Exercise prescription for the prevention and treatment of chronic diseases in primary care: Protocol of the RedExAP study.

BACKGROUND: Existing evidence supports the effectiveness of exercise in preventing and treating chronic diseases, yet its integration into clinical practice remains limited. This study protocol aims to address the evidence-practice gap by exploring barriers to exercise prescription in primary care and developing a clinical practice guideline (CPG). METHODS: Employing a qualitative approach, focus groups will be conducted to investigate primary care professionals' challenges in prescribing exercise and patients' adherence to recommendations. Phenomenological analysis will facilitate data interpretation. Data triangulation, expert analysis, and quality criteria will ensure study reliability. The CPG development process is outlined, emphasizing transdisciplinary collaboration and patient involvement. CONCLUSION: The RedExAP study responds to the imperative for evidence-based exercise integration in primary care. The study's combined qualitative exploration and CPG development present the potential to improve health outcomes and cost-effectiveness. By elucidating primary care professionals' and patients' perspectives, the study contributes to enhancing exercise prescription adoption. The innovative transdisciplinary approach aligns with the 2030 Agenda, promoting better population health and greater social well-being, showing promise in alleviating chronic disease burdens. This study's findings lay the groundwork for advancing evidence-based exercise interventions within primary care to transform chronic disease management.

Efficacy of the use of video games on mood, anxiety and depression in stroke patients: preliminary findings of a randomised controlled trial.

BACKGROUND: In the different published studies, there is no consensus on the efficacy of virtual reality as an adjuvant treatment of mood states. AIM: The aim of this study is to evaluate the impact of no immersive virtual reality with the Nintendo Switch device in rehabilitation treatment on mood, anxiety and depression in stroke patients admitted to neurorehabilitation units. METHODS: Fifty-eight patients admitted to neurorehabilitation units underwent a 1:3 multicentre randomised clinical trial. The intervention group consisted of 17 patients and the control group of 41 patients. The intervention group performed 6 virtual reality sessions together with the conventional treatment, and the control group performed only the conventional rehabilitation sessions. Primary and secondary clinical outcomes were measured before and six weeks after the intervention. RESULTS: Comparing the intervention group and control group, the anxiety levels of the intervention group decreased compared to the results observed in the control group (p = 0.01), as did the dependence of the intervention group (0.015). On the other hand, the results obtained after the intervention by the control group for anxiety (0.479) and depression (0.292) were not statistically significant. CONCLUSION: Rehabilitation VR used as an adjuvant treatment to conventional treatment has a beneficial impact on the neurological status and state of anxiety of stroke patients admitted to neurorehabilitation units. TRIAL REGISTRATION: Registered in the https://clinicaltrials.gov/ repository (NTC NCT05143385). Protocol registration date 7 October 2021, retrospectively registered.

Impact of virtual reality-based therapy on post-stroke depression: A systematic review and meta-analysis of randomized controlled trials.

BACKGROUND: Post-stroke depression is the most common neuropsychiatric consequence and reduces rehabilitation effectiveness. However, the efficacy of virtual reality (VR) on mental health treatment for patients after a stroke is uncertain. AIMS: The aim of this study was to evaluate the efficacy of VR as a co-adjuvant form of treatment to reduce depression in stroke patients admitted to neurorehabilitation units. METHODS: We systematically searched medical databases including PubMed, CINAHL, PsycINFO, Embase, Cochrane Library, Web of Science, and ClinicalTrials.gov from inception to November 16, 2023. Clinical trials comparing the use of VR as an adjuvant form of treatment in stroke patients' rehabilitation with the usual treatment were included. Pooled standardized mean differences were calculated using a random-effects model. Subgroup analyses were performed according to type of stroke, VR characteristics, and the scale used to measure depression. Meta-regression analysis was performed for intervention duration and to determine the mean age of the participants. RESULTS: Eight studies and 388 stroke patients were included. The VR interventions were associated with a lower risk of depression in patients (ES = -0.69; 95% CI [-1.05, -0.33]; I2 = 57.6%; p ≤ .02). The estimates were not affected by the type of stroke, the type of VR used, the blinding process, the type of scale used to detect depression, the duration of the intervention (weeks and minutes), and the total number of sessions. Meta-regression shows that younger samples (p = .00; 95% CI [0.01, 0.08) and longer interventions (p = < .05; 95% CI [-0.00, -0.00) lead to a greater reduction in depression. LINKING EVIDENCE TO ACTION: This review provides an important basis for treating depression in patients after a stroke. Professionals working in stroke neurorehabilitation units should consider VR as a form of co-adjuvant treatment for depression in patients. SYSTEMATIC REVIEW REGISTRATION: CRD42022303968.

[Adaptation and validation of the MoVac-flu scale on motivation towards the flu vaccine]. / Adaptación y validación de la escala MoVac-flu sobre motivación hacia la vacuna de la gripe.

OBJECTIVE: To translate, adapt and validate the psychometric properties of MoVac-flu scale in order to be used in Spanish. METHOD: The present research was an analytical observational study of cross-cultural adaptation and validation into Spanish of the MoVac-flu scale. It has been carried out between the months of March and July 2022. The sample size was 142 people who were obtained by consecutive sampling. The processes used for the adaptation have been translation, validation by a committee of experts, back-translation and pilot test. For validation, the psychometric properties of reliability, internal consistency, appearance validity, content validity, utility and ceiling-floor effect have been verified. RESULTS: The internal consistency of the MoVac-flu scale in its version translated into Spanish was high, showing a McDonald's ω of 0.914. CONCLUSIONS: The MoVac-flu scale in Spanish allows to measure the degree of motivation towards vaccination against influenza in the adult population.

The role of life satisfaction in the association between problematic technology use and anxiety in children and adolescents during the COVID-19 pandemic.

The main aim of this study is to explore problematic technology use among adolescents (Internet, video games, mobiles, and television) and its association with anxiety symptoms. Furthermore, we also analysed the possible moderating role of life satisfaction in this relationship during the COVID-19 pandemic in Spain. A cross-sectional survey of 4025 children and adolescents (52% females and 48% males) between 12 and 18 years old was carried out to explore problematic technology use and its correlation with anxiety and life satisfaction after pandemic lockdown. Four multivariate regressions containing the independent variable (problematic technology use), the moderator (life satisfaction), and their interaction were entered to predict the outcome (anxiety). The moderated models were examined using SPSS PROCESS macro software (Model 1). Analyses showed significant positive correlations with anxiety and negative correlations with life satisfaction regarding problematic technology use (mobile phone, television, and internet). Both gender and age had a significant direct effect on anxiety (showing that women and older participants had the greatest anxiety). In the moderation analysis, when life satisfaction was higher, the presence of anxiety symptoms depended to a greater extent on the problematic use of technology. Our results confirm that problematic technology use is related to higher levels of anxiety in adolescents, with differences by age and gender. The results also showed that life satisfaction mediated the relationship between technology abuse and anxiety, such that when life satisfaction was higher, the presence of anxiety symptoms was more dependent on problematic technology use. These findings have implications for health and education professionals.

Adaptación y validación de la escala MoVac-flu sobre motivación hacia la vacuna de la gripe / Adaptation and validation of the MoVac-flu scale on motivation towards the flu vaccine

Objetivo: Realizar una traducción, adaptación y validación de las propiedades psicométricas de la escala MoVac-flu para ser utilizada en español. Método: Estudio observacional analítico de adaptación transcultural y validación al español de la escala MoVac-flu. Se llevó a cabo entre los meses de marzo y julio del año 2022. El tamaño muestral fue de 142 personas que se reclutaron mediante muestreo consecutivo. Los procesos utilizados para la adaptación fueron traducción, validación por comité de expertos, retrotraducción y prueba piloto. Para la validación se comprobaron las propiedades psicométricas de fiabilidad, consistencia interna, validez de apariencia, validez de contenido, utilidad y efecto techo-suelo. Resultados. La consistencia interna de la escala MoVac-flu en su versión traducida al español fue alta, con una ω de McDonald de 0,914. Conclusiones: La escala MoVac-flu en español permite medir el grado de motivación ante la vacunación frente a la gripe de la población adulta.(AU)

Objective: To translate, adapt and validate the psychometric properties of MoVac-flu scale in order to be used in Spanish. Method: The present research was an analytical observational study of cross-cultural adaptation and validation into Spanish of the MoVac-flu scale. It has been carried out between the months of March and July 2022. The sample size was 142 people who were obtained by consecutive sampling. The processes used for the adaptation have been translation, validation by a committee of experts, back-translation and pilot test. For validation, the psychometric properties of reliability, internal consistency, appearance validity, content validity, utility and ceiling-floor effect have been verified. Results: The internal consistency of the MoVac-flu scale in its version translated into Spanish was high, showing a McDonald's ω of 0.914. Conclusions: The MoVac-flu scale in Spanish allows to measure the degree of motivation towards vaccination against influenza in the adult population.(AU)

Efficacy of the therapeutic use of video games on the depressive state of stroke patients: Protocol for systematic review and meta-analysis.

AIM: To assess the effects of virtual reality (VR) on the depressive state of patients with stroke admitted to neuro-rehabilitation units. Design: Systematic review and meta-analysis protocol. METHODS: Randomized Controlled Trials (RCTs) focusing on the effects of virtual reality on depressive state as a primary outcome will be included. Grey literature and the following databases will be consulted: PubMed, Cinahl, PsycInfo, Scopus, Embase, Cochrane Library and Web of Science. The recently revised Cochrane risk of bias tool will be used to assess the quality of included studies. Data will be extracted and meta-analyses will be performed within the specific condition of the emotional state of stroke patients admitted to neurorehabilitation units. Meta-regression and subgroup analyses will be used to identify effective modes and patterns of therapy delivery. The approach of assessment, development and evaluation of recommendations will be applied to reach a convincing conclusion. DISCUSSION: An accurate, transparent and standardized review process is expected to provide recommendations on the use of VR technology in the healthcare of stroke patients. IMPACT: Emotional difficulties are common after stroke and have an impact on rehabilitation outcome. VR seems to have an important role in the treatment and depression in neurological patients, as it is able to improve levels of well-being, coping strategies and social relationships. The systematic review may contribute to a more convincing and specific conclusion compared to existing studies of this type. TRIAL REGISTRATION: Systematic review registration: CRD42022303968.

Limitation of therapeutic effort experienced by intensive care nurses.

BACKGROUND:: Nurses who practice limitation of therapeutic effort become fully involved in emotionally charged situations, which can affect them significantly on an emotional and professional level. OBJECTIVES:: To describe the experience of intensive care nurses practicing limitation of therapeutic effort. METHOD:: A qualitative, phenomenological study was performed within the intensive care units of the Madrid Hospitals Health Service. Purposeful and snowball sampling methods were used, and data collection methods included semi-structured and unstructured interviews, researcher field notes, and participants' personal letters. The Giorgi proposal for data analysis was used on the data. ETHICAL CONSIDERATIONS:: This study was approved by the Ethical Research Committee of the relevant hospital and by the Ethics Committee of the Rey Juan Carlos University and was guided by the ethical principles of voluntary enrollment, anonymity, privacy, and confidentiality. RESULTS:: In total, 22 nurses participated and 3 themes were identified regarding the nurses' experiences when faced with limitation of therapeutic effort: (a) experiencing relief, (b) accepting the medical decision, and (c) implementing limitation of therapeutic effort. CONCLUSION:: Nurses felt that, although they were burdened with the responsibility of implementing limitation of therapeutic effort, they were being left out of the final decision-making process regarding the same.

Dificultades para ofrecer cuidados al final de la vida en las unidades de cuidados intensivos. La perspectiva de enfermería / End of life care difficulties in intensive care units. The nurses’ perspective

Objetivo: Describir las dificultades percibidas por el personal de enfermería para prestar cuidados al final de la vida al paciente grave dentro de la unidad de cuidados intensivos (UCI). Método: Estudio cualitativo fenomenológico descriptivo. Se aplicó un muestreo por propósito y de bola de nieve. Las enfermeras debían tener una experiencia mínima de 1 año en UCI. Se incluyeron 22 participantes. Los datos se recopilaron mediante entrevistas en profundidad (no estructuradas y semiestructuradas) y notas de campo del investigador. El análisis se realizó mediante la propuesta de Giorgi. Resultados: Se identificaron tres temas: dificultades académico-culturales, relacionadas con la orientación curativa de la UCI y la falta de formación en cuidados al final de la vida; dificultades estructurales-arquitectónicas, relacionadas con la falta de espacio e intimidad para el paciente y la familia en los últimos momentos; y dificultades psicoemocionales, relacionadas con el distanciamiento emocional como estrategia aplicada por el personal de enfermería. Conclusiones: El personal de enfermería necesita formación sobre los cuidados al final de la vida mediante el uso de guías o protocolos y el desarrollo de estrategias de afrontamiento, junto a un cambio en la organización de la UCI orientado al cuidado terminal de los pacientes graves y a la atención de la familia (AU)

Objective: To describe the difficulties perceived by nursing staff in the delivery of end-of-life care to critically ill patients within intensive care units (ICU). Method: A descriptive phenomenological qualitative study was performed. A purposeful and snowball sampling of nursing staff with at least 1 year's previous experience working in an ICU was conducted. Twenty-two participants were enrolled. Data collection strategies included in-depth unstructured and semi-structured interviews and researcher's field notes. Data were analysed using the Giorgi proposal. Results: Three themes were identified: academic-cultural barriers, related to the care orientation of the ICU and lack of training in end of life care; architectural-structural barriers, related to the lack of space and privacy for the patient and family in the last moments of life; and psycho-emotional barriers, related to the use of emotional detachment as a strategy applied by nursing staff. Conclusions: Nursing staff need proper training on end-of-life care through the use of guidelines or protocols and the development of coping strategies, in addition to a change in the organisation of the ICU dedicated to the terminal care of critically ill patients and family support (AU)

[End of life care difficulties in intensive care units. The nurses' perspective]. / Dificultades para ofrecer cuidados al final de la vida en las unidades de cuidados intensivos. La perspectiva de enfermería.

OBJECTIVE: To describe the difficulties perceived by nursing staff in the delivery of end-of-life care to critically ill patients within intensive care units (ICU). METHOD: A descriptive phenomenological qualitative study was performed. A purposeful and snowball sampling of nursing staff with at least 1 year's previous experience working in an ICU was conducted. Twenty-two participants were enrolled. Data collection strategies included in-depth unstructured and semi-structured interviews and researcher's field notes. Data were analysed using the Giorgi proposal. RESULTS: Three themes were identified: academic-cultural barriers, related to the care orientation of the ICU and lack of training in end of life care; architectural-structural barriers, related to the lack of space and privacy for the patient and family in the last moments of life; and psycho-emotional barriers, related to the use of emotional detachment as a strategy applied by nursing staff. CONCLUSIONS: Nursing staff need proper training on end-of-life care through the use of guidelines or protocols and the development of coping strategies, in addition to a change in the organisation of the ICU dedicated to the terminal care of critically ill patients and family support.

Facing death in the intensive care unit. A phenomenological study of nurses' experiences.

BACKGROUND: Nurses may experience considerable emotional burden due to patient death, in part as they are generally the professionals who have the most contact with patients. OBJECTIVE: To describe the lived experience of Spanish nurses working in intensive care units regarding how they face the death of their patients. METHODS: A qualitative phenomenological study was performed. A purposeful sample was used. The data collection strategies used included in-depth unstructured and semi-structured interviews, field notes and personal documents. Afterwards, data were analyzed using the Giorgi proposal. RESULTS: 22 nurses participated, with a mean age of 40.8 years and a mean work experience of 13.8 years. Three themes were identified: 1) dealing with expectations of recovery, 2) accepting the age of death, and 3) experiencing emotional attachment. CONCLUSIONS: Nurses in intensive care units report a great emotional burden derived from patients death, Support programs for nurses should be organised within these units.

Los cuidados de la higiene oral de los ancianos con demencia en las residencias / Oral hygiene care for adults with dementia in residential aged are facilities

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Nuevo impulso a la investigación en enfermería en España: establecimiento del Centro Colaborador Español del Instituto Joanna Briggs para los Cuidados de Salud Basados en la Evidencia / New impetus to nursing research in Spain: establishment of the Spanish Collaborating Center of the Joanna Briggs Institute for Evidence-Based Healthcare

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