Anales del sistema sanitario de Navarra最新文献

{"title":"[Evaluation of a multidisciplinary care programme for people with obesity using patient reported outcome and experience measures (PROMs and PREMs)].","authors":"Ana Zugasti Murillo, Miguel Martí Martínez, Henry Rendón Barragán, Sonsoles Botella Martínez, Amelia Marí Sanchis, Bertha Ortigosa Pezonaga, Maite Yeregui Balda","doi":"10.23938/ASSN.1180","DOIUrl":"https://doi.org/10.23938/ASSN.1180","url":null,"abstract":"<p><strong>Background: </strong>PROMs and PREMs complement clinical indicators by incorporating patient-reported health outcomes and experiences, respectively. However, their combined integration into the multidimensional assessment of care for individuals with obesity remains limited. The aim of this study is to evaluate, using PREMs and PROMs, patient-reported perceptions following a multidisciplinary intervention in individuals with obesity.</p><p><strong>Methodology: </strong>An observational, descriptive, cross-sectional study evaluating PREMs and PROMs using ad hoc, non-validated questionnaires answered by patients who completed the 12-month intensive multidisciplinary intervention in individuals with obesity. Domain scores were described using the median and interquartile range (IQR), sex as a percentage, and age and body mass index as means.</p><p><strong>Results: </strong>Of the 26 patients invited, 14 responded to the PROM questionnaire (53.8%) and 13 to the PREM questionnaire (50.0%). All three PROM domains had a median score of 3.50 (1-4 scale). Among PREMs, Participation in decision-making had the highest median score (5.00; IQR: 4.33-5.00), whereas Access and organisation had the lowest (4.00; IQR: 3.67-4.33).</p><p><strong>Conclusions: </strong>The combined use of PROMs and PREMs identified strengths and areas for improvement in the care model. These descriptive findings require further confirmation using validated instruments and longitudinal assessment.</p>","PeriodicalId":500996,"journal":{"name":"Anales del sistema sanitario de Navarra","volume":"49 3","pages":""},"PeriodicalIF":0.6,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149198618","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Long-term maintenance of the emotional benefits of cognitive stimulation in early-stage cognitive impairment].","authors":"Isabel Gómez-Soria, Juan Nicolás Cuenca-Zaldivar, Bárbara Oliván-Blazquez, Alejandra Aguilar-Latorre, Rosa Mª Magallón-Botaya, Estela Calatayud","doi":"10.23938/ASSN.1164","DOIUrl":"10.23938/ASSN.1164","url":null,"abstract":"<p><strong>Background: </strong>To assess the long-term (12-month) effects of computerized cognitive stimulation versus stimulating leisure activities in adults with subjective cognitive impairment (SCI) and mild cognitive impairment (MCI).</p><p><strong>Methods: </strong>A 12-month follow-up of a single-blind randomized controlled trial was conducted in primary care centres in Zaragoza, Spain, including 50 adults aged = 50 years with SCI or MCI. Participants were allocated to one of three groups: the computerized cognitive stimulation group (IG1, n=18), the stimulating leisure activities group (IG2, n=16), or a control group (CG, n=16). The primary outcome was global cognitive function; secondary outcomes included memory, verbal fluency, activities of daily living, and mood. Effect sizes were calculated using bootstrapped partial eta-squared (?2p) Results. At 12 months, significant between-group differences were observed in depressive symptoms according to the GDS-15 score (p = 0.005, ?2p = 0.209) and anxiety levels measured by the Goldberg Index score (p &lt; 0.001, ?2p = 0.295). Both intervention groups (IG1 and IG2) showed sustained improvements in depressive symptoms, while anxiety levels remained stable in the intervention groups and worsened in the CG.</p><p><strong>Conclusions: </strong>Participation in computerized cognitive stimulation or stimulating leisure activities associates with sustained, long-term improvements in depressive symptoms and levels of anxiety, supporting the effectiveness of non-pharmacological interventions in primary healthcare.</p>","PeriodicalId":500996,"journal":{"name":"Anales del sistema sanitario de Navarra","volume":"49 2","pages":""},"PeriodicalIF":0.6,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13633059/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148852214","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":"[Early detection and active intervention in cognitive decline: A healthcare challenge].","authors":"David Brugos Miranda, Rosa Larumbe Ilundáin","doi":"10.23938/ASSN.1178","DOIUrl":"10.23938/ASSN.1178","url":null,"abstract":"","PeriodicalId":500996,"journal":{"name":"Anales del sistema sanitario de Navarra","volume":"49 2","pages":""},"PeriodicalIF":0.6,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13588550/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148835854","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":"[Primary aldosteronism in resistant hypertension unmasked by a thiazide-induced severe hypokalaemia].","authors":"Antonio José Del Rey Fernández, Ana Garcia-Luengo Pensado, Elena Reyzabal Ereño","doi":"10.23938/ASSN.1174","DOIUrl":"10.23938/ASSN.1174","url":null,"abstract":"<p><p>Primary aldosteronism is the most common cause of secondary hypertension but remains frequently underdiagnosed in primary care. We report a 71-year-old man with resistant hypertension and low-normal serum potassium in whom a minimal increase in hydrochlorothiazide dosage (12.5 to 25 mg) precipitated severe hypokalaemia (1.6 mmol/L), metabolic alkalosis, and rhabdomyolysis. An office electrocardiogram showed hypokalaemia-related changes, prompting urgent referral to the emergency department. Further evaluation revealed an elevated aldosterone-to-renin ratio and a left adrenal nodule, supporting the diagnosis of primary aldosteronism. This case highlights the importance of recognizing a disproportionate hypokalaemic response to thiazide treatment as a potential indicator of underlying primary aldosteronism. It also underscores the role of family physicians in early detection through appropriate screening.</p>","PeriodicalId":500996,"journal":{"name":"Anales del sistema sanitario de Navarra","volume":"49 2","pages":""},"PeriodicalIF":0.6,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13588551/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148835859","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":"Non-pharmacological interventions and quality of life in female survivors of hormone receptor-positive breast cancer receiving adjuvant endocrine therapy: A systematic review.","authors":"Ariana Arias-Martínez, Paula Escalada-Hernández, Gustavo Adolfo Pimentel-Parra, Cristina García-Vivar, Nelia Soto-Ruiz","doi":"10.23938/ASSN.1176","DOIUrl":"10.23938/ASSN.1176","url":null,"abstract":"<p><p>Background Hormone receptor-positive breast cancer is treated with endocrine therapies to reduce recurrence and mortality. These therapies have side effects that negatively affect quality of life (QoL). We aim to synthesize the available evidence on the impact of non-pharmacological interventions on QoL and its specific domains (physical, psychological, social, and spiritual) in female breast cancer survivors undergoing endocrine therapies. Methods A systematic review following the Cochrane and PRISMA guidelines was registered in PROSPERO (CRD42024524238). Studies published from January 2013 to October 2025 were retrieved from PubMed, the Cochrane Library, Scopus, and Web of Science. Randomized controlled trials evaluating QoL in female with BC aged over 18 years, and undergoing endocrine therapies were included. Due to methodological and clinical heterogeneity, a narrative synthesis was performed instead of a meta-analysis. The RoB2 tool was used to assess the risk of bias. Results Seven studies (with 713 participants) were included. Non-pharmacological interventions such as physical exercise, hydrotherapy, physiotherapy, and health promotion programs were analysed. Physical exercise interventions showed significant improvement in overall QoL and specific domains. Conclusions Non-pharmacological interventions show variable effects on QoL in female breast cancer survivors undergoing endocrine therapies. While physical exercise appears promising, the high methodological heterogeneity and limited evidence preclude definitive conclusions. Future research should focus on standardized approaches.</p>","PeriodicalId":500996,"journal":{"name":"Anales del sistema sanitario de Navarra","volume":"49 2","pages":""},"PeriodicalIF":0.6,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13588552/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148835840","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":"Empathy is positively associated with compassion fatigue among nurses working in neonatal and pediatric intensive care: A cross-sectional study.","authors":"Birsen Mutlu, Zeynem Yildirim Balkan, Esra Cumur Baskir","doi":"10.23938/ASSN.1171","DOIUrl":"10.23938/ASSN.1171","url":null,"abstract":"<p><strong>Background: </strong>This study examined the association between empathy and compassion fatigue among nurses working in neonatal and pediatric intensive care units.</p><p><strong>Methods: </strong>A cross-sectional study was conducted among nurses employed in neonatal and pediatric intensive care units at three hospitals in Turkey. Sociodemographic and occupational data were collected, and participants completed the Jefferson Scale of Empathy and the Compassion Fatigue Short Scale. Pearson´s correlation and linear regression analyses were performed to examine the association between empathy, compassion fatigue, and other study variables.</p><p><strong>Results: </strong>Sixty-five nurses participated in the study, representing 90.3% of the target population. Mean empathy and compassion fatigue scores were 79.77 ± 8.69 and 52.09 ± 20.44, respectively. A moderate positive correlation was observed between empathy and compassion fatigue (r = 0.484). Empathy explained 22.2% of the variance in compassion fatigue (R² = 0.222; B = 1.139; 95% CI: 0.621 - 1.657; p &lt; 0.001). Nurses who had voluntarily chosen nursing reported significantly lower compassion fatigue scores than those who had not (49.14 ± 19.39 vs 61.93 ± 21.42; p = 0.032). Working more than 50 hours per week was associated with higher empathy scores (84.06 ± 11.58 vs 78.82 ± 6.46; p = 0.046), but not with compassion fatigue.</p><p><strong>Conclusions: </strong>Higher empathy associates with greater compassion fatigue among nurses working in neonatal and pediatric intensive care units. Voluntarily choosing nursing associates with lower compassion fatigue, whereas longer working hours associate with higher empathy.</p>","PeriodicalId":500996,"journal":{"name":"Anales del sistema sanitario de Navarra","volume":"49 2","pages":""},"PeriodicalIF":0.6,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13548297/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148804279","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":"[Primary care research: The science of proximity - How can we transform everyday practice into a driver of scientific progress?]","authors":"Nuria Goñi-Ruiz, Sara Furtado-Eraso","doi":"10.23938/ASSN.1177","DOIUrl":"10.23938/ASSN.1177","url":null,"abstract":"","PeriodicalId":500996,"journal":{"name":"Anales del sistema sanitario de Navarra","volume":"49 2","pages":""},"PeriodicalIF":0.6,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13548296/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148804242","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":"[Impact of an indicated prevention program on risk behaviors among adolescents at psychosocial risk].","authors":"Garikoitz Mendigutxia, José J López-Goñi","doi":"10.23938/ASSN.1173","DOIUrl":"10.23938/ASSN.1173","url":null,"abstract":"<p><strong>Background: </strong>Indicated prevention targeting adolescents at psychosocial risk is a public health priority, yet evidence on its effectiveness in Spain remains limited. This study evaluates the impact of a preventive program on personality traits, personal competencies, psychopathological symptoms, cannabis use, and other risk behaviors.</p><p><strong>Methods: </strong>A quasi-experimental design with three assessment points (pre-intervention, post-intervention, and three-month follow-up) was used. Participants were adolescents recruited though the Suspertu Programme of Fundación Proyecto Hombre Navarra between March 2014 and June 2017. Validated instruments assessing personality, psychopathology, and risk behaviors were administered. Statistical analyses included repeated-measures general linear models, effect sizes were estimated using Cohen's d.</p><p><strong>Results: </strong>The sample comprised 61 adolescents (44 males, 72.1%), with a mean age of 16.7 years (SD = 2.0). Statistically significant changes were observed in personality variables and improvements in personal competencies, including self-esteem, self-efficacy, planning, and decision-making. Significant improvements were also observed across all Symptom Checklist-90-Revised dimensions at both post-intervention and follow-up. Daily cannabis use decreased from 45.5% to 4.5% among males and from 37.5% to 18.8% among females. A general reduction in other risk behaviors was also observed.</p><p><strong>Conclusions: </strong>These findings support the effectiveness of the Suspertu Programme as an indicated prevention intervention, with positive effects maintained at three-month follow-up. The findings also underscore the importance of considering sex as a potential differentiating factor when designing and implementation indicated prevention programs.</p>","PeriodicalId":500996,"journal":{"name":"Anales del sistema sanitario de Navarra","volume":"49 2","pages":""},"PeriodicalIF":0.6,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13548298/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148804195","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":"[Nurses' perceptions of the integration of patient-reported experience measures and patient-reported outcome measures for care improvement: A multicenter qualitative study].","authors":"Cayetana Ruiz-Zaldibar, Pilar Montes-Muñoz, Mayte Ruano-Sanz, Desiree Cidoncha-López, Sandra Crespo-Hernández, María de la Loma Segarra-Cañamares","doi":"10.23938/ASSN.1169","DOIUrl":"10.23938/ASSN.1169","url":null,"abstract":"<p><strong>Background: </strong>Patient-reported experience measures (PREMs) and patient-reported outcome measures (PROMs) are increasingly recognized as valuable tools for evaluating healthcare quality. This study aims to explore nurses' perceptions across diverse clinical settings regarding the usefulness of PREMs and PROMs for identifying opportunities to improve care and informing quality improvement initiatives.</p><p><strong>Materials and methods: </strong>Interpretive, exploratory, multicenter qualitative study conducted between November 2025 and February 2026. Five focus groups were held with 32 nurses recruited through purposive sampling from inpatient wards, adult and neonatal intensive care units, emergency departments, operating rooms, and oncology units across four HM hospitals in Madrid. Data were collected using a semi-structured interview guide and analyzed through inductive thematic analysis.</p><p><strong>Results: </strong>Six themes emerged: 1) communication, therapeutic relationship, and humanized care as key determinants of patient experience; 2) holistic care, particularly comfort, patient safety, and pain management; 3) clinical information and patient education to reduce uncertainty and improve continuity of care; 4) positive perceptions of PREMs and PROMs despite their limited systematic implementation; 5) organizational constraints, workload, and time pressure as major barriers; and 6) opportunities for innovation through humanization strategies, technology integration, and advanced nursing practice.</p><p><strong>Conclusions: </strong>Nurses perceive PREMs and PROMs as valuable resources for improving patient-centered case and supporting quality improvement. However, their integration into routine clinical practice remains limited by organizational and structural barriers. Addressing these challenges may facilitate the systematic use of patient-reported measures to enhance care quality and patient outcomes.</p>","PeriodicalId":500996,"journal":{"name":"Anales del sistema sanitario de Navarra","volume":"49 2","pages":""},"PeriodicalIF":0.6,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13548292/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148804284","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":"The neuromatrix theory: A necessary step toward multidimensional understanding of pain by medical students.","authors":"Daniel Alexander Huayamis Huasupoma, Grace Connie Riquelme Murguia","doi":"10.23938/ASSN.1175","DOIUrl":"10.23938/ASSN.1175","url":null,"abstract":"","PeriodicalId":500996,"journal":{"name":"Anales del sistema sanitario de Navarra","volume":"49 2","pages":""},"PeriodicalIF":0.6,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13548293/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148804290","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}