Rosa María Cardaba García

Contemporary healthcare systems face a structural crisis driven by biomedical reductionism, institutional biopower, and corporate rationalization. In this context, professional enculturation in nursing has historically functioned to reproduce subalternity and institutional docility through a clinical hidden curriculum that privileges delegated biomedical routines over autonomous care. Drawing upon a transnational genealogy across four foundational paradigms (biomedical positivist, interpretive‐humanistic, disciplinary, and critical‐sociopolitical), this article deconstructs how organizational architectures constrain Care Science. Crucially, rather than framing role transition shock and moral distress as individual psychological fragility or resilience deficits, we conceptualize them as acts of legitimate epistemological resistance. To overcome this institutional alienation, we propose the Emancipatory Praxis and Care Sovereignty Paradigm (EPCSP). Grounded in critical pedagogy, feminist ethics, and systemic humanism, the EPCSP redefines nursing education and clinical practice. It establishes the ontological parity of care in relation to medical cure, equips practitioners with critical agency to dismantle institutional biopower, and provides the operational framework required to address complex chronicity, mitigate clinical iatrogenesis, and secure the disciplinary sovereignty of Care Science.

Background: The historical fracture between biomedical positivism and social constructivism has perpetuated an epistemic schizophrenia, reducing the human body either to a molecular machine (Körper) or to a discursive epiphenomenon, thus obscuring the structural roots of illness. This study establishes a rigorous metatheoretical framework to overcome this fragmentation. Methods: We employ a dialectical-transdisciplinary epistemological matrix—integrating Peircean abduction and negative dialectics as vectors of conceptual translation—to map the intersection between natural/medical sciences and social theories without falling into reductionisms. Results: The analysis demonstrates that health and illness constitute stratified complex wholes where structural violence and biological somatization (such as allostatic load) co-determine one another. Likewise, it deconstructs the technocratic neutrality of the medical model, proving that clinical practice must reintegrate the lived body (Leib). Conclusions: We propose an innovative paradigm—Transdisciplinary Enactive Realism—that bridges empirical evidence and hermeneutic meaning, providing a holistic, critical, and humanized foundation for contemporary sociosanitary ecosystems.

Background/Objectives: Person-centred care necessitates addressing the growing biopsychosocial vulnerability within public health. This study analysed eating behaviours and sociocultural pressures regarding physical appearance in a convenience sample of adults to help inform potential evidence-based policies and programmes in primary care tailored to these exploratory symptom correlates. Methods: A quantitative, observational, cross-sectional study was conducted with 1287 participants. Data were collected via an online platform using the Eating Attitudes Test (EAT-26) and the Sociocultural Attitudes Towards Appearance Questionnaire (SATAQ-4). Descriptive statistics, bivariate tests, multiple linear regression models, and complementary binary logistic regression models were utilised to identify variables independently associated with scores and clinical risk thresholds (EAT-26 ≥ 20). Results: Multiple linear regression analysis determined that the scores indicating potential risk of altered eating behaviours (EAT-26) was primarily associated with female sex (β = 0.134, p < 0.001), followed by never eating in company (β = 0.149, p < 0.001), an active lifestyle (β = 0.094, p = 0.001), excessive social media usage (β = 0.088, p = 0.002), and smoking (β = 0.091, p = 0.001). Likewise, susceptibility to sociocultural pressures (SATAQ-4) showed a major association with excessive digital connectivity (β = 0.159, p < 0.001), female sex (β = 0.094, p = 0.001), smoking (β = 0.078, p = 0.004), both sometimes and never eating in company (β = 0.078, p = 0.008 and β = 0.082, p = 0.005 respectively), and younger age (β = −0.202, p < 0.001). Furthermore, the binary logistic sensitivity analysis confirmed that a high clinical risk score (≥20) was independently associated with female sex (Exp(B) = 2.660), smoking (Exp(B) = 2.381), never eating alone (Exp(B) = 2.253), excessive social media use (Exp(B) = 1.665), being active (Exp(B) = 1.500), a greater number of children (Exp(B) = 1.402), and younger age (Exp(B) = 0.969). Conclusions: Due to the non-probabilistic convenience nature of the sample, these findings cannot be directly generalized to the general population; however, they delineate the vulnerable demographic profile—young, active, female smokers who are frequent social media users and habitually eat alone—which may help generate hypotheses for future primary care prevention strategies. Furthermore, these results underscore the potential value of integrating specific screening considerations and digital literacy into person-centred healthcare, pending longitudinal validation.

Background/Objectives: Childhood cancer profoundly affects families, particularly parents, who assume demanding caregiving roles associated with significant emotional and social burden that remain underexplored qualitatively. To explore the experiences of parents of children with cancer during the disease process: diagnosis, treatment, follow-up, and their child’s progress. Methods: An exploratory qualitative interview study was conducted using individual semi-structured interviews with six parents of children with cancer in Spain. Participants were intentionally recruited through a parent association. Interviews were conducted online, audio- and video-recorded with consent, transcribed verbatim, and analyzed using thematic analysis following Braun and Clarke. Sullivan’s interpersonal theory was subsequently used as a conceptual framework to interpret the emerging themes, particularly in relation to interpersonal anxiety, security, emotional regulation, and significant relationships. Results: Six parents were included in the analysis, representing heterogeneous clinical trajectories, including active treatment, remission, and bereavement. Five axes, 12 categories, and 52 codes were identified. Parents described uncertainty and emotional disruption around diagnosis, the coexistence of perceived strength and distress during treatment, changes in family and interpersonal relationships, continuing concerns following remission, and profound grief and continuing bonds following the death of a child. These findings were interpreted through Sullivan’s interpersonal framework. Conclusions: This exploratory study suggests that parents’ experiences of childhood cancer are shaped by changes in interpersonal relationships, emotional regulation, perceived security, and support networks across different phases of the illness. The findings highlight potential areas for psychosocial support, although they should be interpreted cautiously given the small and heterogeneous sample.

Background: Non-invasive intrauterine resuscitation measures, such as maternal repositioning and intravenous fluid therapy, are used in the presence of suspicious or pathological cardiotocographic (CTG) patterns during labor. However, evidence regarding their link with CTG abnormalities, amniotic fluid color, and immediate neonatal outcomes is limited. Objectives: To analyze the link between maternal repositioning and intravenous fluid therapy and the occurrence of suspicious or pathological intrapartum CTG patterns, as well as their relationship with amniotic fluid color and immediate neonatal effects. Methods: An analytical, observational, prospective study was conducted in women in labor with continuous monitoring. Changes in maternal position, administration of intravenous fluid therapy, CTG patterns, amniotic fluid color, and immediate neonatal outcomes were analyzed. Links were evaluated using appropriate statistical tests, considering maternal positions in isolation and in combination. Results: Maternal repositioning, both alone and in combination, was associated with the presence of suspicious or pathological CTG and with statistically significant differences in the 5 min Apgar score when analyzed as a continuous variable. No significant association was observed between intravenous fluid therapy and CTG patterns or neonatal outcomes. The presence of meconium-stained amniotic fluid was associated with a higher frequency of suspicious or pathological CTG. Conclusions: Maternal repositioning was most frequently applied as a clinical response to a suspicious CTG. Intravenous fluid therapy showed no link with CTG abnormalities or adverse neonatal outcomes. These findings reinforce the need to interpret intrapartum CTG in an integrated manner with the overall clinical context and support the use of maternal repositioning as a non-invasive measure in intrapartum management.

Objectives: To describe the process for the translation and validation of the Postpartum Specific Anxiety Scale—Preterm Birth [PSAS‐PTB] and the Postpartum Specific Anxiety Scale—Neonatal Intensive Care Unit [PSAS‐NICU]. Methods: We outline a four‐stage process for translation and validation of the 10‐item PSAS‐PTB and the 16‐item PSAS‐NICU. Results: The protocol outlines a multi‐stage translation and validation process, including (1) independent forward translation, (2) independent back translation, (3) final approval following review, and (4) validity and reliability study. Conclusions: Culturally and contextually relevant assessment of postpartum anxiety is vital, particularly in vulnerable populations. Following standardised procedures will support broader applicability across diverse populations, providing a reliable self‐report tool for both research and clinical use.

El presente capítulo presenta los resultados obtenidos en el marco del proyecto de innovación docente HumanizAS en estudiantes del Grado en Enfermería de la Universidad de Valladolid, con especial atención a la evaluación de la humanización mediante la escala HUMAS. Se analizan las entrevistas realizadas a profesionales de enfermería, los aprendizajes percibidos por los estudiantes y las puntuaciones obtenidas en las dimensiones de la escala, en comparación con profesionales. Los hallazgos refuerzan la pertinencia de introducir competencias de humanización en etapas tempranas de la formación, con un impacto positivo en la percepción de la práctica clínica y en el desarrollo de competencias comunicativas y emocionales.

Aim: This study aims to investigate the influence of fatigue and mood disturbances in Spanish long-COVID patients and to establish relationships between these factors and other clinical manifestations. Method: A descriptive correlational study was conducted using a self-administered online questionnaire. The sample was obtained through non-random convenience sampling, comprising 374 participants from various regions of Spain. Data collection occurred between July 2, 2022, and November 30, 2022. The questionnaire collected demographic information and inquired about symptomatology as well as self-perception of health status. Validated scales, namely the Fatigue Severity Scale (FSS) and the Scale for Mood Assessment (EVEA), were utilized. Results: The non-random sample consisted of 374 participants from diverse regions of Spain, of whom 79.9% were women. Over 70% of participants reported fatigue, while the EVEA revealed high scores in sadness-depression (4.94 ± 2.82) and anxiety (4.57 ± 2.88). Significant relationships were identified between fatigue and mood disturbances and neurological, psychological, locomotive, and pain symptoms. Conclusions: Given the impact of the syndrome on psychological, social and economic spheres, regular monitoring of patients with long COVID is crucial. This study corroborates previous research findings and is notable for demonstrating the persistence of symptoms for over a year. Mood disorders, such as anxiety and depression, are closely related to physical symptoms, highlighting the need for holistic healthcare approaches.

Background: Chronic kidney disease (CKD) has a significant impact on patients’ physical, psychological, and social well-being. Emotional disorders are common and contribute to a higher prevalence of symptoms compared to that in the general population. This study aimed to analyze the relationship between the emotional profiles and symptomatology in patients undergoing hemodialysis (HD). Methods: A multicenter, cross-sectional, observational/analytical study was developed in seven centers of the Spanish Renal Foundation in the Community of Madrid (Spain). The study protocol was reviewed and approved by the Clinical Research Ethics Committee of Hospital Clínico San Carlos, Madrid (C.I. 20/685-E). In the study, two validated measurement scales were used: the Mood Rating Scale (EVEA) to assess the “emotional profile” and the Palliative care Outcome Scale, Renal Symptoms (POS-S Renal) to evaluate “symptomatology”. Results: The sample (245 patients) was predominantly male (65.7%; n = 161), with a mean age of 63.52 years (SD = 14.99) and an average HD treatment duration of 81.44 months (SD = 96.62). The analysis of the symptom–emotion relationships revealed that patients with a sadness–depression profile had a higher probability of experiencing weakness or a lack of energy (OR = 1.741; CI 95% 1.01–3.00) and feelings of depression (OR = 3.236; CI 95% 1.98–5.30). Additionally, patients with an anger–hostility profile exhibited a significant association with pain (OR = 3.463; CI 95% 1.34–8.94) and excessive sleepiness (OR = 3.796; CI 95% 1.21–11.95), indicating that this emotional state substantially increases the likelihood of developing these symptoms. Conclusions: The emotional profiles of CKD patients undergoing HD significantly influence their symptomatology. While positive emotions may play a protective role in preventing debilitating symptoms, negative emotions increase the risk of their onset. These findings highlight the importance of addressing emotional well-being as part of comprehensive care for HD patients.

(1) Background: The climacteric phase is a crucial period in a woman’s life, due to the changes that affect both her physical and psychological well-being. This study aims to explore the psychological risks associated with the climacteric period in Spanish women, evaluating the influence of conformity to female gender norms. (2) Methods: A descriptive correlational study was conducted with 429 women, using surveys to assess psychological risk (GHQ-12) and conformity to gender norms (CFNI-45). The sample was recruited from central Spain, covering women aged 45–64 years. (3) Results: 20% of the women showed signs or suspicion of psychological pathology, with a higher prevalence in younger women. Participants displayed greater conformity to gender norms related to domestic chores, but less conformity to norms of sexual fidelity and thinness. Health perception was identified as significantly influencing psychological risk and conformity to the norm of thinness, acting as a moderator in this relationship. (4) Conclusions: The study indicates that age and conformity to female gender norms influence psychological risk during the climacteric phase. Younger women and those with greater conformity to the norm of thinness exhibited higher psychological vulnerability. This highlights the need for interventions that address these factors in order to promote emotional well-being and a positive perception of health during this stage of life.