodologies. The first is a population-based cohort study that will use real-life data to analyze the rates and evolution of health needs, care provision, and services utilization before, during, and after the pandemic. The second is a prospective cohort study with 18 months of follow-up that will evaluate the impact of COVID-19 disease on mortality, frailty, functional and cognitive capacity, and quality of life of the participants. Finally, the third will be a qualitative study with a critical social approach to understand and interpret the social, political, and economic dimensions associated with the use of health services during the pandemic. We have followed the SPIRIT Checklist to address trial protocol and related documents. This research is being funded by the Instituto de Salud Carlos III since 2021 and was approved by its ethics committee (June 2022). Discussion: The study findings will reveal the long-term impact of the COVID-19 pandemic on the older adults and their caregivers. This information will serve policymakers to adapt health policies to the needs of this population in situations of maximum stress, such as that produced by the COVID-19 pandemic. Trial registration: Identifier: NCT05249868 [ClinicalTrials.gov].
Balance and Health-Related Quality of Life After 1 Year of COVID-19 Social Restriction Measures: A Cross-Sectional Study in Two Samples from Spain
(Multidisciplinary Digital Publishing Institute (MDPI), 2024-10-30) Huertas-Hoyas, Elisabet; Rodríguez-Rivas, Cristina; Rodríguez-Pérez, Mª Pilar; García-de-Miguel, María; Trugeda-Pedrajo, Nuria; Delgado-Lobete, Laura; Fernández-Gómez, Gemma; Camacho-Montaño, Lucia
Background: The COVID-19 pandemic significantly impacted the well-being of the general population. However, more information is needed regarding the relationship between participation-related outcomes. This study aimed to analyze the impact of the pandemic on occupational balance (OB) and health-related quality of life (HRQoL) before and after social restrictions and to explore their relationship with COVID-19 diagnosis. Methods: We conducted a study among individuals diagnosed with COVID-19, assigning a healthy control group with the same sociodemographic characteristics using the EQ-5D-5L and the Occupational Balance Questionnaire (OBQ). Results: The final sample size consisted of 61 participants in the COVID-19 diagnosis group (50.8% male; mean age 34.6 ± 14.17 years) and 57 healthy participants (50.8% male; mean age 33.7 ± 13.77 years). There were no differences in the sociodemographic variables between the groups. Significant differences were found between groups both before the pandemic and 1 year after confinement measures in HRQoL and OBQ (p < 0.005). The regression model indicated significant associations (p < 0.001) between HRQoL and both current OB and COVID-19 diagnosis. However, the OBQ scores from before the pandemic did not show a significant association with HRQoL (p = 0.336). Conclusions: In conclusion, social restrictions from the COVID-19 pandemic negatively impacted HRQoL in our sample even 1 year after confinement, with COVID-19 diagnosis and occupational imbalance predicting worse outcomes, highlighting the need for targeted interventions not only for the current situation but also for possible future public health crises.
The implementation of Best practice guidelines in Spain through the Programme of the Best Practice Spotlight Organizations®.
(Elsevier, 2020) Gonzalez-Maria, Esther; Moreno-Casbas, Teresa; Albornos-Muñoz, Laura; Grinspun, Doris; Grupo de Trabajo del Programa de implantación de buenas prácticas en Centros Comprometidos con la Excelencia en Cuidados®
The implementation of Best practice guidelines is effective in improving clinical practice and reducing clinical variability. The Best Practice Guidelines of the Ontario Nurses Association have been implemented in Spain since 2012 following the principles of the Canadian programme of the Best Practice Spotlight Organisations® (BPSO®). The Nursing and Healthcare Research Unit (Investén-isciii) coordinates this programme in Spain, having been nominated BPSO Host by the Ontario Nurses Association. Four strategies were followed: translation of the Best Practice Guidelines, dissemination of same and of the programme, implementation of the Best Practice Guidelines and assessment of the results in competitively selected centres, and, finally, the development of sustainability mechanisms. Implementation is based on the theoretical Knowledge to Action model, which establishes a cycle of 6 phases: identification of the problem and training of selected BPSO®; adaptation to the local context; assessment of facilitators and barriers; adaptation and implementation of interventions; monitoring and evaluation of results, and sustainability. Each of these phases incorporate evidence-based elements that promote the effectiveness of implementation, such as the competitive selection of candidates to participate in the programme, selection by the institution of the guidelines to be implemented, leadership by nurses with a multi-professional approach, planning of the process from work structures that are non-vertical but with the support of the institution, the simultaneous use of multiple strategies, ongoing assessment and feedback of results. All of which is mentored and supported by the BPSO Host. There are currently 27 institutions in Spain of different characteristics that implement a total of 20 clinical guidelines. The scope and structure of the programme has recently been extended with regional BPSO Host coordinating centres, which has brought the number of institutions to 36 and the number of implemented clinical guidelines to 22. The programme has had a positive impact on organisations and the system, on care processes and on patient health. This is evidenced by enriched evidence-based professional practice, the promotion of collaborative networking and by improved patient health outcomes and the quality of care provided.
The efficacy of nursing interventions on sleep quality in hospitalized patients: A systematic review of randomized controlled trials
(Elsevier, 2021-03) Bellon, Filip; Mora-Noya, Veronica; Pastells-Peiró, Roland; Abad-Corpa, Eva; Gea-Sánchez, Montserrat; Moreno-Casbas, Teresa
Objective: To determine the effect of interventions that could be performed by nurses to improve the sleep quality of hospitalized patients in acute and semi-acute units. Design: A systematic review of randomized controlled trials and narrative synthesis. Data sources: Seven electronic databases (PubMed, CINAHL Plus, Scopus, ISI WoS, CENTRAL, PsycInfo, and Embase) were accessed on 20 May 2019 with a temporal limit of 10 years prior. Review methods: Original research studies of interventions that could be delivered by nurses to improve sleep quality during hospitalization in acute and semi-acute units were included. Study selection, data extraction, and risk of bias assessment were performed by two independent reviewers. Results: Seventeen studies met the inclusion criteria and were included in this review. The interventions carried out in the trials were classified into four categories of measurement: environmental, physical, behavioural, and combined. Fourteen studies obtained statistically significant improvements; two showed a blend of significant and non-significant improvements; and one reported non-significant results. However, only four trials of the seventeen were judged as having a low risk of bias. Conclusions: Overall evidence about interventions that could be performed by nurses to improve perceived sleep quality in hospitalized patients was found to be positive, and no negative effects were reported. However, higher quality research using both subjective and objective measures is needed, in order to strengthen the evidence.
Recursos proyecto OPTIM-PARK: Optimización de los recursos comunitarios y sistemas de apoyo para mejorar el proceso de convivencia con la enfermedad de parkinson: una intervención multisectorial
(2024) Navarta-Sánchez, María Víctoria; Palmar-Santos, Ana María; Pedraz-Marcos, Azucena; Casado-Ramirez, Elvira; Portillo, María Carmen; Rubio Casado, Laura Alicia; Pelaez Raposo, Belén; Herrero Yusta, Susana; Martín Alonso, Natalia; Bernabéu Soriano, María; Guijarro Guijarro, María Carmen; Herraiz Ahijado, Borja Jesús; Dominguez, Encinas, María Carmen; Gutierrez García, María; Martín Lara, Alicia; Gallego Rubio, María Ángeles; Campos Pardos, Concepción; González Mancebo, Bárbara; Fernández del Álamo, Patricia; Unión Europea. EU Joint Programme-Neurodegenerative Disease Research
Este documento presenta un mapa de recursos comunitarios (públicos y privados) para personas con Parkinson y sus familiares cuidadores. Su principal ventaja es que ha permitido agrupar y clasificar información sobre recursos de diversa índole (centros municipales, centros de servicios sociales, parques, asociaciones vecinales, centros culturales, etc.), que pueden proporcionar diferentes tipos de apoyos para facilitar la convivencia con el Parkinson.
Optimized Continuity of Care Report on Nursing Compliance and Review: A Retrospective Study
(Multidisciplinary Digital Publishing Institute (MDPI), 2024-08-23) Luna-Aleixos, David; Francisco-Montesó, Lorena; López-Negre, Marta; Blasco-Peris, Débora; Llagostera-Reverter, Irene; Valero-Chillerón, María Jesús; Cervera-Pitarch, Ana Dolores; Gallego-Clemente, Andreu; Leal-Costa, César; González-Chordá, Víctor M
The Continuity of Care Report (CCR) is a fundamental document for ensuring high-quality healthcare and a smooth transition between different levels of care. The aim of this study was to evaluate the impact of optimizing the CCR to improve its completion rate by hospital nurses and its review by primary care nurses. To achieve this, a retrospective observational study was conducted on patients discharged from the University Hospital of La Plana de Vila-real during two three-month periods, one prior to the CCR improvement (2022) and one after (2023). No increase in the completion rate for the CCR was observed following its optimization ( = 0.226). However, a statistically significant improvement was noted in the percentage of reports reviewed ( > 0.001), increasing from 4.4% ( = 49) in 2022 to 30.5% ( = 327) in 2023. These results indicate that the optimization of the Continuity of Care Report enhances the communication between specialized care and primary care professionals.
Monitoring of the Main Reasons for Early Abandonment of Breastfeeding during the First Six Months of Life: A Secondary Analysis
(Multidisciplinary Digital Publishing Institute (MDPI), 2024-08-09) Valero-Chillerón, María Jesús; Soriano-Vidal, Francisco Javier; Mena-Tudela, Desirée; Cervera-Gasch, Águeda; Vila-Candel, Rafael; Llagostera-Reverter, Irene; Andreu-Pejó, Laura; Ortíz-Mallasén, Víctor; González-Chordá, Víctor M; Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana
The rate of six-month-old infants exclusively breastfed in Spain remains below the recommended rate. This study aimed to explore in detail the evolution of feeding during the first six months of life of a group of newborns, as well as to identify the reasons reported by the mothers for feeding change. A secondary analysis of two prospective longitudinal observational studies was conducted. In both studies, women participants, during the clinical puerperium, opted for exclusive breastfeeding for their newborns. The participants were followed up during the infants' first six months. A sample size of 314 participants was obtained, of which 77.1% ( = 232) were of Spanish origin, and 51% ( = 160) were primiparous. The prevalence of exclusive breastfeeding at six months was 55.4% ( = 174). During the first four months of life, the main reason for early abandonment of breastfeeding was the perception of insufficient milk production. After the fourth month, the predominant reason was starting work. Statistically significant differences were observed between the reasons for giving up and the total weeks of exclusive breastfeeding ( < 0.001) and total weeks of breastfeeding ( = 0.002). Early weaning from breastfeeding is a multifactorial phenomenon. However, depending on the moment cessation occurs, some reasons predominate over others and, in many cases, can be prevented. These results indicate the need to continue investing efforts to promote and protect breastfeeding in Spain.
Development and validation of meta-measurement instruments: A methodological approach
(Elsevier, 2024) Llagostera-Reverter, Irene; Luna-Aleixos, David; Valero-Chillerón, María Jesús; González-Chordá, Víctor M; Jaume I University (España); Generalitat Valenciana (España)
[EN] A valid and reliable nursing assessment is essential for identifying required care and ensuring patient safety. The convenience of conducting a comprehensive assessment of the patient has led to a significant increase in assessment tools that may slow down the process. Nevertheless, the possibility of consolidating various instruments that measure common or similar constructs into a meta-instrument is considered an alternative that could enhance assessment efficiency. A meta-instrument can be defined as a measurement tool that consolidates other instruments based on measuring related constructs and sharing dimensions or items, aiming to achieve a more parsimonious measurement. Literature on such assessment tools is scarce, and there are numerous options for their construction and initial validation. Additionally, it is advisable to confirm their psychometric properties and ensure that they maintain, at the very least, the same diagnostic capacity as the original instruments. This article presents a proposal for the phases to follow in constructing meta-instruments, along with various methodological alternatives that can be employed based on the characteristics of the original instruments and the purpose of creating the meta-instrument. Furthermore, special attention is given to the checklists that should be used to study the psychometric properties and diagnostic capacity of the meta-instruments. Finally, future lines of research and challenges in the development of nursing assessment meta-instruments are discussed. [ES] Una valoración enfermera válida y fiable resulta imprescindible para identificar los cuidados requeridos y garantizar la seguridad del paciente. La conveniencia de realizar una valoración integral al paciente ha propiciado un considerable aumento de instrumentos de valoración que restan agilidad al proceso. No obstante, la posibilidad de colapsar varios instrumentos que presentan constructos comunes o similares en un meta-instrumento que los integre se plantea como una alternativa que puede facilitar la eficiencia de la valoración. Un meta-instrumento puede definirse como un instrumento de medida que colapsa otros instrumentos en base a que miden constructos relacionados y comparten dimensiones o ítems, con el objetivo de obtener una medición con un enfoque más parsimonioso. La literatura sobre este tipo de herramientas de valoración es escasa y las opciones para su construcción y validación inicial son amplias. Además, es conveniente confirmar sus propiedades psicométricas y que mantienen, al menos, la misma capacidad diagnóstica que los instrumentos originales. En este artículo se presenta una propuesta de las fases a seguir para la construcción de meta-instrumentos, así como diferentes alternativas metodológicas que pueden utilizarse en función de las características de los instrumentos originales y el objetivo de la creación del meta-instrumento. Además, se hace especial mención los listados de verificación que será conveniente utilizar para estudiar las propiedades psicométricas y la capacidad de diagnóstica de los meta-instrumentos. Por último, se plantean futuras líneas de investigación y retos en el desarrollo de los meta-instrumentos de valoración enfermera.
Cross-cultural adaptation and validation of the Hospital Survey on Patient Safety questionnaire for a Chilean hospital
(BioMed Central (BMC), 2024-10-12) Hurtado-Arenas, Paulina; Guevara, Miguel R; González-Chordá, Víctor M; Universidad de Playa Ancha de Ciencias de la Educación (Chile); Ministry of Education (Chile)
Background: Hospital Survey on Patient Safety version 2.0 (HSOSPS 2.0) from the Agency for Healthcare Research and Quality enables hospitals to gather the information needed to evaluate the patient safety culture within their institution. However, version 2.0 has not been widely implemented in Chile. This study aims to customize and validate the original HSOSPS 2.0 for a Chilean hospital. Methods: Translation and cross-cultural adaptation, content validity through a group of experts, and a pilot test with cognitive pretest were applied to 259 participants from the nursing team in 11 hospital services to study construct validity and reliability. Results: In the current study, a version of the questionnaire adapted to the Chilean cultural context showed excellent content validity with an index of 0.982 (S-CVI). After conducting exploratory factor analysis, a new model with 7 dimensions and 23 questions was proposed, down from the original 10 dimensions and 32 questions. This new model explains 71% of the variability. The model's goodness of fit indicators were CFI=0.995, TLI=0.994, and RMSEA=0.048. The results of McDonald's Omega showed high overall reliability with 0.9325. Conclusions: This study provides a validated measurement instrument that contributes to improving patient safety conditions at the level of the hospital nursing team in highly complex establishments in Chile. However, the dimensions, such as the number of items, were reduced This questionnaire can be used in future nursing research by expanding the sample among health professionals in Chile. Relevance to clinical practice: Applying this version of the questionnaire will be highly beneficial for clinical administrators and nursing staff. It will improve their care practices and promote patient safety in public hospitals in Chile, as well as assist in enhancing nursing policies.

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