Leticia Bazo-Hernández

Aims: To analyse the perceptions of registered nurses in Spain regarding family presence during invasive procedures (FPIP), identifying perceived benefits, barriers to its implementation, and associated sociodemographic variables. Design: A descriptive, cross‐sectional, quantitative study. Methods: A nationally representative sample of 1836 registered nurses was obtained using the validated Spanish version of the Questionnaire on Family Presence in Invasive Procedures ( QFP‐IP ). Data were collected anonymously online between November and December 2024. Descriptive and inferential statistical analyses were performed (Student's t , ANOVA, post hoc tests), and the psychometric properties of the scale were examined (Cronbach's α = 0.904; ICC = 0.90). Results: Overall, nurses showed favourable attitudes towards FPIP, though barriers such as insufficient training, fear of interference, and professional stress persisted. Positive attitudes increased with age, years of experience, and higher educational attainment. Paediatric and geriatric services were the most supportive, whereas intensive care and operating theatre units were more reluctant. Men and those with postgraduate or specialised training expressed greater acceptance. Conclusions: FPIP is recognised by Spanish nurses as an ethically relevant and humanising practice that strengthens communication, autonomy, and compassion in care. Organisational and ethical frameworks are needed to ensure its safe and equitable implementation. Impact: This nationwide study offers the first empirical evidence in Spain on FPIP from a nursing perspective. Its findings provide guidance for developing clinical protocols, ethics education, and institutional policies that promote moral agency and family‐centred, humanised care. Contribution From Patients or the Public: Nurses participated via an online survey and were able to respond to it by accepting the study conditions.

Background: Neonatal nursing care requires ethical competence alongside technical expertise. Despite progress in Spain, disparities persist in ethical training and professional autonomy in neonatal units. Objective: To examine the ethical dimension of neonatal nursing in Spain, including training, institutional resources, ethical climate, and experiences of ethical conflict and moral distress. Research design: A descriptive, observational, and cross-sectional study was conducted, combining quantitative and qualitative analyses to examine the ethical-professional reality of neonatal nurses nationwide. The study was based on an ad hoc questionnaire specifically designed for this research and validated through expert review and content validation procedures. Participants and research context: A total of 307 neonatal nurses in Spain completed an online questionnaire developed by the researcher with 24 structured and semi-structured items. The sample size was determined based on voluntary nationwide participation during the 6-month data collection period, aiming to maximize territorial representation and professional heterogeneity among neonatal nursing staff. The instrument explored sociodemographic, educational, professional, and institutional variables, together with experiences of moral distress and ethical conflict. Ethical consideration: The study followed the Declaration of Helsinki and Spanish and European data protection regulations. The questionnaire was fully anonymous, and no personal data or IP addresses were collected. Informed consent was obtained from all participants. As the study involved anonymous voluntary participation without clinical intervention or sensitive data processing, Ethics Committee approval was not required under regulations. Findings: Most participants had non-formal bioethics training, whereas formal postgraduate education was rare. Moral distress was reported by 85% of respondents, mainly related to treatment limitation, therapeutic obstinacy, and end-of-life care. Bioethics training and professional experience predicted moral distress, while Clinical Ethics Committees showed no predictive value. These findings highlight the need to strengthen ethics education and promote participatory institutional environments to support ethical decision-making and reduce moral distress in neonatal nursing practice. Conclusion: The ethical dimension of neonatal nursing in Spain is shaped by education, experience, and institutional climate. Training was associated with moral distress, but its impact depends on organizational support, underscoring the need for participatory environments to reduce suffering and strengthen ethical care.

Aims: To explore students’ experiences of taking part in a Death Café and whether they consider the Death Café as being a useful educational tool. Background: Talking about death remains a taboo for both nursing professionals and students. Recognizing the importance of open dialogue, Death Cafés were established to provide safe spaces for individuals to share thoughts and feelings on this topic. Design: A qualitative, exploratory, and descriptive study employing a descriptive analytical approach. Methods: This study was conducted between April 2025 and July 2025 at a public university in Catalonia. The Death Café was a mandatory activity within the palliative care course for all third-year bachelor/undergraduate nursing students. After the course, students were invited to participate in a questionnaire containing 12 open-ended questions, and all 39 students agreed to participate. Data were analyzed using Sandelowski’s qualitative descriptive approach. Results: Following questionnaire analysis, 24 units of meaning, categorized into 7 subcategories and 2 categories emerged: (1) death without fear: normalizing dialogue and communication. The Death Café fostered speaking about death freely and without prejudices; (2) emotional management and group support in the learning process. Students reported a sense of emotional relief when speaking about death and considered it a tool that can enhance their capacity to support patients and families. Conclusion: Most participants regarded the Death Café as a comfortable and enriching experience that provided a respectful environment for open conversation about death. The activity reduced perceived fears and taboos, promoted emotional reflection, and encouraged the sharing of diverse perspectives.

Fundamento. El objetivo es evaluar la higiene de manos en estudiantes de enfermería y conocer sus reflexiones tras una intervención pedagógica innovadora. Metodología. Estudio de simulación con estudiantes de grado de enfermería con diseño mixto: cuantitativo transversal para evaluar la efectividad de la intervención, y exploratorio cualitativo mediante escritura reflexiva. Se realizó lavado de manos con una solución hidroalcohólica que emite radiación ionizante que brilla con luz ultravioleta, empleando un dispositivo de irradiación ultravioleta para visualizar áreas limpias y sucias. Se registró el tiempo empleado y el porcentaje de superficie limpia. Tras evaluar los resultados se repitió la higiene y se compararon el tiempo empleado y la superficie limpia. Posteriormente, las personas participantes respondieron por escrito a preguntas directas y abiertas sobre el trabajo realizado. Resultados. Treinta estudiantes participaron en el estudio transversal y sesenta en el cualitativo. Las áreas de difícil limpieza fueron las yemas de los dedos y la palma de la mano, junto a los pulgares. El segundo lavado requirió 2,6 s más (p=0,012) y consiguió un 9% más de superficie mediana limpia (0,006), y las personas con limpieza ≥70% incrementaron del 36,7 al 66,7%. Las experiencias de los estudiantes mostraron grandes ventajas, como la concienciación sobre errores personales, el aprendizaje visual, y la importancia de una técnica correcta. Conclusiones. Esta estrategia educativa visual y práctica permite aumentar la concienciación del estudiantado sobre la relevancia de la higiene de manos, pudiendo contribuir a disminuir las infecciones nosocomiales provocadas iatrogénicamente.

Background: Being admitted to a paediatric intensive care unit is a stressful situation for the minor and their family, causing emotional alterations that generate changes in psychological, physical and social aspects, as well as on how to take care of the minor.Aim: The objective of this study was to explore the coping strategies experienced by families who have a minor admitted to the paediatric intensive care unit.Methods: Phenomenological qualitative research study. A sample of 12 participants was obtained from families who had a prolonged admission to the paediatric intensive care unit of a minimum duration of 3 months and who were not in an end‐of‐life situation. The data analysis was carried out by deepening the study theme during the data collection of the three group interviews conducted.Ethics Statement: This study is part of a predoctoral research project approved by the Ethics Committee of the Vall d'Hebrón University Hospital in Barcelona (approval code: PRAMI‐273/2015).Results: Two main categories were identified that emerged from the families' perceptions related admission of their minors to the paediatric intensive care unit and their subsequent adaptation to the new situation: (1) Family self‐perception: the families' own perceptions of different feelings and emotions experienced during admission and their interpretations are collected. (2) Role of the caregiver: understood as the families' perceptions of the capacity and willingness to face the new situation in the child's health‐disease process; and 10 subcategories: training, comfort, confidence, fear, anxiety, impotence, loneliness, will, adaptability and reference family group.Conclusions: The findings show the need to carry out an integrative approach to families which coexist in a paediatric intensive care unit; through the training of these families to be able to cope with health changes.

Virtual simulations have experienced widespread adoption in higher education in recent years due to the advantages they offer as an educational tool. Designing these simulations considering not only technological criteria but also pedagogical and content-related aspects is a crucial element for the future educational success of the tool. The Erasmus+ project ENVISION has facilitated the creation of two Virtual Gaming Simulations (VGS) for implementation in the nursing degree program, alongside the development of an implementation guide for these simulations and a designer’s guide documenting their creation process following the guidelines of the TPACK model. This study focuses on the development of the VGS designer’s guide, employing a qualitative research methodology in three phases: 1) literature review and documentation of the process, 2) validation of the guide's content, and 3) evaluation of its usability. The positive outcomes regarding the tool's validity and usability, coupled with subsequent improvements implemented based on evaluation cycles, affirm the development of a tool that will enable higher education instructors, both experienced and inexperienced, to create their own VGS. Las simulaciones virtuales han visto extendido su uso en educación superior en los últimos años debido a las ventajas que ofrecen como herramienta educativa. Diseñarlas teniendo en cuenta no solo criterios tecnológicos, sino pedagógicos y de contenido, es un elemento crucial para el futuro éxito educativo de la herramienta. El proyecto Erasmus+ ENVISION ha permitido crear dos Simulaciones Virtuales Gamificadas (VGS por sus siglas en inglés) para su implementación en el grado de enfermería, así como elaborar una guía de uso de estas simulaciones y otra guía de diseño que documentara su proceso de creación siguiendo las directrices del modelo TPACK. En este trabajo nos centramos en el desarrollo de la guía de diseño de VGS, para lo que se adoptó una metodología de investigación cualitativa en 3 fases: 1) revisión de la literatura y documentación del proceso, 2) validación del contenido de la guía y 3) evaluación de su usabilidad. Los resultados del estudio muestran, por un lado, unos datos positivos en cuanto a la validez del contenido y usabilidad de la guía, y por otro, una serie de mejoras con las que refinar el producto final. Los buenos resultados obtenidos y las sucesivas mejoras implementadas a partir de los ciclos de evaluación confirman que se ha desarrollado una herramienta que permitirá a docentes de educación superior, con o sin experiencia, desarrollar sus propias VGS.

Introduction: Non-adherence to treatments increases the probability of therapeutic failure and unnecessary complications.Objective: To explore the sources of support perceived by patients with chronic diseases that facilitate adherence to treatment. Method: Qualitative descriptive study with a phenomenological approach, in which eight complex chronic patients were recruited, without distinction of gender or age, residents of Barcelona, and who, after evaluating pharmacological adherence with the Morisky-Green test and the test of Batalla resulted in being adherent to the therapeutic regimen. After which, two open questions were asked that were recorded on an audio device and transcribed verbatim. For data analysis, the method Colaizzi was used. Results: Three thematic groups emerged: 1) Having family support; 2) Understanding of the disease and strategies that facilitate adherence to treatments; and 3) Relationship with reference professionals. Conclusions: The most important source of support perceived by the participants is the family, coinciding with other authors. The finding of this study is that shows medicine and nursing are evidenced as instigators that promote their empowerment and as a recognized source of influence that has allowed their assimilation and training to adopt measures that help them follow the pharmacotherapeutic guidelines. Introducción: La falta de adherencia a los tratamientos aumenta la probabilidad de fracaso terapéutico y complicaciones innecesarias. Objetivo: Explorar las fuentes de apoyo percibidas por los pacientes con enfermedades crónicas que les facilitan la adherencia a los tratamientos. Método: Estudio cualitativo descriptivo con enfoque fenomenológico, en el que se reclutaron ocho pacientes crónicos complejos, sin distinción de género, ni edad, residentes en Barcelona, y que tras evaluar la adherencia farmacológica con los test de Morisky-Green y el test de Batalla diera como resultado ser adherente al régimen terapéutico. Tras lo cual se efectuaron dos preguntas abiertas que fueron grabadas en un dispositivo de audio y transcritas textualmente. Para el análisis de los datos, se utilizó el método Colaizzi. Resultados: Surgieron tres grupos temáticos: 1) Tener el apoyo familiar; 2) Comprensión de la enfermedad y estrategias que facilitan la adhesión a los tratamientos; y 3) Relación con los profesionales de referencia. Conclusiones: La fuente más importante de apoyo percibida por los participantes, es la familia, coincidiendo con otros autores. El hallazgo de este estudio, es que se evidencia a medicina y enfermería como instigadores que fomentan su empoderamiento y como fuente de influencia reconocida que ha permitido su asimilación y capacitación para adoptar medidas que les ayudan a seguir las pautas farmacoterapéuticas.