María Dolores Guerra-Martín

Background/Objectives: Chronic non-cancer pain often requires approaches beyond pharmacological treatment. This protocol describes a mixed-methods study evaluating the effectiveness of a multicomponent intervention based on non-pharmacological therapies (NPhTs) and exploring participants’ post-intervention experience. Methods: The design includes a randomized, controlled, two-arm parallel-group clinical trial with 1:1 allocation, embedded within a mixed-methods approach that includes a qualitative phenomenological strand. This study will be conducted at Hospital San Juan de Dios del Aljarafe, Spain. A total of 160 adults with chronic non-cancer pain will be randomly assigned to the intervention or control group. The intervention group will receive five weekly 3.5 h face-to-face sessions combining pain education, emotional regulation, cognitive-motivational and mind–body techniques, lifestyle recommendations, peer support, and home practice, supported by a mobile application. The control group will continue usual care, without the workshop or intervention-related app content. The primary outcome will be change in the EuroQol-5D (EQ-5D) index from baseline to 1 month. Secondary outcomes will include the EQ-5D visual analogue scale (VAS) score, pain intensity, well-being, self-esteem, resilience, anxiety and depression, pain catastrophizing, medication use, and healthcare resource use. Outcomes will also be assessed at 4 months and, in the intervention group, at 7 months. Semi-structured interviews will explore the participants’ experiences, perceived usefulness of the techniques, and barriers and facilitators to maintaining the strategies learned. Conclusions: This protocol will evaluate the effectiveness and acceptability of a structured group-based NPhT intervention for chronic non-cancer pain. The findings may inform its applicability to person-centered and self-care-oriented models of care. Trial registration: ClinicalTrials.gov NCT06440668.

Background/Objectives: Breast cancer is the most prevalent malignancy among women worldwide and remains a major cause of morbidity and mortality. Conventional treatments, while effective, often produce physical and psychological adverse effects that impair quality of life. Complementary therapies (CTs) have gained prominence as supportive strategies to mitigate these effects. This systematic review aimed to evaluate the potential benefits of CTs in women with breast cancer undergoing or having completed chemotherapy and radiotherapy. Methods: Following PRISMA 2020 guidelines and Cochrane standards, a systematic search was conducted in PubMed, CINAHL, Web of Science, and Scopus for studies published up to March 2026. Randomized controlled trials assessing CTs in breast cancer patients were included. Methodological quality was appraised using the PEDro scale, and risk of bias was evaluated using the Cochrane RoB 2 tool. Results: Thirty-two RCTs met the inclusion criteria. The interventions included acupuncture and related techniques, mindfulness-based therapies, massage, dance–movement therapy, music therapy, slow breathing, prayer, and natural products. Overall, CTs produced improvements in pain, fatigue, anxiety, depression, sleep quality, and social well-being, though the effects were sometimes therapy-specific and varied. Conclusions: Complementary therapies represent non-pharmacological strategies that may offer potential benefits across physical, emotional, and social outcomes in women with breast cancer. However, mixed results in certain therapies indicate that conclusions must be drawn cautiously. Future research should pursue methodological consistency and longer follow-ups.

Purpose: This study aimed to explore Nursing students' opinions and perceptions of their experiences with Clinical Simulation services at three centres affiliated with a public university in southern Spain. Design/methodology/approach: A qualitative, descriptive-interpretive design was applied with third-year Nursing students who had completed a ten-session Clinical Simulation-based “Life Support” course. Open-ended responses regarding their perceptions of the service were analysed through categorical content analysis using Atlas.ti. Two independent evaluators conducted the analysis to ensure and enhance the trustworthiness of findings. Findings: Approximately one-third of students provided a total of 96 verbatim statements, classified into three categories: (1) Time, (2) Resources and infrastructures, and (3) Utility of Clinical Simulation and adequacy. Students valued clinical simulation as an effective learning strategy bridging theory and practice, yet identified shortcomings in session duration, material accessibility, and realism of scenarios. Conclusions: The study highlighted the need to expand clinical simulation session time, improve material quality and accessibility, and diversify clinical scenarios to enhance realism and student engagement. These findings provided actionable insights for educators and institutions to optimise clinical simulation implementation, ensuring that simulation-based education fulfilled its potential as a core pedagogical tool in Nursing curricula. Originality/value: Students perceived clinical simulation as an effective learning method. More time and frequency for simulation sessions were widely requested access to simulation materials outside class time was considered insufficient. Students reported poor quality and limited variety in simulation scenarios. Smaller group sizes were recommended to improve simulation experience.

Se trata de un recurso visual que informará al espectador del proyecto que se está realizando. Proyecto obtenido mediante la ayuda del VII Plan Propio de Investigación y Transferencia, en el Programa al Estímulo de Áreas con Necesidades Investigadoras y de la Actividad Investigadora Emergente. Este recurso didáctico está dirigido, principalmente, a estudiantes de Grado y Posgrado en Enfermería, así como a profesionales en activo que desempeñan su labor en el ámbito de la Enfermería Escolar. Se encuadra especialmente en asignaturas relacionadas con la Enfermería Comunitaria, Salud Pública y Enfermería de la Infancia y Adolescencia, donde el abordaje de los trastornos de la conducta alimentaria (TCA) y el bienestar emocional son competencias transversales críticas. Debido a la creciente complejidad de la salud mental infantojuvenil tras la pandemia, es fundamental que el futuro profesional desarrolle habilidades para la detección precoz de alteraciones vinculadas a problemas emocionales. El recurso sirve como una herramienta de transferencia de conocimiento cualitativo, permitiendo a los estudiantes conocer de primera mano las actitudes, creencias y retos reales que enfrentan las enfermeras escolares en las provincias andaluzas. Al integrar narrativas obtenidas mediante entrevistas semiestructuradas y analizadas bajo rigor científico, este video permite a los alumnos analizar casos prácticos desde una perspectiva fenomenológica. Su utilidad reside en servir de puente entre la teoría académica y la práctica asistencial, facilitando la implementación de protocolos de intervención integral y reforzando el rol de la enfermería como figura esencial para promover una escuela más sana y resiliente. Este recurso audiovisual se fundamenta en el fenómeno de la interrelación entre la salud mental y la conducta alimentaria en el entorno escolar, un vínculo cuya complejidad se ha visto intensificada en el escenario pospandemia. El concepto central es el papel de la enfermera escolar como figura estratégica para la detección precoz y la intervención integral en las aulas. Desde una perspectiva teórica, el recurso explora las actitudes, creencias y percepciones de los profesionales de enfermería como determinantes de la calidad del cuidado. Se basa en la premisa de que el conocimiento profundo de los factores emocionales que influyen en la alimentación es esencial para fundamentar la promoción de una "escuela sana". En cuanto a su base metodológica, el material contribuye a entender la aplicación de la investigación cualitativa descriptiva en el ámbito asistencial. El proceso sigue los estándares internacionales de la guía COREQ y utiliza el análisis de contenido temático de carácter inductivo, apoyado por herramientas tecnológicas como el software NVivo 14, para transformar las experiencias individuales en narrativas que integren hallazgos científicos transferibles a la práctica profesional.

Background/Objectives: Between 20 and 30% of the global population experiences Chronic Pain (CP). A comprehensive, interdisciplinary approach incorporating non-pharmacological interventions and active patient participation is recommended. This study evaluated the short- and medium-term effectiveness of a multicomponent workshop compared with a control group. Methods: A detailed description of the workshop and a single-group before–after evaluation in 197 patients were recently published. The present study used a quasi-experimental before–after design with a three-month follow-up, comparing an intervention group (n = 64) with a contemporaneous control group that continued with usual care (n = 64). Validated scales were used to measure pain, well-being, quality of life (QoL), self-esteem, resilience, anxiety, and depression. Two ad hoc surveys assessed satisfaction and perceived impact on pain, medication use, habits, and mood. Results: A total of 128 patients participated (64 per group). The intervention group showed statistically significant improvements in all indicators at both short-term (end of workshop) and medium-term (three months) follow-up. Pain decreased by −1.3 (−3.0–0) [3 months: −1.0 (−3.0–−1.0)], anxiety by −3.0 (−5.0–−1.0) [3 months: −3.0 (−5.0–1.0)], and depression by −4.0 (−7.0–−2.0) [3 months: −3.0 (−6.0–0)]. Well-being increased by 3.0 (1.0–4.0) [3 months: 1.0 (0–4.0)]; QoL by 0.213 (0.072–0.388) [3 months: 0.185 (0.013–0.337)]; perceived health by 13.5 (0–30.0) [3 months: 10.0 (0–30.0)]; self-esteem by 4.5 (1.0–7.3) [3 months: 3.0 (−1.0–6.0)], and resilience by 1.0 (−1.0–5.0) [3 months: 1.0 (0.0–5.0)]. In the control group, resilience worsened (−1.0 [−5.0–1.0], p = 0.002) and depression increased (1.0 [−1.0–3.0], p = 0.037). Pain decreased in 47 participants (74.6%) at the end of the workshop [3 months: 34 (65.4%)]. Of 55 who used medication, 48 (81.4%) reduced their intake [3 months: 34; 68.0%]. Healthy habits improved in 58 (92.1%) [3 months: 40; 78.4%]. Mood improved: 26 (41.3%) described themselves as “cheerful” and 24 (38.1%) as “neutral” [3 months: 23; 44.2% and 14; 26.9%]. Overall satisfaction: 9.7 (scale 0–10). Conclusions: The workshop enabled patients to mitigate pain, actively participate in self-care, and improve quality of life, self-esteem, and emotional well-being. These effects persisted three months post-intervention.

Background: Chronic pain is a prevalent and disabling condition, affecting 20–30% of the global population, which requires multidisciplinary approaches integrating non-pharmacological therapies and promoting patient engagement in self-management. Objective: To describe the structure, content, outcomes, and lessons learned from multicomponent workshops for chronic non-cancer pain using non-pharmacological therapies. Methods: A quasi-experimental before–after study was conducted in patients attending a chronic pain workshop at San Juan de Dios Hospital (Bormujos, Seville, Spain) between November 2021 and May 2024, with a 3-month follow-up, Validated scales and an ad hoc patient survey were administered at baseline, immediately post-workshop, and at 3-month follow-up. Furthermore, comparative analysis was conducted 4 months before and after the intervention for emergency visits and consultations, medication consumption, and employment status. Analyses employed Chi-square or Fisher’s exact tests (categorical variables); student’s t-tests or Mann–Whitney U (between-group); paired t-tests or Wilcoxon (within-group pre–post); and effect sizes (Cohen’s d, Rosenthal’s r). Significance was set at p < 0.05. Results: 197 patients completed the workshop; 178 (90.4%) were women, mean age: 55.0; 114 (57.9%) had fibromyalgia. Reductions were observed in: pain (scale 0–10) (baseline: 7.0; end of workshop: 5.0; 3 months: 5.0; p < 0.001); anxiety (13.0; 9.0; 11.0; p < 0.001); and depression (11.4; 7.2; 6.8; p < 0.001) (scales 0–21). Increases were noted in: well-being (scale 0–10) (4.0; 6.0; 5.0; p < 0.001); quality of life (scale 0–1) (0.399; 0.581; 0.556; p < 0.001); health status (scale 0–100) (40.0; 60.0; 60.0; p < 0.001); self-esteem (scale 9–36) (23.5; 27.1; 26.6; p < 0.001); and resilience (scale 6–30) (17.0; 18.0; 18.0; p = 0.002, p < 0.001). PROMs were completed by 189 patients at the end of the workshop and 110 at 3 months: pain decreased (end of workshop: 76.7%; 3 months: 80.7%); medication decreased (80.5%; 78.1%); and habits improved (87.2%; 87.6%). 40 patients (37.4%) reduced emergency visits and scheduled consultations. Overall satisfaction: 9.7. Conclusions: The workshop enhanced patients’ self-management and produced improvements in pain, quality of life, emotional well-being, and self-esteem, with effects maintained at 3 months.

Enquadramento: A indução do parto resulta frequentemente em partos complicados e numa maior intervenção, o que pode levar à frustração e ansiedade. Objetivo: Analisar a satisfação com o processo de parto em mulheres submetidas a indução. Metodologia: Estudo observacional. Amostragem não probabilística e de conveniência. Foram estabelecidos critérios de inclusão e exclusão. A amostra foi constituída por 46 participantes. Foi utilizado um questionário sociodemográfico e obstétrico e da versão espanhola da Mackey Childbirth Satisfaction Rating Scale. Resultados: A satisfação global foi boa. A subescala melhor classificada foi a relacionada com o recém-nascido e as dimensões com pior classificação foram as relacionadas com as fases de dilatação e expulsão. A satisfação com o parceiro e o conforto foi maior em mulheres com idade entre 30-34 anos do que em mulheres com idade ≥ 40 anos. A satisfação global foi maior nas mulheres que tinham recebido informação prévia sobre o processo de indução e cujas expectativas tinham sido satisfeitas. Conclusão: A satisfação global e por dimensão foi elevada. Os resultados fornecem evidências de cuidados de qualidade para melhorar os níveis de satisfação de mulheres induzidas.

Background: Postoperative pain management after a cesarean section remains a significant challenge, as inadequate control can delay maternal recovery and hinder early bonding and breastfeeding. While multimodal analgesia is the standard approach, non–pharmacological strategies like immediate skin–to–skin contact (SSC) are often underused despite their potential benefits in reducing pain, improving uterine contractions, and increasing maternal satisfaction. Objective: To evaluate the effects of immediate SSC on postoperative pain perception, uterine contraction quality, and maternal satisfaction, and to explore ways to incorporate SSC into routine post–cesarean care to promote recovery and humanized care. Method: A randomized clinical trial was conducted with 80 women undergoing elective cesarean sections, divided into two groups: SSC (40 women) and control (40 women). Postoperative pain was measured using the Visual Analog Scale (VAS) at various intervals, while uterine contraction quality and maternal satisfaction were assessed through clinical observation and a Likert scale, respectively. Results: We found that women in the SSC group experienced significantly lower pain scores (VAS2 and VAS3, p < 0.001), stronger infraumbilical uterine contractions (92.5%, p < 0.001), and higher satisfaction levels (average 9.98 vs. 6.50, p < 0.001). An inverse correlation was observed between pain intensity and satisfaction, indicating that SSC enhances both physiological and psychological recovery. Conclusions: Immediate SSC after cesarean is an effective, humanizing intervention that reduces pain, supports uterine contractions, and boosts maternal satisfaction. These findings advocate for integrating SSC into standard postoperative care, aligning with ethical principles of beneficence and autonomy. Further research with larger samples is necessary to confirm these benefits and facilitate widespread adoption in maternity protocols.

Background: Cancer is one of the leading causes of morbidity and mortality worldwide and in Spain. Individuals with cancer are at a higher risk of suicide compared to the general population due to both general and disease-specific risk factors. Objective: To update knowledge on nursing care measures to address the risk of suicide in cancer patients. Methods: A narrative review was conducted by searching PubMed, WOS, Scopus, and CINAHL during February and March 2025. The inclusion criteria comprised original qualitative, quantitative, and/or mixed-methods studies related to the topic of the review. Results: Of the 289 identified studies, 23 were selected. Twelve studies of cancer patients, ten studies of healthcare professionals, and one study of caregivers and survivors were included. Regarding suicide risk factors, eight studies addressed demographic aspects, fifteen socio-economic factors, twenty-one psycho-emotional factors, and seventeen physical factors. Key risk factors included male sex, advanced age, social isolation, lack of social support, hopelessness, and physical deterioration. Seventeen studies highlighted the need for continuous and comprehensive nursing care using validated tools for systematic assessment of suicide risk. Eight emphasised the importance of ongoing training in suicide prevention, which is essential for developing communication skills and improving therapeutic relationships. Five studies underscored the relevance of a holistic approach that addresses the physical, emotional, social, and spiritual dimensions of patient care. Six extended this approach to include family members and caregivers. Conclusions: Suicide risk in cancer patients is associated with multiple risk factors. Emotional support and a comprehensive, continuous nursing approach—based on systematic assessments, specialised training, and a holistic focus—are key to effective suicide prevention.