Can Virtual Reality Help Improve Motor and Cognitive Function in Active Aging in Older Adults? A Scoping Review.

BACKGROUND: Active aging is considered one of the most effective methods for a healthy aging process. There are numerous clinical practice guidelines that address this model and propose multiple strategies for its achievement through the improvement of motor and cognitive function. Virtual reality is emerging as a potential tool, with various modalities focused on promoting good health maintenance in older adults. The objectives of this review were to map the potential benefits of virtual reality for active aging and delve into adaptability and adherence in older individuals. METHODS: A scoping review was conducted on studies published between 2013 and 2023 in English, Spanish, or Catalan, examining virtual reality interventions in older adults. The search was performed using the Medline, CINAHL, Scopus, and Web of Science databases. The methodological quality was assessed using CASPe and FLC 3.0 critical appraisal guidelines. The graphical data were reported narratively, grouping results based on the study characteristics and the impact of virtual reality. RESULTS: The review process resulted in the inclusion of 22 articles out of the initial 459 following the application of the selection criteria. Most articles were randomized controlled trials (45.4%; n = 10), systematic reviews (40.9%; n = 9), observational studies (9%; n = 2), and pilot studies (4.5%; n = 1). The information was organized based on the virtual reality modality (immersive, non-immersive, and 360) and application area (motor, cognitive, and mental health). CONCLUSIONS: Virtual reality (both immersive and non-immersive) is a valuable tool for promoting physical exercise in older adults, helping to prevent recurrent accidental falls. It also yields positive results for cognitive stimulation in healthy older individuals, improving memory, depression, and mental health in those with cognitive impairment. Virtual reality is generally well-received by older adults, achieving high adherence rates.

Nomophobia and Its Relationship with Social Anxiety and Procrastination in Nursing Students: An Observational Study.

Nomophobia is a phenomenon that describes the fear of not having one's mobile phone accessible. This study aimed to evaluate the presence of nomophobia among nursing students as well as its relationship with procrastination and social anxiety. METHODS: An observational, descriptive, cross-sectional study was conducted in a sample of 308 nursing students. Data were collected using the Nomophobia Questionnaire, Academic Procrastination Scale-Short Form, and Social Anxiety Questionnaire for Adults. Additionally, sociodemographic variables related to academic performance and smartphone use were collected. We performed a descriptive, bivariate, and multivariate analysis of the Nomophobia Questionnaire score. RESULTS: 19.5% (n = 60) of the students presented with or were at high risk of nomophobic behaviour. Moreover, nomophobic behaviour was positively correlated with high levels of social anxiety (p < 0.001), longer daily smartphone usage time (p < 0.001), and a high frequency of smartphone checking in class (p < 0.001). The predictive variables for nomophobic behaviour included age, variables related to smartphone use, social anxiety levels, work, procrastination tendency, sex, and self-reported average grade. CONCLUSION: One out of five students in the sample studied presented with or were at high risk of nomophobic behaviour. Additionally, nomophobic behaviour was associated with social anxiety and variables related to smartphone use. This study was not registered.

Impact of hospitalization on nutritional status in persons aged 65 years and over (NUTRIFRAG Study): Protocol for a prospective observational study.

BACKGROUND: Malnutrition is a recurring problem that has become more relevant in recent years. The aim of this study is to assess the risk of malnutrition and nutritional status on admission and its evolution until discharge in patients aged 65 and over admitted to medical and surgical hospitalization units in hospitals of the Spanish National Health System. METHODS: Prospective observational study to be carried out in the medical-surgical hospitalization units of 9 public hospitals between 01/09/2022 and 31/12/2024. Using consecutive sampling, a total of 4077 patients will be included (453 in each hospital). Variables included are related to the care process, functionality, cognition and comorbidity, risk profile, nutritional status and dysphagia; as well as frailty, dietary quality and contextual variables. The incidence of risk of malnutrition, undernutrition and dysphagia during the care process and at discharge will be calculated. The association with risk factors will be studied with logistic regression models and multivariate Cox regression models. In addition, an analysis of participants' satisfaction with food services will be carried out. The study was approved by the Ethics and Research Committee on 30/09/2020, approved for funding on 02/12/2021 and with registration number RBR-5jnbyhk in the Brazilian clinical trials database (ReBEC) for observational studies. DISCUSSION: Some studies address nutritional status or dysphagia in older people in various care settings. However, there is a lack of large sample studies including both processes of the impact of hospitalization. The results of the project will provide information on the incidence and prevalence of both pathologies in the study subjects, their associated factors and their relationship with the average length of stay, mortality and early readmission. In addition, early detection of a problem such as malnutrition related to the disease and/or dysphagia during a hospital stay will favor the action of professionals to resolve both pathologies and improve the health status of patients.

Breastfeeding and Obstetric Violence during the SARS-CoV-2 Pandemic in Spain: Maternal Perceptions.

Catalan legislation, a pioneer in Europe, has defined obstetric violence (OV) as "preventing or hindering access to truthful information, necessary for autonomous and informed decision-making". The definition also states that OV can affect physical and mental health, as well as sexual and reproductive health. Some authors have expressed concern about an increase in OV during the SARS-CoV-2 pandemic. During the pandemic, recommendations were also openly offered on the non-establishment and/or early abandonment of breastfeeding without scientific evidence to support them. Experiencing a traumatic childbirth can influence breastfeeding outcomes. Here, we conducted a cross-sectional study using a self-administered online questionnaire. The sample consisted of women who gave birth in Spain between March 2020 and April 2021. The mean age was 34.41 (±4.23) years. Of the women, 73% were employed, 78.2% had a university education, and almost all were Caucasian. Among the subjects, 3.3% were diagnosed with SARS-CoV-2 during pregnancy and 1% were diagnosed during delivery. Some of the women (1.6%) were advised to stop breastfeeding in order to be vaccinated. Women diagnosed with SARS-CoV-2 during delivery (p = 0.048), belonging to a low social class (p = 0.031), with secondary education (p = 0.029), or who suffered obstetric violence (p < 0.001) perceived less support and that the health care providers were less inclined to resolve doubts and difficulties about breastfeeding. Breastfeeding has been significantly challenged during the pandemic. In addition to all the variables to be considered that make breastfeeding support difficult, we now probably need to add SARS-CoV-2 diagnosis and OV.

Integrative review of the literature on screening for gender-based violence during pregnancy: Barriers, facilitators, and tools.

An integrative review of the literature has been developed to explore barriers and facilitators in screening for gender-based violence in pregnant women and identify available tools for this screening. Studies were identified via a systematic search on the PubMed, CINAHL Plus (Cumulative Index of Nursing and Allied Health Literature Complete), Scopus, and LILACS (Latin American and Caribbean Health Sciences Literature) databases and a manual reverse reference search to obtain literature published between 2015 and 2020. The methodology followed the recommendations made by Whittemore & Knafl. The quality of studies was evaluated using the Critical Skills Appraisal Program tool. Twenty-three of the 4202 articles fulfilled the inclusion criteria. The principal barriers identified were lack of training for professionals (mainly nurses and midwives), lack of support policies, and lack of human and material resources. The main facilitators were to increase professional training programs on case detection, availability of effective instruments, and greater investment in resources to guarantee safety and referral of cases. With regard to the available tools, the Abuse Assessment Screen (AAS) continues to be the most widely used, although others such as the Humiliation, Afraid, Rape, and Kick questionnaire (HARK) could be suitable for antenatal care settings.

Influence of Health Literacy on Maintenance of Exclusive Breastfeeding at 6 Months Postpartum: A Multicentre Study.

Background: International organizations recommend initiating breastfeeding within the first hour of life and maintaining exclusive breastfeeding for the first 6 months. However, worldwide rates of exclusive breastfeeding for 6-month-old infants is far from meeting the goal proposed by the World Health Organization, which is to reach a minimum of 50% of infants. Education is one of the factors affecting the initiation and continuation of breastfeeding, and incidentally, it is also related to lower health literacy. This study explored the influence of health literacy on maintenance of exclusive breastfeeding at 6 months postpartum. Methods: A longitudinal multicenter study with 343 women were recruited between January 2019 and January 2020. The first questionnaire was held during the puerperium (24−48 h) with mothers practicing exclusive breastfeeding, with whom 6-month postpartum breastfeeding follow-up was performed. Socio-demographic, clinical and obstetric variables were collected. Breastfeeding efficiency was assessed using the LATCH breastfeeding assessment tool. The health literacy level was evaluated by the Newest Vital Sign screening tool. A multivariate logistic regression model was used to detect protective factors for early exclusive breastfeeding cessation. Results: One third of the women continued exclusive breastfeeding at 6 months postpartum. Approximately half the participants had a low or inadequate health literacy level. An adequate health literacy level, a high LATCH breastfeeding assessment tool score (>9 points) and being married were the protective factors against exclusive breastfeeding cessation at 6 months postpartum. Conclusion: Health literacy levels are closely related to maintaining exclusive breastfeeding and act as a protective factor against early cessation. A specific instrument is needed to measure the lack of "literacy in breastfeeding", in order to verify the relationship between health literacy and maintenance of exclusive breastfeeding.

Perception of obstetric violence in a sample of Spanish health sciences students: A cross-sectional study.

BACKGROUND: Obstetric violence is a problem that has grown worldwide, and a particularly worrying one in Spain. Such violence has repercussions for women, and for the professionals who cause them. Preventing this problem seems fundamental. OBJECTIVE: This study evaluated how health sciences students perceived obstetric violence. DESIGN: A cross-sectional study conducted between October 2019 and November 2020. PARTICIPANTS: A sample of Spanish health sciences students studying degrees of nursing, medicine, midwifery, and psychology. METHODS: A validated questionnaire was used: Perception of Obstetric Violence in Students (PercOV-S). Socio-demographic and control variables were included. A descriptive and comparative multivariate analysis was performed with the obtained data. RESULTS: 540 questionnaires were completed with an overall mean score of 3.83 points (SD ± 0.63), with 2.83 points (SD ± 0.91) on the protocolised-visible dimension and 4.15 points (SD ± 0.67) on the non-protocolised-invisible obstetric violence dimension. Statistically significant differences were obtained for degree studied (p < 0.001), gender (p < 0.001), experience (p < 0.001), ethnic group (p < 0.001), the obstetric violence concept (p < 0.001) and academic year (p < 0.005). There were three significant multivariate models for the questionnaire's overall score and dimensions. CONCLUSIONS: Health sciences students perceived obstetric violence mainly as non-protocolised aspects while attending women. Degree studied and academic year might be related to perceived obstetric violence.

Necessary political competences for nurses from the perception of the student body: Cross-sectional study in Spain.

BACKGROUND: Nursing should have a fundamental role in the development of health policies. The current state of the educational system regarding leadership-related skills and political competence in nursing students is a field to explore. OBJECTIVES: To explore Spanish nursing students' perceptions about their political competence. DESIGN: Cross-sectional study that was carried out between December 2019 and June 2020. SETTINGS AND PARTICIPANTS: Students of the Degree in Nursing at the Universitat Jaume I (Spain). METHODS: An ad hoc scale composed of 33 items was designed. Sociodemographic variables of interest for the study were collected, such as participation in organizations. A descriptive analysis of the sample and the scale and a bivariate analysis were carried out. RESULTS: 91.8% (n = 90) of items were answered by women. The 2nd (40.8%, n = 40) and 4th (29.6%, n = 29) courses were the most represented. 29.6% (n = 29) belonged to some association or organization, with sports (31.1%, n = 9), NGOs (17.2%, n = 5), cultural (17.2%, n = 5) and student organizations (13.8%, n = 4) being the most represented. Within these associations, 48.3% (n = 14) of participants claimed to have an active role. Statistically significant differences were observed by course in the Political Knowledge category (p = 0.030). The variables "belonging to an organization" and "having an active role" in it seemed to have more influence on the scale than the rest of the sociodemographic variables. CONCLUSIONS: Learning strategies must benefit from skills and prior experiences of students to strengthen new learning. It also seems to be important to emphasize that the theoretical basis is important, but that promoting civic participation among students can be very relevant for the acquisition of political competence.

Obstetric Violence in Spain (Part III): Healthcare Professionals, Times, and Areas.

BACKGROUND: Obstetric violence is a worldwide public health problem, which seems greater in Spain. As no studies were found that identify the most representative healthcare professionals, times, and areas involved in obstetric violence, the objective of this work was to study at what time of maternity, with which professionals, and in what areas women identified obstetric violence. METHODS: This descriptive, retrospective, and cross-sectional study was performed from January 2018 to June 2019. The main variables were the area (hospital, primary care, both), the time (pregnancy, birth, puerperium), and the professionals attending to women. RESULTS: Our sample comprised 17,541 participants. The area identified with the most obstetric violence for the different studied variables was hospitals. Women identified more obstetric violence at time of birth. Findings such as lack of information and informed consent (74.2%), and criticism of infantile behavior and treatment (87.6%), stood out. The main identified healthcare professionals were midwives and gynecologists, and "other" professionals repeatedly appeared. CONCLUSIONS: Having identified the professionals, times, and areas of most obstetric violence in Spain, it seems necessary to reflect on not only the Spanish National Health System's structure and management but also on healthcare professionals' training.

Telelactation with a Mobile App: User Profile and Most Common Queries.

Background: Mobile applications related to health issues are currently expanding. Different uses of new technologies have produced positive results regarding breastfeeding support. Breastfeeding applications are increasing. Objective: We conducted a descriptive analysis of a mobile application for breastfeeding (LactApp) to study the user profile and the most frequent queries. Materials and Methods: This was a retrospective, comparative, and descriptive ecological time-series study of LactApp from 2016 to 2019. Google Analytics and the app itself were used for data collection. The data were analyzed in Excel, and for the time series, Prais-Winsten autoregressions were applied based on the Durbin-Watson method in Stata. Results: A total of 115,830 users and 71,780 infants were registered in the application. A total of 1.91% of these users obtained the medical version. The application was used for both queries and surveys and for users to interact through chat. A total of 30.17% of the responses were related with "baby's sleep" (8.94%), 8.91% were related to "preservation of milk," 6.16% were related to "breastfeeding crisis," and 6.15% were related to "physiological evolution of breastfeeding," all with an increasing trend. Conclusion: LactApp is a resource for breastfeeding that is widely downloaded and used by a substantial number of individuals. The most recurring topics were baby's sleep, milk extraction and preservation, breastfeeding crisis and physiological evolution of breastfeeding.

Design and Validation of the PercOV-S Questionnaire for Measuring Perceived Obstetric Violence in Nursing, Midwifery and Medical Students.

BACKGROUND: Obstetric violence could be defined as the dehumanized treatment or abuse of health professionals towards the body or reproductive process of women. Some practices associated with obstetric violence have been routinely standardized and do not include the woman in decision making. This type of violence has consequences for the health of both the mother and the baby and that of the professionals who practice or observed it. METHODS: A questionnaire consisting of 33 items that measured perception through a Likert scale was developed. Some sociodemographic variables were collected. The instrument was applied to a sample of nursing, medicine and midwifery students to determine its psychometric properties. RESULTS: The final sample consisted of 153 students. The Kaiser-Meyer-Olkin (p = 0.918) and Barlett tests (p ≤ 0.001) allowed for factor analysis, which explained 54.47% of the variance in two factors called protocolized-visible obstetric violence and non-protocolized-invisible obstetric violence. CONCLUSIONS: The PercOV-S (Perception of Obstetric Violence in Students) instrument was validated. The distribution and content of the two factors are closely related to obstetric violence against women. The existence of statistically significant relationships between the sociodemographic variables collected and the global measurements, domains and items of the PercOV-S scale highlight the normalization of obstetric violence as a central factor for future studies.

Obstetric Violence in Spain (Part I): Women's Perception and Interterritorial Differences.

The decentralization of health systems can have direct repercussions on maternity care. Some inequalities can be noted in outcomes, like neonatal and child mortality in Spain. This study aimed to make the presence of obstetric violence in Spain visible as an interterritorial equity criterion. A descriptive, restrospective and cross-sectional study was conducted between January 2018 and June 2019. The sample comprised 17,541 questionnaires, which represented all Spanish Autonomous Communities. Of our sample, 38.3% perceived having suffered obstetric violence; 44.4% perceived that they had undergone unnecessary and/or painful procedures, of whom 83.4% were not requested to provide informed consent. The mean satisfaction with the attention women received obtained 6.94 points in the general sample and 4.85 points for those women who viewed themselves as victims of obstetric violence. Spain seems to have a serious problem with public health and respecting human rights in obstetric violence. Offering information to women and requesting their informed consent are barely practiced in the healthcare system, so it is necessary to profoundly reflect on obstetric practices with, and request informed consent from, women in Spain.

Female Employees' Perception of Breastfeeding Support in the Workplace, Public Universities in Spain: A Multicentric Comparative Study.

BACKGROUND: Despite scientific recommendations for exclusive breastfeeding until 6 months of age and complementary breastfeeding to 2 years of age, breastfeeding abandonment rates increase with time, and one of the main reasons is that women go back to work. AIM: To analyze the perception of support of breastfeeding workers to continue breastfeeding at two Spanish universities, and associated factors. METHODS: A multicenter retrospective cross-sectional comparative study conducted in a population of 777 female workers at the Universidad de Sevilla (US) and the Universitat Jaume I (UJI) in Spain using an online questionnaire. RESULTS: The response rate was 38.74% (n = 301). Of all the participants, 57.8% continued breastfeeding after returning to work. The factors associated with continuing breastfeeding for longer were the university having a breastfeeding support policy and special accommodation (p < 0.001); participating in breastfeeding support groups (p < 0.001); intending to continue breastfeeding after returning to work (p < 0.001); knowing the occupational legislation in force (p = 0.009); having a female supervisor (p = 0.04). CONCLUSION: Breastfeeding support initiatives and having special accommodation to pump and preserve breast milk after returning to work are associated with a longer duration of female workers' breastfeeding.

Is it compatible with breastfeeding? www.e-lactancia.org: Analysis of visits, user profile and most visited products.

INTRODUCTION: One of the factors to influence abandoning breastfeeding is mothers' use of medications. The www.e-lactancia.org website is a reliable source in Spanish and English for online free-access information about the compatibility of medications with breastfeeding. The aim of this study was to analyse the search profiles, and groups and products, searched the most on this website. MATERIALS AND METHODS: A retrospective and descriptive study of the e-lactancia.org website during 2014-2018. Google Analytics was used for data collection. The following variables were analysed: number of users and queries; professional profile; country; language; users' and groups' access modes/devices; most searched products. RESULTS: We found 16,821.559 users and 63,783.866 pages. Of users, 62.7 % were "mother/father", and 31.9 % were health professionals. Visits came mostly from: Spain (25.86 %); Mexico (16.87 %); Argentina (7.99 %); Chile (7.31 %). The preferred access mode and device were organic searches (62.1 %) and mobile phones (73.4 %), respectively. Phytotherapy (14.4 %), antibacterial agents (12.3 %) and NSAIDs (12.3 %) were the most searched groups, and ibuprofen (6.25 %) was the most popular product. CONCLUSION: Users and consultations in e-lactation increased significantly during the study period. Mothers/fathers were the main website users, followed by health professionals. The main consulted groups were antibacterial agents, NSAIDs and systemic phytotherapy. Ibuprofen, paracetamol and amoxicillin stood out as the most consulted products. These results revealed increase Internet resources use to solve parents and health professionals' breastfeeding doubts. Future research should study how users (parents, health professionals) interact with this information.

Changes in health sciences students' perception of obstetric violence after an educational intervention.

BACKGROUND: Obstetric violence is a type of gender-based violence that is presented structurally. This type of violence has physical and psychological consequences for both the women who experience it and health professionals. The World Health Organization adds that health professionals need training to ensure that pregnant women are treated with compassion and dignity. OBJECTIVES: The objective of the study was to evaluate health sciences students' perception of obstetric violence and to identify possible changes after an educational intervention. DESIGN: A pre-post quasi-experimental study was carried out between January and June 2019. SETTINGS AND PARTICIPANTS: Students of medicine and nursing from Jaume I University (Universitat Jaume I) (Spain). METHODS: An ad hoc scale comprising 33 items was designed to measure the students' perceptions. In addition, sociodemographic and control variables were collected. Descriptive analyses of the sample and the scale were carried out, and a bivariate analysis was performed. RESULTS: Of the students surveyed, 89.7% were women, and the majority was nursing students. Of the 33 items, 28 (84.84%) showed statistically significant changes in the pre-post-intervention measurement. Twenty-five of the 33 items (75.75%) showed a relationship with the sociodemographic variables of gender, field, course and ever having been pregnant. CONCLUSION: This study shows the change in health sciences students' perceptions of obstetric violence after an educational intervention. In addition, the normalization of this type of violence was observed with the progression of training and with personal obstetric experience.

Obstetric Violence in Spain (Part II): Interventionism and Medicalization during Birth.

BACKGROUND: obstetric violence can partially be represented by the high number of interventions and medicalization rates during the birthing process. The objective of the present study was to determine the interventionism and medicalization levels during childbirth in Spain. METHODS: a descriptive, retrospective, and cross-sectional study was conducted between January 2018 and June 2019. RESULTS: the intervention percentages were 34.2% for Kristeller maneuver and 39.3% for episiotomy. Differences appeared in public, private, and mixed healthcare settings (p < 0.001). The mean satisfaction, with healthcare in the different settings, was estimated at 6.88 points (SD ± 2.146) in public healthcare, 4.76 points (SD ± 3.968) in private healthcare, and 8.03 points (SD ± 1.930) in mixed healthcare (p < 0.001). No statistically significant differences were found in Spanish autonomous communities. CONCLUSIONS: births in Spain seem to be highly intervened. In this study, a certain equity criterion was found concerning interventionism during childbirth in Spain. Healthcare influenced female intervention, satisfaction, and perception levels for obstetric violence; this evidences that female empowerment plays an important role.

Burnout syndrome in nursing students: An observational study.

BACKGROUND: Academic burnout appears attributable to work and academic overload and may negatively affect learning and care quality during clinical clerkship. OBJECTIVES: To evaluate the presence of burnout syndrome in nursing students and to detect the main stressors that occur during clinical clerkship. DESIGN: Observational, descriptive and cross-sectional study carried out between January and July 2017. SETTINGS AND PARTICIPANTS: Second-, third- and fourth-year nursing students at Jaume I University (Universitat Jaume I) (Spain) (n = 126). METHODS: The KEZKAK questionnaire and the Maslach Burnout Inventory Student Survey were used when carrying out the data collection; sociodemographic and clinical clerkship variables were also collected. Descriptive and bivariate analyses of these instruments' variables were performed. RESULTS: No student manifested high levels of depersonalisation or low personal accomplishment. Moreover, depersonalisation was found to increase as the academic year progressed (p = 0.027). The most stressful factors were Helplessness and Uncertainty (m = 3.61, sd = 0.345) and Confusion of Medication (m = 2.50, sd = 0.754). The female subsample showed higher stress levels due to multiple factors, such as Lack of Competence (p = 0.001) and Having to Give Bad News (p = 0.01). CONCLUSION: This study found that its sample did not meet the criteria indicating the presence of burnout syndrome. In addition, the main stressors affecting nursing students during clinical clerkship were identified.

Cross-cultural adaptation and validation of Pamela Reed's Self-Transcendence Scale for the Spanish context.

OBJECTIVES: the current study aimed to adapt the Self-Transcendence Scale (STS) to the Spanish context and analyse its psychometric properties. METHOD: the STS was administered to a general Spanish population of adults (i.e., older than 20 years; n = 116) through an online platform. The Psychological Well-Being (PWB) and the Functional Assessment of Chronic Illness Therapy - Spiritual Well-being - modified version for healthy people (FACIT-Sp-Non-Illness) scales were also applied in two moments separated by an interval of 15 days. RESULTS: the results of the validation included the following statistics: α t = 0.772 (test) and α rt = 0.833 (retest); ICC = 0.278 (p = 0.097, intraclass) and 0.932 (p < 0.001, interclass); a Bland-Altman confirmation of the test/re-test (TRT) concordance; global content validity coefficient (S-CVI) = 0.92; r 1 = 0.636 (PWB) and r 2 = 0.687 (FACIT-Non-Illness; both p < 0.001); and three factors explained 42.3% of the variance. The STS showed positive apparent validity and feasibility. CONCLUSIONS: the Spanish version of the STS is valid for use in the general population, with updates relative to the Colombian version that include more natural wordings, syntactic corrections, inclusive language, a better definition of the concepts, and an alternative factor model.