Investigación y Educación en Enfermería

The journal Investigación y Educación en Enfermería receives the Family and Community Nursing Chair Award for “Recognition of the Scientific Development of Family and Community Nursing” from Universidad de Alicante in Spain

José Ramón Martínez Riera, María de los Ángeles Rodríguez Gazquez — Sat, 03 May 2025 00:00:00 -0500

Ethical Challenges in Abortion Decision-Making: Perspectives from Perimenopausal Women’s Nursing Care

Tram Thi Bich Nguyen, Chi-Yin Kao, Yu-Yun Hsu, Riksa Wibawa Resna — Sat, 03 May 2025 00:00:00 -0500

Serious game as an educational tool to promote the health of children and adolescents with cancer

Sat, 03 May 2025 00:00:00 -0500

Objective. To develop and evaluate the usability of a serious game as an educational tool for promoting the health of children and adolescents with cancer.

Methods. The Contextualized Instructional Design (CID) methodology was applied to develop the serious game, structured in five stages: analysis, design, development, implementation, and evaluation. Usability assessment included children and adolescents diagnosed with cancer in a public federal referral hospital in a city in Northeastern Brazil, from April to June 2024. A sociodemographic questionnaire and the System Usability Scale with values ranging from 0 to 100 points were used.

Results. The serious game, entitled Oncoped: on the health journey, is an educational and playful board game that contains eight personalized Paper Toys, 35 houses, and 100 cards divided into multiple-choice questions about cancers, diagnosis, treatments, and challenges; and cards containing information and care tips. The usability assessment was carried out by 12 hospitalized children and 3 adolescents, who after using the game filled out the information on the scale, resulting in a mean score of 95.16 points.

Conclusion. The serious game Oncoped: on the health journey is a fun and playful educational tool that provides effective and active learning. The educational technology received an excellent usability assessment among the game's target audience. Thus, it was found that the tool is innovative and has good acceptability for teaching and promoting the health of children and adolescents with cancer.

Risk and factors related to the development of lesions due to xerosis in hospitalized elderly people

Sat, 03 May 2025 00:00:00 -0500

Objective. To analyze the risk and factors related to the development of skin lesions due to xerosis in hospitalized elderly people.

Methods. This was a descriptive and cross-sectional study with 455 elderly people hospitalized in Paraíba (Brazil). The Risk Assessment Scale for the Development of Lesions Associated with Xerosis Cutis in Elderly People (ERLAX-53) developed in Brazil by Cruz in 2023 was used.

Results. The sample consisted of 272 (59.8%) elderly people from the medical clinic and 183 (40.2%) from the ICU, most of whom were females (54.5%). There were high frequencies of the variables “immobility” (58.9%), “friction and shear” (87.7%), “presence of comorbidities” (99.3%) and “predominance of dry skin” (79.8%). The correlation was positive and moderate for “mobility”, “level of consciousness”, “tactile sensitivity”, “temperature” and “phototype”. As for the risk of lesions associated with xerosis, 337 (74.1%) were at medium risk and 101 (22.2%) at high risk.

Conclusion. 96.3% of the elderly people with xerosis cutis who participate in the study were at medium to high risk of developing additional skin lesions, which is why nursing must implement preventive and treatment strategies to care for these people.

Effectiveness of an educational intervention on the components of the metabolic syndrome of adults with type 2 diabetes: non-randomized clinical trial

Sat, 03 May 2025 00:00:00 -0500

Objective. To verify the effectiveness of an educational intervention on the components of metabolic syndrome in adults with type 2 diabetes.

Methods. A non-randomized clinical trial included 51 adults (48.73±7.84 years old; 86.3% women) diagnosed with type 2 diabetes and metabolic syndrome (intervention group, n=26; control group, n=25). The intervention consisted of a multidisciplinary health promotion educational program over six months, structured in seven workshops led by nurses. The primary outcome was the improvement of metabolic syndrome components, and the secondary outcome was the reduction in the number of metabolic syndrome criteria assessed at two time points, baseline and after six months of monitoring.

Results. Compared to the control group, the educational program reduced glucose levels (p=0.001) and improved high-density lipoprotein cholesterol concentrations (p=0.001) in the intervention group participants at six months. A significant decrease in the mean metabolic syndrome score was observed in the intervention group, while the control group showed an increase (p=0.033). At the end of the study, 11.5% of the participants in the intervention group no longer met the criteria for metabolic syndrome.

Conclusion. A nurse-led health promotion educational program was effective in improving glucose and high-density lipoprotein cholesterol levels among adults with type 2 diabetes and metabolic syndrome, as well as reducing the number of metabolic syndrome components in the participants.

Determining the impact of a self-care educational program designed based on the Peplau theory on adherence to treatment and self-care in elderly patients with diabetes

Sat, 03 May 2025 00:00:00 -0500

Objective. To examine the impact of a self-care program designed using Peplau's theory on adherence and self-care in elderly diabetic patients.

Methods. This semi-experimental study involved 102 elderly diabetic patients from a diabetes clinic in Hormoz, Iran, in 2023. Participants were randomly allocated to either the control group (n=51) or the intervention group (n=51). Before and two weeks after the intervention, participants completed a demographic information questionnaire, the Modanloo Adherence to Treatment Questionnaire for Patients with Chronic Illness, and the Summary of Diabetes Self-Care Activities Scale. The intervention group received a self-care educational program based on Peplau's therapeutic communication theory, delivered in three phases: orientation, working, and termination. The program focused on key diabetes self-care factors including diet, medication adherence, physical activity, blood sugar monitoring, and foot care. Educational sessions were conducted in small groups or individually in the clinic’s education room. The control group received routine educational content provided by the diabetes clinic.

Results. The findings showed that the difference between the pre-post mean scores was significantly higher in the intervention group compared with the control group in the total self-care score, as well as in its dimensions: diet, blood sugar regulation, and foot care (p<0.001). On the other hand, in terms of adherence, no significant difference was observed in the mean difference between groups for the total score (p=0.307), although a statistical difference was found in the dimensions of willingness to participate in treatment (p=0.035) and ability to adapt (p<0.001).

Conclusion. The self-care educational program based on Peplau's theory improved the self-care and two dimensions of the adherence: willingness to participate in treatment and ability to adapt in diabetic patients.

Dreaming of motherhood: experiences of women who have undergone fertility treatment

Sara Rujas Bracamonte, Pilar Serrano Gallardo, Mercedes Martínez Marcos — Sat, 03 May 2025 00:00:00 -0500

Objective. to describe the strategies used by women who have undergone assisted reproductive technologies (ART) to cope with the process of becoming mothers and to describe their relationships with their partners and healthcare professionals throughout this process.

Methods. This is a qualitative study based on grounded theory. Twenty women who had undergone ART in Spain were selected. Semi-structured interviews were used to collect the data. The analysis followed grounded theory methods.

Results. ‘Fighting for a dream: motherhood’ is the main category describing women’s struggles from their diagnosis of infertility to their successful pregnancy and delivery. This process makes it possible for them to fulfil their dream and become parents along with their partners. Three subcategories describe the different stages in the process: ‘Accepting treatment: doing everything possible’, ‘Undergoing treatment: an emotional rollercoaster’, and ‘Reconsidering the dream: give up or gather strength to keep going?’

Conclusion. Women undergoing ART experience difficulties as they seek to achieve pregnancy, as there is no guarantee that they will be able to fulfil their greatest desire in life: motherhood. Women use a variety of coping strategies during ART and continue to seek emotional support from their peers and/or women who are experiencing the same situation.

The effect of a gratitude program based on positive thinking on nurses' resilience in the post-Coronavirus 2019 pandemic era

Ali Dehghani — Sat, 03 May 2025 00:00:00 -0500

Objective. To evaluate the effect of a gratitude program based on positive thinking on nurses' resilience in the post-Coronavirus pandemic era.

Methods. This is a quasi-experimental study. Eighty nurses in Peimanieh Hospital affiliated to Jahrom University of Medical Sciences were selected using convenience sampling method. They were randomly assigned to the intervention group (n=40) and control groups (n=40) from September to December 2023 in the southern of Iran. The intervention group were given a gratitude plan based on positive thinking in 28 days using WhatsApp in the form of daily. Training content were according to the positive psychotherapy and gratitude of Seligman and Rhonda Byrne. The subjects of control group were not taught. Data were gathered using Connor-Davidson Resilience Scale.

Results. The findings determined that immediately and two months after the intervention the total mean resilience scores had significant differences between the two groups (p<0.001). Repeated measures testing revealed significant improvements in total mean resilience scores from baseline to two months post-intervention (p=0.002), while between time points in the control group was not significant difference (p=0.32).

Conclusion. The findings provide evidence for the use of a gratitude programme, based on positive thinking, to increase resilience in nurses in the post-Coronavirus 2019 era.

Understanding the Mental Health of Students and Professors within Universities: a Cross-sectional, Multicultural Analysis across Three European Countries

Sat, 03 May 2025 00:00:00 -0500

Objective. To analyze the relationship among the professional role (student or professor), geographic location, and mental health in the university community after the COVID-19 pandemic.

Methods. Quantitative cross-sectional study conducted at universities in Spain, Germany, and the Czech Republic. Non-probability convenience sampling was used, obtaining a sample of 449 participants (372 students and 77 professors). Mental health was assessed using the Scale for Mood Evaluation (EVEA), measuring sadness-depression, anxiety, anger-hostility, and happiness.

Results. Significant differences were found between students and professors, with students reporting higher levels of sadness-depression (3.8 vs. 2.4; p<0.001), anxiety (4.6 vs. 2.9; p<0.001), and anger-hostility (3.4 vs. 2.5; p<0.01). Professors showed higher levels of happiness (6.7 vs. 5.4; p<0.001). In addition, differences among countries were observed: participants from Spain showed higher levels of sadness-depression and anxiety compared to Germany and the Czech Republic.

Conclusion. University students have greater emotional vulnerability than professors, highlighting the need for differentiated psychosocial support strategies in the academic setting.

Health Sciences Students: Witnesses of Discrimination in the Care of Foreign Patients in Chile

Sat, 03 May 2025 00:00:00 -0500

Objective. This work sought to inquire on the perception of Health Sciences students about the health care provided to patients of foreign origin in clinical environments.

Methods. Phenomenological approach with multiple case study design. Health Sciences students from three Chilean universities participated with intensity sampling. Semi-structured interviews were conducted via Zoom after the consent was signed. Data analysis included open and axial coding axial with the aid of the ATLAS.ti 24 software.

Results. The study had the participation of 106 students, who identified different types of discrimination, besides diverse exclusion manifestations that take place during the care process, such as: apathy, prejudice/stereotyping, derogatory comments, evading, underestimating, normalizing discrimination, infantilizing, and scoffing. Some of the participants normalized these behaviors due to the overload health system.

Conclusion. The Health Sciences students witnessed several types of discrimination and exclusion manifestations occurring during the care process, highlighting apathy and evading as characteristic of the clinical environment, which could favor negative vicarious learning that perpetuates discriminatory conducts against foreign patients.

Depressive symptoms and frailty, effects of social distancing and isolation in older adults

Sat, 03 May 2025 00:00:00 -0500

Objective. To analyze the effects of social distancing and isolation during the Covid-19 pandemic on depressive symptoms and frailty in older adults in Primary Health Care. Methods. Prospective cohort study, using the following data collection instruments: Center for Epidemiological Studies depression scale, adherence to social distancing and isolation, and markers of the physical frailty phenotype. Descriptive statistical analysis, association and proportional hazards regression were performed. Results. 51.8% of the older adults progressed to pre-frailty, 14.1% had depressive symptoms, and a low degree of adherence to social distancing and isolation (69.4%). There was no association between distancing and isolation and depressive symptoms (p=0.748) and physical frailty (p=0.5). Single, separated, divorced or widowed people have 62% (HR=0.38; 95%CI 0.15-0.96) less risk of being classified as frail and 57% (HR=0.43; 95%CI 0.21- 0.9) less chance of presenting depressive symptoms compared to married people. Conclusion: the low degree of adherence to social distancing and isolation showed no association with depressive symptoms and physical frailty. Sociodemographic factors highlighted risks of frailty and depressive symptoms that require attention and an individualized gerontological care plan.

Affective states and stress in health-professional caregivers of people with functional diversity: the important role of empathy and social support as mediators of this relationship

Elvira García Marín, Marián Pérez Marín, Ana Martínez Cuevas — Sat, 03 May 2025 00:00:00 -0500

Objective. The aim of this study was to analyse how empathy and social support mediate levels of perceived and relational stress, depending on the person's type of affect.

Methods. This was a multicentre, cross-sectional, descriptive study. The sample consisted of 756 working health professionals for people with functional diversity in the province of Valencia. The following scales were analysed: (i) Perceived Stress Scale; (ii) The Nurse Stress Scale; (iii): Empathy Quotient (EQ); (iv) Social Support Questionnaire, and (v) Scale of Positive and Negative Affects. Descriptive statistics, reliability tests, comparison of means, correlation coefficients and PROCESS were performed.

Results. The findings showed that stress was positively correlated with negative affects, and negatively correlated with empathy, social support and positive affects, and that these variables influence perceived stress, significantly reducing its levels, while the effect of these variables on relational stress was not significant.

Conclusion. The data obtained highlights the importance of empathy and a good social support network in these professionals and how this will influence the care and relationship with the users.

Nursing Intervention "EducaTHE" to Improve Knowledge and Self-care Behaviors for Hypertensive Disorders in Pregnant Women: a Randomized Controlled Pilot Study

Iliana Milena Ulloa Sabogal, Mauricio Arias Rojas — Sat, 03 May 2025 00:00:00 -0500

Objective. This work sought to determine the feasibility, acceptability, and potential effect of the nursing intervention “Knowledge and self-care behaviors of pregnant women in the face of hypertensive disorders of pregnancy - EducaTHE”.

Methods. This study is a pilot randomized controlled trial. Sixty pregnant women who were enrolled in the antenatal care program of a health institution participated. They were selected via simple random sampling and assigned to the experimental group (n = 30) and control group (n = 30). The intervention consisted of four educational sessions once a week, while the control group received usual antenatal care. Recruitment, follow-up, and dropout rates were assessed, as well as participant satisfaction. Both groups completed the "Knowledge and Self-Care Behaviors - CoNOCiTHE" and "Determinants of Behavior" scales before and four weeks after the intervention to assess impact.

Results. The recruitment rate was 75.94%, 90% at follow-up and 10% dropouts. Overall satisfaction was 4.82 out of 5. The effect of the intervention showed a significant increase in the level of knowledge and behaviors in the experimental group compared to the control group (77 vs. 69; p< 0.001) and in the determinants of behavior (159 vs. 154; p=0.066), and a large effect size (d-Cliff = 0.7517). These changes were not significant in the control group (p≥0.05).

Conclusion. This study shows the feasibility and acceptability of the intervention in the maternal population, as well as the potential effect of improving knowledge and self-care behaviors in the face of hypertensive disorders of pregnancy. Therefore, it is recommended to use these types of educational interventions in maternal and perinatal nursing care.

Resilience as Empathy Predictor in Nursing Students

Sat, 03 May 2025 00:00:00 -0500

Objective. To determine if resilience can predict empathy. Specifically, explain what would be the effect of the resilience dimensions on the dimensions of empathy in the nursing students examined in this study.

Methods. Cross-sectional study with the participation of 340 nursing students from a private university in Colombia. Jefferson’s Empathy Scale (student version) and the Resilience-Trait Scale were used. The complete psychometry of the Empathy and Resilience scales was carried out, followed by the application of Structural Equations.

Results. Ecological Resilience predicts negatively the dimensions of “Compassionate Care” (β = -0.11) and “Walking in the patient’s shoes” (β = -0.19); the Engineering Resilience predicts positively the dimension “Walking in the patient’s shoes” (β = 0.08).

Conclusion. Overall, resilience predicts empathy, thereby, introducing empathetic training of nursing students in the population studied must also include training in resilience.

Potentialities and challenges of stricto sensu graduate studies in health: A qualitative meta-synthesis

Sat, 03 May 2025 00:00:00 -0500

Objective. To analyze the potentialities and challenges of stricto sensu graduate programs in the health field from the perspective of post-graduate students and graduates.

Methods. This study is a qualitative meta-synthesis analyzing 23 studies selected from the following databases: BDENF, LILACS, MEDLINE via PubMed, PsycINFO and Scopus in Spanish, English and Portuguese, published between 2002 and 2022. Data were analyzed using the constant comparative analysis technique.

Results. The synthesis identified the potentialities and challenges of stricto sensu graduate studies across four domains: personal, academic, professional, and social. Key potentialities included the development of research skills, the production of relevant studies, the training of highly qualified professionals, and interdisciplinary collaboration. However, significant challenges were also noted, such as time management difficulties, high academic demands, competitiveness, workload overload, financial constraints, and professional undervaluation.

Conclusion. The qualitative studies reviewed highlight both the potentialities and challenges of stricto sensu graduate programs in the health field, emphasizing their impact on personal, academic, professional, and social aspects. It is essential for training institutions to develop and implement strategies that support graduate students in overcoming the challenges inherent in this formative process.

Care provided by humanoid robots: a scoping review

Sat, 03 May 2025 00:00:00 -0500

Objective. To identify the evidence in the literature regarding the care provided to the population by humanoid robots.

Methods. A scoping review based on the guidelines established by the Joanna Briggs Institute. The Preferred Reporting Items for Scoping Review (PRISMA-ScR) checklist was followed. The review protocol was registered on the Open Science Framework under the number osf.io/6ur93. The search was conducted in November 2023 in the following databases: PubMed®, EMBASE®, LILACS, Web of Science, Scopus®, and CINAHL, as well as in the gray literature, including Google Scholar and the Catalog of Theses and Dissertations of the Coordination for the Improvement of Higher Education Personnel (CAPES), using the search strategy: “humanoid robot*” AND “patient*”.

Results. A total of 27 articles were analyzed. Most of the identified studies were conducted in hospital settings (n=13), with a primary focus on adults (n=10) and children (n=8). The countries with the highest number of publications were Japan (n=6), Canada (n=5), and France (n=4). Three areas of care were identified: social interaction (n=17), physical rehabilitation (n=7), and dissemination of health information (n=3). Additionally, only four studies involved collaboration between humanoid robots and healthcare providers.

Conclusion. Despite the increasing use of humanoid robots in healthcare, it remains essential to enhance their integration with professionals in the field. Social interaction highlighted the need to improve patient care, underscoring the importance of aligning the capabilities of these robots with the expertise of healthcare providers. Accordingly, future research should focus on developing strategies that ensure this technology not only assists but also optimizes the quality of care and strengthens interdisciplinary collaboration.

Pain manifestations in nursing professionals: a scoping review

Sat, 03 May 2025 00:00:00 -0500

Objective. To map the literature on the prevalence of pain in nursing professionals.

Methods. This is a scoping review that was conducted according to the Joanna Briggs Institute (JBI) methodology for scoping reviews, and according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). The protocol was developed and registered in the Open Science Framework (OSF) [https://osf.io/2zu73/]. The search was carried out in the following databases: PubMed/MEDLINE, Virtual Health Library (VHL), Web of Science, Scientific Electronic Library Online (SciELO), SciVerse Scopus, Embase, and the Catalog of Theses and Dissertations of the Coordination for the Improvement of Higher Education Personnel (CAPES).

Results. A total of 49 studies were included, all of which were cross-sectional studies, and the total sample of the included studies was 35,069 participants. Most of the included studies were concentrated in the Asian continent (71.4%). Among the selected studies, it was shown that the most affected area was the lumbar region (81.57%), followed by the neck (71.5%) and shoulder (31.57%) regions.

Conclusion. According to the studies evaluated, the prevalence of occupational pain in nursing professionals was of musculoskeletal origin. The high prevalence of pain found reinforces the importance of monitoring the health of nursing workers.