José Manuel Alcaide-Leyva

"Introducción: En pacientes con trastornos psiquiátricos como la esquizofrenia, el insight puede influir en cómo se desarrolla la enfermedad y en su pronóstico, por lo que presenta un interés clínico de importante relevancia. A pesar de las contraposiciones en cuanto a la paradoja del insight, y de intentar identificar qué estado de insightsería más beneficioso para estos pacientes, la literatura científica aún no esclarece del todo la relación. Objetivo: Determinar la relación del insight o falta de conciencia de déficit con el pronóstico de la es-quizofrenia mediante los factores: adherencia al tratamiento, riesgo de suicidio y sintomatología. Metodología: Revisión sistemática de la bibliografía en un intervalo de 5 años (2018-2024), en las bases de datos Pubmed, Scopus y APA PsycINFO. La selección de los artículos se realizó en base a unos criterios de inclusión y exclusión preestable-cidos y conforme a la declaración PRISMA. Las palabras Claves (tér-minos DeCS y MeSH): Fueron “Schizophrenia”, “Insight”, “Illness”, “Anosognosia”, “Lack of awareness”, “Improve”; operador booleano: “AND”. Se seleccionaron 9 artículos."

Background: The Callista Roy Adaptation Model posits that adaptation in later life emerges from the interaction among physical, psychological, and social dimensions. However, empirical evidence integrating these domains through predictive approaches remains limited. The aim of this study was to identify the main predictors of adaptive classification in older adult women using functional and subjective well-being measures. Methods: A predictive study was conducted in older adult women enrolled in community-based exercise programs. Assessments included the Senior Fitness Test and the SF-12 and WHO-5 questionnaires. Multiclass classification models were trained, with Random Forest selected due to superior performance. Model evaluation incorporated oversampling strategies and robustness analyses without oversampling, using metrics resilient to class imbalance (macro-F1 and balanced accuracy). Model interpretability was examined through variable importance analysis, partial dependence, and ICE plots. Results: Under the oversampling framework, the Random Forest model achieved an overall accuracy of 74% and a macro-F1 score of 0.73, with reduced performance observed in robustness analyses, particularly for the minority “High” class. The most influential predictors were the physical component of the SF-12, the 2 min step test, the mental component of the SF-12, and the chair sit-and-reach test. Conclusions: The findings highlight the joint contribution of physical and psychosocial factors to adaptive processes, in alignment with the Roy Adaptation Model. This study provides exploratory evidence supporting the integrated use of the SFT, SF-12, and WHO-5; however, external validation and longitudinal evaluation are required prior to clinical implementation.

Background/Objectives: Metabolic syndrome is a significant public health issue, particularly in urbanizing regions like the Peruvian Amazon, where lifestyle changes have increased the prevalence of metabolic disorders. This study aimed to develop and validate a simple, cost-effective diagnostic model for early detection of metabolic syndrome in the urban population of San Juan Bautista, Iquitos. Methods: A cross-sectional study was conducted with 251 adults aged over 18 years. Data collection included anthropometric measurements, body composition analysis, and biochemical assessments. Logistic regression analyses identified key predictors of metabolic syndrome, and clinical decision trees were developed to enhance diagnostic accuracy. Results: The prevalence of metabolic syndrome was 47.9%. Systolic blood pressure, triglycerides, and very-low-density lipoprotein cholesterol were the strongest predictors. The most effective diagnostic model, combining very-low-density lipoprotein cholesterol and systolic blood pressure, achieved a sensitivity of 91.6% and a specificity of 78.5%, demonstrating high diagnostic accuracy. Conclusions: The proposed model offers a practical, low-cost tool for early detection of metabolic syndrome in resource-limited urban settings. However, its findings are limited by the small sample size and the lack of external validation, requiring further studies to confirm its generalizability and applicability to other populations. Its implementation in primary healthcare could facilitate timely interventions, reducing the risk of chronic diseases in vulnerable populations.

Background/Objectives: Perinatal loss is a challenging experience that significantly impacts families and healthcare professionals. This study aimed to explore the perceptions and experiences of the nursing team in the gynecology unit at a Spanish hospital regarding the implementation of a new protocol for perinatal bereavement care. Methods: A qualitative descriptive study was conducted involving a focal group interview with nursing staff from the gynecology unit. Participants were selected through purposive sampling, and data were analyzed using thematic analysis to identify recurring patterns and insights. Results: The findings revealed a disparity in attitudes toward perinatal bereavement care, with some nurses demonstrating empathy and understanding, while others expressed discomfort and avoidance behaviors. Barriers to effective care included a lack of formal training, insufficient emotional support, and practical challenges in implementing the protocol. Participants suggested improvements such as enhanced communication training, the appointment of a bereavement coordinator, and earlier psychological interventions to support both families and staff. Conclusions: The study highlights the need for continuous education and emotional support to facilitate the adoption of perinatal bereavement protocols. Involving nursing staff in protocol development and addressing systemic barriers can improve the quality of care for bereaved families while supporting healthcare professionals’ emotional well-being.

Aim: To explore the role of health communication in Shared Decision‐Making (SDM) between nursing staff and older people in the community setting. Background: Society and healthcare services are marked by an exponentially ageing population, leading to a significant proportion of patients being older adults with highly demanding care needs. Scientific literature supports shared decision‐making as a process that engages patients in their care. However, the increasing use of technology and the consequences of the COVID‐19 pandemic have influenced how nurses communicate with older patients. Therefore, it is crucial to understand how to develop health communication to reach effective, shared decision‐making processes. Methods: Whittemore and Knafl's integrative review method, the literature search comprised five databases: PubMed, CINALH, Web of Science, Scopus and PsycINFO. Results: The 12 included studies were synthesised into three study patterns: (1) nurse–older patient health communication relationship, (2) older patients' perspectives and (3) nontherapeutic communication in end‐of‐life care. Conclusion: This review underscored the crucial role of effective health communication in shaping SDM dynamics between nursing staff and older people in the community setting. Key elements included transparent information exchange, establishing trust and maintaining communication channels with informal caregiving networks. SDM actions were aligned with preserving older people's autonomy, but communication challenges persisted, particularly in end‐of‐life situations. Advanced care planning was recommended to address these shortcomings and improve communication among older people, healthcare professionals and families. Implications: Implementing educational measures based on verbal and nonverbal health communication in nursing training could be beneficial. Nursing research could continue to develop and refine specific communication strategies adapted to the social determinants of health for diverse clinical situations regarding older adults in the community setting. Reporting Method: The authors have adhered to relevant EQUATOR guidelines through the PRISMA 2020 checklist. No Patient or Public Contribution.

Background: The coexistence of malnutrition due to over- and under-nutrition in the Peruvian Amazon increases chronic diseases and cardiovascular risk. Methods: A cross-sectional study of a male population where anthropometric, clinical, and demographic variables were obtained to create a binary logistic regression predictive model of cardiovascular risk. Results: We compared two methods with good predictive results, finally choosing Model 4 (r² = 0.57, sensitivity 73.68%, specificity 95.35%, Youden index 0.69, and validity index 94.21), with non-invasive variables such as blood pressure (p < 0.001), hip circumference (p < 0.001), and FINDRISC test result (p < 0.05); Conclusions: We developed a cheap, fast, and non-invasive tool to determine cardiovascular risk in the population of this endemic area.

Background: Overweight and obesity are public health problems that affects the workplace. This paper aims to analyse the effectiveness of workplace health promotion interventions in reducing Body Mass Index (BMI); Methods: Following PRISMA guidelines, a systematic review was conducted using PubMed, MEDLINE, and SCOPUS databases. The inverse variance statistical method was used for the meta-analysis with a random effects analysis model and standardised means. The results have been represented by Forest Plots and Funnel Plots graphs; Results: The multicomponent approach had the best results for reducing BMI (−0.14 [−0.24, −0.03], 95% CI; p = 0.009) compared to performing physical activity only (−0.09 [−0.39, 0.21], 95% CI; p = 0.56). However, both methods resulted in positive changes in reducing BMI in the general analysis (−0.12 [−0.22, −0.02], 95% CI; p = 0.01). The GRADE evaluation showed low certainty due to the high heterogeneity between interventions (I² = 59% for overall analysis). Conclusions: The multicomponent approach could be an effective intervention to reduce obesity in the working population. However, workplace health promotion programs must be standardised to conduct quality analyses and highlight their importance to workers’ well-being.