Guillerma Medina Martin

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: Telemedicine has established itself as a growing form of healthcare within global health systems. However, despite its technological implementation, ethical challenges remain that limit its optimal practice. Objective: The objective of this study was to explore the fundamental aspects and ethical shortcomings of telemedicine practice in hospitals and primary care settings. Research Design, Participants and Research Context: The study design was qualitative, using inductive content analysis as described by Elo and Kyngäs. The information was obtained through a focus group and seven in‐depth interviews with healthcare professionals who are experts in bioethics, from the hospital and primary care settings. MAXQDA software was used for data management, and the analysis was conducted by two researchers. Ethical Considerations: The study was approved by a Research Ethics Committee (approval number 104/2025). Results: Six main categories emerged from this study: autonomy, equity, safety, clinical practice, professional competence and person‐centred care. Problems were identified with informed consent and the choice of telemedicine practice based on user characteristics. Conclusions: Telemedicine cannot be imposed as a universal substitute for face‐to‐face care without compromising ethical principles such as equity and autonomy. Failures in its ethical application were detected, especially in obtaining consent and data protection. Including the bioethical perspective in its regulation is key to responsible and person‐centred implementation and development.

Background: Changes in health needs led to an increase in virtual care practices such as telemedicine. Nursing plays an essential role in this practice as it is the key to accessing the healthcare system. It is important that this branch of nursing is developed considering all the ethical aspects of nursing care, and not just the legal concepts of the practice. However, this question has not been widely explored in the literature and it is of crucial relevance in the new concept of care. Objective: The purpose of this scoping review is to identify the ethical aspects of the development of telemedicine from a nursing practice perspective. Methods: A scoping review of the literature based on Arksey and O’Malley’s framework. The search was conducted in Scopus, PubMed/MEDLINE and CINAHL databases, from 2012 to 2022. A total of 1322 articles were retrieved, of which 12 met the inclusion criteria. Ethical considerations: The research was conducted in accordance with the best scientific practices. Findings: The most relevant aspects were the safety of the patient, the benefits for the user and the digital competence of the professionals. Informed consent and patient’s willingness to use new technologies were relevant to the practice, as was person-centered care and how telemedicine can influence the quality of the therapeutic relationship. Another relevant issue was the concern about professional competence for optimal outcomes. Conclusion: It is necessary to further explore and develop the ethical aspects of the new practices, disassociating them from the legal aspects only. Professionals demand more training providing them with more competence and confidence.

Background: Family Presence During Invasive Procedures (FPDI) generates controversy among healthcare professionals. Twibell and her team designed an instrument that measured nurses’ Risk-Benefit and Self-Confidence perceptions regarding family presence during resuscitation and was used in numerous studies. Objectives: Evaluate the new tool for Family Presence Risk-Benefit and Family Presence Self-Confidence during invasive procedures and find out the opinions of the medical and nursing staff on FPDIP. Method: Cross-sectional methodological pilot study. Online and paper questionnaires modified from a previous translation. A factor analysis was performed for the validity of the indices and bivariate analysis for all the variables. Ethical approvals and research permissions were obtained according to national standards. Results: One hundred twenty healthcare professionals (22.18%) answered the survey. Cronbach’s α on the Family Presence Risk-Benefit scale was 0.877. Cronbach’s α on the Family Presence Self-Confidence scale was 0.937. The correlation between the Risk-Benefit and Self-confidence variables is significant and with a moderate intensity of the relationship. A lower predisposition to Family Presence During Invasive Procedures is observed. Physicians are more reluctant than nurses. Conclusions: The FPDI generates controversy as it alters health professionals’ routines when they decide whether to allow it or not. There is a tendency for younger professionals to support FPDI. In general, health professionals, mainly physicians, do not favor FPDI. Health workers who perceive fewer risks and more benefits in FPDI and have greater self-confidence are more in favor of FPDI. The psychometric properties and internal consistency of the questionnaire indicate the validity and reliability of this tool.