Revista Cuidarte最新文献

{"title":"Two epidemics, one patient: coinfection by SARS-CoV-2 and influenza in Colombia.","authors":"Jhon H Quintana-Ospina, Luis M Osorio-Toro, Gustavo A Urriago-Osorio, Jasbleidy Posu-Barco, Giovanna P Rivas-Tafurt, Jorge E Daza-Arana, José M Oñate-Gutiérrez","doi":"10.15649/cuidarte.4264","DOIUrl":"https://doi.org/10.15649/cuidarte.4264","url":null,"abstract":"<p><strong>Introduction: </strong>Coinfection by SARS-CoV-2 and influenza (commonly referred to as \"Flurona\") presents a significant diagnostic and therapeutic challenge in pandemic and postpandemic settings. Although the two viruses share clinical similarities and transmission routes, their treatments differ substantially. The early suspicion of viral coinfection is crucial, particularly in patients with comorbidities or atypical clinical courses. A literature review was conducted in PubMed, Scopus, and Google Scholar (Spanish and English), identifying few documented clinical reports in Colombia.</p><p><strong>Case description: </strong>We report the case of an 83-year-old male patient with a significant cardiovascular history, admitted to the intensive care unit for congestive heart failure and severe aortic valve disease. During hospitalization, the patient developed respiratory failure, and coinfection with influenza and SARS-CoV-2 was confirmed Treatment included oseltamivir, oxygen therapy, and therapeutic thoracentesis. Transcatheter aortic valve implantation was indicated, but the patient died during the procedure.</p><p><strong>Conclusion: </strong>Coinfection by SARS-CoV-2 and influenza should be considered in the differential diagnosis of patients with acute respiratory distress, particularly in contexts of concurrent viral circulation. Prompt recognition enables targeted therapeutic intervention. A multidisciplinary approach is essential to optimize the prognosis in patients with complex comorbidities.</p>","PeriodicalId":43234,"journal":{"name":"Revista Cuidarte","volume":"16 3","pages":"e4264"},"PeriodicalIF":0.4,"publicationDate":"2025-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12834527/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147277380","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Objective Structured Clinical Examination for pediatric medication administration.","authors":"Mery Luz Valderrama-Sanabria, Gisella Bonilla-Santos, Daniela Muñoz-Duitama, Natalia Sofia Tellez-Avila","doi":"10.15649/cuidarte.4659","DOIUrl":"https://doi.org/10.15649/cuidarte.4659","url":null,"abstract":"<p><strong>Introduction: </strong>The systematic evaluation of clinical competencies of nursing professionals has been a subject of interest among educators, professionals, and other experts in this field, which enables the tracking of the graduation profile, career trajectory, and achievement of goals throughout the professional career. Faculty must prioritize efficiency in the performance of future nursing professionals by using instruments such as clinical simulation for practice development.</p><p><strong>Objective: </strong>To determine the construct validity of the objective structured clinical examination (OSCE) for assessing competence in pediatric medication administration.</p><p><strong>Materials and methods: </strong>An observational, psychometric, and prospective study was conducted to determine the validity and reliability of the instrument \"Objective Structured Clinical Examination for pediatric medication administration.\"</p><p><strong>Results: </strong>The final instrument consisted of 15 items. Bartlett's test of sphericity was significant (χ2 =145.887, p < 0.001), and the Kaiser-Meyer-Olkin (KMO) measure of sampling adequacy was acceptable (0.703). Cronbach's alpha for the total instrument was 0.798.</p><p><strong>Discussion: </strong>Developing psychometric tests for an OSCE in medication administration provides an empirical indicator that can be used accurately in nursing professionals' work.</p><p><strong>Conclusion: </strong>The validity of the OSCE for assessing competence in pediatric medication administration was established, and the instrument was deemed moderately acceptable for application in this area of knowledge. Its use favors both learning and evaluative processes of clinical practice for health sciences students.</p>","PeriodicalId":43234,"journal":{"name":"Revista Cuidarte","volume":"16 3","pages":"e4659"},"PeriodicalIF":0.4,"publicationDate":"2025-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12858412/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147277407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Experience of being a worker with a disability in the Colombian formal sector.","authors":"Luz América Martínez-Álvarez, Stephania Hermann-Agudelo, Cecilia Andrea Ordóñez-Hernández","doi":"10.15649/cuidarte.4648","DOIUrl":"https://doi.org/10.15649/cuidarte.4648","url":null,"abstract":"<p><strong>Introduction: </strong>In Colombia, 3 out of 10 WWDs have a formal employment contract. When workers are the ones required to adapt to the company, rather than the company adapting to them, barriers persist, limiting genuine inclusion.</p><p><strong>Objective: </strong>To understand the experiences of WWDs employed in the formal sector of the economy through an employment contract.</p><p><strong>Materials and methods: </strong>A qualitative study with a phenomenological approach was conducted. Three men and two women participated: a man with a visual impairment and four individuals with motor disabilities, all formally employed in Cali, Colombia, and selected through purposive sampling. Data were collected through in-depth interviews, and the phenomenological analysis followed three phases: description, reduction, and interpretation. The lifeworld existentials of lived body, lived space, lived time, and lived human relations, as well as perceptions of working conditions, were categorized.</p><p><strong>Results: </strong>Workers reported access limitations and restrictions in work tasks due to their disabilities. Despite receiving support from their companies, a lack of commitment to adapting spaces and processes for inclusion was observed.</p><p><strong>Discussion: </strong>WWDs perceive reasonable accommodations as a desirable factor to facilitate adaptation. However, companies do not consistently implement such adaptations.</p><p><strong>Conclusion: </strong>WWDs develop adaptation strategies, making a personal commitment to integrate into the workplace, often without specific accomodations from the company. Once integrated, they perform autonomously and productively, under conditions similar to those of their colleagues without disabilities.</p>","PeriodicalId":43234,"journal":{"name":"Revista Cuidarte","volume":"16 3","pages":"e4648"},"PeriodicalIF":0.4,"publicationDate":"2025-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12858411/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147277431","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Satisfaction and adherence to pharmacological treatment for glycemic control in adults.","authors":"Jessica Jazmín Leyva-Perea, Patricia Enedina Miranda-Félix, Juana Mercedes Gutiérrez-Valverde, Rosario Edith Ortiz-Félix, Luis Antonio Mancillas-Berrelleza","doi":"10.15649/cuidarte.4128","DOIUrl":"https://doi.org/10.15649/cuidarte.4128","url":null,"abstract":"<p><strong>Introduction: </strong>The management of Type 2 Diabetes should be based on a person-centered approach to ensure the appropriate selection of pharmacological treatment. Satisfaction with pharmacological treatment is a patient-reported assessment measure that evaluates the treatment process and related factors, which may enhance adherence and glycemic control.</p><p><strong>Objective: </strong>To determine the strength of association between satisfaction with pharmacological treatment and adherence for glycemic control in adults with Type 2 Diabetes.</p><p><strong>Materials and methods: </strong>A cross-sectional predictive study with model testing was conducted. A total of 146 participants with Type 2 Diabetes were enrolled using snowball sampling. The Diabetes Treatment Satisfaction Questionnaire (DTSQ), the Morisky Medication Adherence Scale (MMAS-4), and a sociodemographic and clinical data form were administered, and glycated hemoglobin level was measured. Associations were estimated using multiple linear regression.</p><p><strong>Results: </strong>Adherence to pharmacological treatment only predicted glucose control. The difference in glycated hemoglobin between adherent and non-adherent individuals was 0.22 lower in adherent individuals (β = -0.22, F = 2.95, p = 0.001).</p><p><strong>Discussion: </strong>The results differ from other studies that have reported subsequent changes in glycated hemoglobin associated with treatment satisfaction.</p><p><strong>Conclusion: </strong>Adherence to pharmacological treatment influences glycemic control. It is essential for healthcare professionals to consider this evidence for decision- making and in the design, implementation, and/or reinforcement of educational interventions.</p>","PeriodicalId":43234,"journal":{"name":"Revista Cuidarte","volume":"16 3","pages":"e4128"},"PeriodicalIF":0.4,"publicationDate":"2025-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12834525/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147277350","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Burnout and perceived stress as predictors of quality of life in nurses.","authors":"Alexandra Estrella Buitron Saavedra, Alessandra Cricel Quispe Caballero, Jonatan Baños Chaparro","doi":"10.15649/cuidarte.5113","DOIUrl":"https://doi.org/10.15649/cuidarte.5113","url":null,"abstract":"<p><strong>Introduction: </strong>Burnout and perceived stress are prominent psychological problems manifested by nursing staff and substantially affect the quality of life and performance in daily activities of licensed nurses and nursing technicians.</p><p><strong>Objective: </strong>To analyze the influence of burnout and perceived stress on the quality of life of nursing personnel.</p><p><strong>Materials and methods: </strong>Predictive, comparative, cross- sectional, quantitative study. A total of 450 participants (42.89% registered nurses and 57.11% nursing technicians) from a public military hospital completed psychological instruments and were recruited through non-probability convenience sampling. Structural equation modeling and Bayesian analysis were performed.</p><p><strong>Results: </strong>The model demonstrated adequate fit, and negative stress (β = -0.59, p = 0.00) was identified as a statistically significant negative predictor of mental health. In addition, registered nurses reported higher levels of negative stress, depersonalization, and emotional exhaustion compared to nursing technicians.</p><p><strong>Discussion: </strong>Negative stress is a determinant of mental health in nurses, a finding consistent with empirical evidence in highly demanding work environments such as hospitals. The greater symptoms observed in registered nurses can be explained by their greater responsibility for patient care and the institution.</p><p><strong>Conclusion: </strong>Negative stress is a significant predictor of mental health in nursing personnel, and registered nurses reported higher levels of negative stress, depersonalization, and emotional exhaustion. Effective prevention strategies are needed to manage stress and burnout in clinical contexts.</p>","PeriodicalId":43234,"journal":{"name":"Revista Cuidarte","volume":"16 3","pages":"e5113"},"PeriodicalIF":0.4,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12834526/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147277298","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characterization of absconding and attempts to abscond in a Colombian general hospital.","authors":"Nicolas J Prada, Esteban Castrillón-Martínez, Ana María Perez-Gutierrez, Juan Pablo Zapata-Ospina","doi":"10.15649/cuidarte.4548","DOIUrl":"https://doi.org/10.15649/cuidarte.4548","url":null,"abstract":"<p><strong>Introduction: </strong>Patient absconding in healthcare institutions has been associated with negative outcomes for both patients and the institutions themselves. Despite this, few studies have evaluated the frequency and characteristics of these events in Latin America, especially in general healthcare hospitals that do not specialize in psychiatric care.</p><p><strong>Objective: </strong>To describe the sociodemographic and clinical characteristics, as well as the event characteristics, among patients who absconded or attempted to abscond from a tertiary general hospital in Medellín, Colombia, between 2015 and 2023.</p><p><strong>Materials and methods: </strong>Quantitative, descriptive cross-sectional study using secondary sources, where information was collected from the medical records of patients who absconded or attempted to abscond at the Hospital Alma Mater de Antioquia. A descriptive statistical analysis of the data was performed.</p><p><strong>Results: </strong>A total of 141 events were recorded during the evaluated period (135 absconds and 6 attempts to abscond). The period prevalence of absconding was 5.5 per 10,000 admissions, and most patients were young, single males, with a high frequency of substance use. Most events took place in the emergency department during the daytime.</p><p><strong>Discussion: </strong>Studying the epidemiological profile of absconding patients and their motivations could facilitate prevention and intervention.</p><p><strong>Conclusion: </strong>A lower absconding rate was found compared to reports from other countries. However, the characteristics of the patients were similar, with a predominance of young, single male patients with psychiatric history.</p>","PeriodicalId":43234,"journal":{"name":"Revista Cuidarte","volume":"16 3","pages":"e4548"},"PeriodicalIF":0.4,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12834524/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147277438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Silent victims: risk factors associated with school violence in Peruvian adolescents.","authors":"Jhan Carlos Manuel Fernández-Delgado, Francisca Edita Diaz-Villanueva, Carlos Jesus Canova-Barrios, Felipe Machuca-Contreras, Maria Kappes, Eman Sameh AbdElhay","doi":"10.15649/cuidarte.4878","DOIUrl":"https://doi.org/10.15649/cuidarte.4878","url":null,"abstract":"<p><strong>Introduction: </strong>School violence is a global and complex problem.</p><p><strong>Objective: </strong>Identify the types of school violence and their associated factors in Peruvian adolescents.</p><p><strong>Materials and methods: </strong>An analytical cross-sectional study was conducted. Two self-administered instruments were administered to 253 adolescents selected through stratified random sampling from the first to fifth grade of secondary school at a Peruvian public institution in 2024. Bivariate and multivariate regression analyses were used to identify factors associated with school violence.</p><p><strong>Results: </strong>Verbal violence (63.24%) and psychological violence (54.94%) were the most prevalent, while physical violence (37.55%) and sexual violence (3.95%) were less frequent. The most influential factors were individual (75.49%), social (62.87%), and family (56.13%) factors, whereas community (35.56%), cultural (35.97%), and school (43.10%) factors had less influence. Bivariate analysis revealed significant associations between school violence and sex (p = 0.03), family type (p = 0.02), socioeconomic status (p = 0.01), and area of residence (p = 0.03). Multivariate analysis found an association between individual, family, and social factors and school violence, specifically with verbal and psychological violence.</p><p><strong>Discussion: </strong>These findings confirm the central role of personal, social, and family dynamics in shaping experiences of school violence. Addressing only school-related factors may be insufficient; interventions should also target adolescents' interpersonal environments to achieve long-term impact.</p><p><strong>Conclusion: </strong>School violence is a complex and multifactorial phenomenon. Comprehensive intervention strategies are recommended, not only to reduce violence but also to promote positive school climates that support learning and emotional well-being.</p>","PeriodicalId":43234,"journal":{"name":"Revista Cuidarte","volume":"16 3","pages":"e4878"},"PeriodicalIF":0.4,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12834521/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147277365","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Geographic information systems for occupational cancer surveillance: a scoping review.","authors":"Diana Carolina Sanchez, Lorena Lisbeth Talero, Jose Ferney Mejia-Duarte, Alejandra Mendoza-Monsalve, Maricel Licht-Ardila, Alexandra Hurtado-Ortiz","doi":"10.15649/cuidarte.4747","DOIUrl":"https://doi.org/10.15649/cuidarte.4747","url":null,"abstract":"<p><strong>Introduction: </strong>Geographic Information Systems (GIS) are key tools for managing spatial data and understanding the determinants of occupational cancer.</p><p><strong>Objective: </strong>To evaluate the applications, advantages, and limitations of GIS in the surveillance of occupational cancer.</p><p><strong>Materials and methods: </strong>: A systematic scoping review was conducted using PubMed, Embase, Scopus, and Bireme databases, following the Population, Context, and Concept (PCC) framework outlined in the Joanna Briggs Institute (JBI) methodological guidelines and the PRISMA ScR. A semi-automated process supported by Rayyan® software was employed for study selection. The variables identified were transferred to a spreadsheet for qualitative analysis and synthesis.</p><p><strong>Results: </strong>A total of 55 articles were included, addressing various cancer types and exposure to industrial emissions and potentially carcinogenic pollutants. The most commonly used GIS, spatial analysis methodologies, and the main advantages and limitations of their use were identified in monitoring morbidity and mortality, equity, timeliness, coverage, and access to health services, as well as in modeling environmental agents.</p><p><strong>Discussion: </strong>GIS advance cancer research by integrating and analyzing diverse datasets, mapping cases, and identifying risk factors. Challenges include data accuracy, incomplete records, and omission of socioeconomic variables. Despite limitations, GIS support cancer surveillance, occupational health policies, and prevention plans.</p><p><strong>Conclusion: </strong>GIS are valuable tools for cancer surveillance, as they improve understanding of the geographic patterns of exposure and associated variables, providing critical insights for public policy formulation, healthcare planning, and preventive strategies.</p>","PeriodicalId":43234,"journal":{"name":"Revista Cuidarte","volume":"16 3","pages":"e4747"},"PeriodicalIF":0.4,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12834529/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147277357","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Social Frailty in Older People: A Concept Analysis.","authors":"Javier Rojas-Avila, Alejandra Ximena Araya, Nicole Pinilla Carrasco","doi":"10.15649/cuidarte.4939","DOIUrl":"https://doi.org/10.15649/cuidarte.4939","url":null,"abstract":"<p><strong>Introduction: </strong>Social frailty is a multidimensional concept that includes general and social resources, activities, and the fulfillment of needs; understanding and assessing it helps guide interventions for older adults.</p><p><strong>Objective: </strong>To clarify the concept of social frailty in older adults to improve its application in research, clinical practice, and education.</p><p><strong>Materials and methods: </strong>The Walker and Avant method was used to analyze social frailty in older adults, following stages such as concept selection, purpose definition, identification of uses, attributes, and related cases. Systematic searches were conducted in PubMed, ScienceDirect, Web of Science, and CINAHL, along with manual searches of references and dictionaries.</p><p><strong>Results: </strong>Social frailty in older adults is primarily defined as the loss of social resources, reduced ability to meet basic social needs, and diminished participation in meaningful activities such as maintaining close relationships, engaging in volunteering, having an occupation (paid or unpaid), and participating in religious or community activities. Factors such as loneliness, isolation, and lack of social support are associated with negative health outcomes.</p><p><strong>Discussion: </strong>Social frailty must be addressed from an interdisciplinary perspective. Health professionals should play an active role in identifying social frailty and implementing community-based strategies, psychosocial programs, and support networks that strengthen inclusion and social connection, thereby contributing to the prevention of functional and emotional decline.</p><p><strong>Conclusion: </strong>Social frailty impacts the physical, mental, and emotional health of older adults, underscoring the importance of inclusive, preventive, and care-centered policies.</p>","PeriodicalId":43234,"journal":{"name":"Revista Cuidarte","volume":"16 3","pages":"e4939"},"PeriodicalIF":0.4,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12654292/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145640680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Healthcare attention and access for deaf individuals: a phenomenological study.","authors":"Daniel Minte-Valderrama, Valentina Silva-Zurita, Camila Alvarado-Salfate, Jenifer Villa-Velásquez, Miguel Valencia-Contrera, Flérida Rivera-Rojas","doi":"10.15649/cuidarte.4665","DOIUrl":"https://doi.org/10.15649/cuidarte.4665","url":null,"abstract":"<p><strong>Introduction: </strong>In Chile, access to health care for deaf individuals faces communication and legal barriers.</p><p><strong>Objective: </strong>To reveal the experiences of deaf people from a southern province of Chile regarding their health care access between February 2022 and February 2023.</p><p><strong>Materials and methods: </strong>A qualitative phenomenological study was conducted with deaf individuals who had accessed health services in the past year. Semi-structured personal interviews were conducted with the support of Chilean Sign Language interpreters.</p><p><strong>Results: </strong>Participants aged 24 to 30 reported communication difficulties with health personnel, exacerbated by the lack of interpreters or facilitators trained in sign language, forcing them to rely on third parties and technological aids.</p><p><strong>Discussion: </strong>The barriers identified in health care access align with existing literature; however, the limited number of studies on the Chilean context restricts local comparisons.</p><p><strong>Conclusion: </strong>The findings highlight access barriers and issues in health care delivery, impacting care quality. Key challenges include improving physical spaces, communication strategies, health literacy, training, and culturally competent care.</p>","PeriodicalId":43234,"journal":{"name":"Revista Cuidarte","volume":"16 3","pages":"e4665"},"PeriodicalIF":0.4,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12654279/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145640614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}