Virtual reality and critical care education in nursing: A cross-sectional study.

BACKGROUND: The nursing care of a critically ill patient in the intensive care unit requires specific training. Virtual reality can facilitate the nursing assessment of critically ill patients. OBJECTIVE: To evaluate the utility of virtual reality as a tool for teaching nursing assessment of critically ill patients. DESIGN: This is a cross-sectional study. SETTING: University of the Balearic Islands (Spain) during the 2022 academic year. PARTICIPANTS: Third-year nursing students. METHODS: A specific environment was designed for virtual reality immersion using a BNEXT head-mounted display. Data were collected using three questionnaires: perception of self-efficacy regarding skill-acquisition in the nursing care process; immersivity; utility and tool satisfaction. RESULTS: A total of 111 undergraduated nursing students responded, 86.8 % of whom had no previous intensive care units experience. They rated the virtual reality experience positively for learning the nursing care process, emphasising the need for skin and mucosal hygiene, patient mobilisation and family care, as well as an understanding of the therapeutic technology required. A total of 67.6 % felt as though they were physically present. They reported a high degree of acceptance and satisfaction. CONCLUSIONS: Virtual reality has facilitated the exposure of students to an unfamiliar environment such as the intensive care units, proving to be useful, satisfying, and motivating in teaching the nursing care process.

Experience sampling methods for the personalised prediction of mental health problems in Spanish university students: protocol for a survey-based observational study within the PROMES-U project.

INTRODUCTION: There is a high prevalence of mental health problems among university students. Better prediction and treatment access for this population is needed. In recent years, short-term dynamic factors, which can be assessed using experience sampling methods (ESM), have presented promising results for predicting mental health problems. METHODS AND ANALYSIS: Undergraduate students from five public universities in Spain are recruited to participate in two web-based surveys (at baseline and at 12-month follow-up). A subgroup of baseline participants is recruited through quota sampling to participate in a 15-day ESM study. The baseline survey collects information regarding distal risk factors, while the ESM study collects short-term dynamic factors such as affect, company or environment. Risk factors will be identified at an individual and population level using logistic regressions and population attributable risk proportions, respectively. Machine learning techniques will be used to develop predictive models for mental health problems. Dynamic structural equation modelling and multilevel mixed-effects models will be considered to develop a series of explanatory models for the occurrence of mental health problems. ETHICS AND DISSEMINATION: The project complies with national and international regulations, including the Declaration of Helsinki and the Code of Ethics, and has been approved by the IRB Parc de Salut Mar (2020/9198/I) and corresponding IRBs of all participating universities. All respondents are given information regarding access mental health services within their university and region. Individuals with positive responses on suicide items receive a specific alert with indications for consulting with a health professional. Participants are asked to provide informed consent separately for the web-based surveys and for the ESM study. Dissemination of results will include peer-reviewed scientific articles and participation in scientific congresses, reports with recommendations for universities' mental health policy makers, as well as a well-balanced communication strategy to the general public. STUDY REGISTRATION: osf.io/p7csq.

The impact of COVID-19 on migrant women in son Gotleu (Palma) and the development of outreach tools to improve health and social care.

AIMS: The objectives of this research protocol are as follows: to examine the influence of the COVID-19 pandemic on health and social care for migrant women in the Son Gotleu district of Palma de Mallorca, Spain, and to develop outreach tools to target this specific group. DESIGN: This is a qualitative study that uses content analysis to obtain in-depth knowledge of personal experience (manifest content) and contextual experience (latent content) in a specific social setting. METHODS: The study population are migrant women living in Son Gotleu district, who are segmented by their age and experience of COVID-19, defined as positive or negative according to whether or not they have been infected with the disease. RESULTS: The shortcomings and needs relating to communication and health care that affect this group's current and future quality of life will be identified. CONCLUSION: The study of migrant women offers a gateway allowing vulnerability in health care to be detected. An awareness of their needs will allow prototype tools to be developed to facilitate communication and care for general and acute health needs between the scientific community and the vulnerable population.

NoFumo+: A Clinical Trial of an mHealth for Smoking Cessation with Hospitalized Patients.

Smartphone applications (apps) improve accessibility to smoking cessation treatments. The NoFumo+ app administers a cognitive behavioral therapy program for smoking cessation. This study evaluates the efficacy of NoFumo+ for quitting smoking or reducing cigarette consumption versus the usual information-based treatment. A clinical trial was conducted with 99 hospitalized smokers, 54 pseudo-randomly assigned to the app treatment and 45 to the usual treatment. The two groups had homogeneous baseline characteristics to ensure comparability. Abstinence was evaluated at post-treatment (two months) and at a six-month follow-up. The results obtained indicate that participants who receive the usual treatment are 5.40 times more likely to continue smoking than those who undergo the app treatment (95% CI = [1.35; 20.15]). Participants who do not succeed in quitting smoking with the app manage to decrease their habitual consumption. Users who successfully complete treatment with NoFumo+ access all its contents and use the chat, but without requesting professional support. There is not enough empirical evidence to attribute this success to any specific element of the app. NoFumo+ achieves better abstinence rates than the usual information-based treatments, and the goal of generalizing its use to the non-hospitalized smoking population may be achievable in the future.

The Impact of the COVID-19 Pandemic on ICU Healthcare Professionals: A Mixed Methods Study.

The large numbers of patients admitted to intensive care units due to COVID-19 has had a major impact on healthcare professionals. The incidence of mental health disorders among these professionals has increased considerably and their professional quality of life has suffered during the pandemic. This study aims to explore the impact of the provision of COVID-19 patient care on ICU healthcare professionals. A mixed methods study with an exploratory concurrent design was conducted between June and November 2020 in the Balearic Islands, Spain. Data were collected using a self-report online survey (n = 122) based on three validated questionnaires, and individual semi-structured in-depth online interviews (n = 11). Respondents scored 2.5 out of 5 on the moral distress scale, moderate/high on the compassion satisfaction scale, and moderate on the burnout and compassion fatigue subscales. Age was significantly and negatively related to professional quality of life but was positively related to workload and unavailability of protective equipment. Three main groups of themes relating to the impact of the pandemic emerged from the in-depth interviews: (a) clinical, (b) professional, and (c) personal and family impacts in the two waves. ICU healthcare professionals should be viewed as second victims of the COVID-19 pandemic as they have suffered significant psychological, professional, and moral harm.

Apps for smoking cessation through Cognitive Behavioural Therapy. A review. / Apps para dejar de fumar mediante Terapia Cognitivo Conductual. Una revisión sistemática.

Smoking is a health and economic problem that is difficult to eradicate. Nicotine addicts also often suffer from psychological problems such as depression and anxiety. The recommended treatment according to clinical practice guidelines (CPG) is Cognitive Behavioural therapy (CBT), alone or combined with medication. Currently, health-related apps (m Health) enable wider availability and access to this treatment. The objectives of this study are to carry out a review of the smoking cessation apps that apply CBT and to describe the techniques used by them. Following the PRISMA framework, the databases EBSCOhost, Cochrane, Web of Science and Scopus were searched for publications between 2010-2019. Four hundred fifteen studies were found and, after applying the inclusion and exclusion criteria, only five articles were eligible for systematic review. Only three apps were identified as using CBT, and the techniques most commonly used were the recording of smoking history, progress visualised through graphics, psycho-educational videos, motivation, social support through social media, and elements of gamification to reinforce adherence and abstinence behaviour. The results recommend the inclusion of smoking behaviour analysis in these types of apps, as not all of them do so, as well as an interface between the health professionals and the users to provide a personalised treatment.

El tabaquismo constituye un problema sanitario y económico de difícil erradicación. Las personas más dependientes a la nicotina suelen presentar, además, problemas psicopatológicos como depresión y ansiedad. Según las Guías de Práctica Clínica (GPC), el tratamiento recomendado para abandonar el hábito es la Terapia Cognitivo Conductual (TCC), sola o combinada con medicación. Actualmente, las aplicaciones móviles (App) en salud (mHealth) permiten un acceso masivo y económico a este tratamiento. El objetivo de este trabajo consiste en llevar a cabo una revisión bibliográfica de las Apps para dejar de fumar que apliquen TCC y describir las técnicas implementadas. En el marco del protocolo PRISMA, la búsqueda se ciñó al periodo 2010-19 y se realizó en las bases de datos: EBSCOhost, Cochrane, Web of Science y Scopus. Se hallaron un total de 415 trabajos, de los cuales, tras aplicar los criterios de inclusión/exclusión, solo 5 artículos fueron objeto de revisión. Únicamente se identificaron 3 Apps (en inglés) que incluyeran TCC y, las técnicas más utilizadas fueron: el registro de cigarrillos, la visualización del progreso mediante gráficas, videos psicoeducativos, la motivación, el apoyo social mediante redes sociales y elementos de gamificación para reforzar la adherencia y la conducta de abstinencia. Los resultados sugieren incluir en este tipo de Apps el análisis de la conducta de fumar, ya que no todas lo hacen, así como una interfaz que comunique el personal sanitario con el usuario y pueda proporcionar un tratamiento personalizado.

Apps para dejar de fumar mediante Terapia Cognitivo Conductual. Una revisión sistemática / Apps for smoking cessation through Cognitive Behavioural Therapy. A review

El tabaquismo constituye un problema sanitario y económico de difícil erradicación. Las personas más dependientes a la nicotina suelen presentar, además, problemas psicopatológicos como depresión yansiedad. Según las Guías de Práctica Clínica (GPC), el tratamientorecomendado para abandonar el hábito es la Terapia Cognitivo Conductual (TCC), sola o combinada con medicación. Actualmente, lasaplicaciones móviles (App) en salud (mHealth) permiten un accesomasivo y económico a este tratamiento. El objetivo de este trabajo consiste en llevar a cabo una revisión bibliográfica de las Apps para dejarde fumar que apliquen TCC y describir las técnicas implementadas.En el marco del protocolo PRISMA, la búsqueda se ciñó al periodo2010-19 y se realizó en las bases de datos: EBSCOhost, Cochrane, Webof Science y Scopus. Se hallaron un total de 415 trabajos, de los cuales,tras aplicar los criterios de inclusión/exclusión, solo 5 artículos fueron objeto de revisión. Únicamente se identificaron 3 Apps (en inglés)que incluyeran TCC y, las técnicas más utilizadas fueron: el registrode cigarrillos, la visualización del progreso mediante gráficas, videospsicoeducativos, la motivación, el apoyo social mediante redes socialesy elementos de gamificación para reforzar la adherencia y la conductade abstinencia. Los resultados sugieren incluir en este tipo de Apps elanálisis de la conducta de fumar, ya que no todas lo hacen, así comouna interfaz que comunique el personal sanitario con el usuario ypueda proporcionar un tratamiento personalizado. (AU)

Smoking is a health and economic problem that is difficult to eradicate.Nicotine addicts also often suffer from psychological problems suchas depression and anxiety. The recommended treatment according toclinical practice guidelines (CPG) is Cognitive Behavioural therapy(CBT), alone or combined with medication. Currently, health-relatedapps (m Health) enable wider availability and access to this treatment.The objectives of this study are to carry out a review of the smokingcessation apps that apply CBT and to describe the techniques used bythem. Following the PRISMA framework, the databases EBSCOhost,Cochrane, Web of Science and Scopus were searched for publicationsbetween 2010-2019. Four hundred fifteen studies were found and,after applying the inclusion and exclusion criteria, only five articleswere eligible for systematic review. Only three apps were identifiedas using CBT, and the techniques most commonly used were therecording of smoking history, progress visualised through graphics,psycho-educational videos, motivation, social support through socialmedia, and elements of gamification to reinforce adherence and abstinence behaviour. The results recommend the inclusion of smokingbehaviour analysis in these types of apps, as not all of them do so, aswell as an interface between the health professionals and the users toprovide a personalised treatment. (AU)

Dejar de fumar, terapia cognitivo-conductual y perfiles diferenciales con árboles de decisión / Quitting smoking, cognitive behavioral therapy and differential profiles with decision tres

Este estudio evalúa si el sexo, la dependencia a la nicotina y variables emocionales (ansiedad, depresión e ira) permiten describir un perfil de paciente que pueda beneficiarse de una terapia cognitivo-conductual para abandonar la adicción al tabaco. Se analizaron los resultados de una muestra de 120 fumadores adultos que voluntariamente recibieron TCC. Se valoró la adherencia de los pacientes y el éxito del programa a través de árboles de decisión. Los resultados indicaron que la adherencia al tratamiento ya implica alta probabilidad de éxito (86.4%), aumentando hasta el 95.6% cuando los participantes presentaban altos niveles de ira externa. Además, la adherencia al tratamiento fue completa (100%) cuando la ansiedad en contexto de evaluación, la ansiedad fisiológica y la motivación fueron altas. La obtención de este tipo de perfiles diferenciales permite determinar qué personas son más indicadas para cada tratamiento, lo que incrementaría la eficacia de los mismos

The aim of this study is to analyse if gender, nicotine dependence, and emotional variables (anxiety, depression, and anger) help to describe a patient profile that could benefit from a cognitive behavioral therapy (CBT) to quit tobacco addiction. The sample consisted of 120 adult smokers who voluntarily received the CBT. Decision trees were used to assess patients' treatment adherence and program success. Data showed that just programme adherence implied a high success probability (86.4%), increasing to 95.6% when participants showed a high anger response. Besides, treatment adherence was 100% when anxiety in an evaluative context, physiologic anxiety, and motivation were high. Finding these differential profiles would help to determine the patient profile that would benefit most from treatment, and would increase their effectiveness

Estrés y control percibido en trabajadores de emergencias / Perceived stress and control in emergency workers

INTRODUCCIÓN Y OBJETIVOS: Por su propia naturaleza, la emergencia implica situaciones de elevado riesgo. El objetivo del trabajo es analizar la relación del estrés generado y el grado de control percibido en personal de emergencias con las variables sexo, edad, nivel de estudios, rama profesional y antigüedad y, a su vez, comparar estos resultados con los datos baremados del Inventario de Respuestas de Afrontamiento en Adultos (CRI-A) en población general española. MATERIAL Y MÉTODOS: En el estudio participaron 120 profesionales y voluntarios de diferentes instituciones civiles y militares del área de emergencias. Se utilizó un cuestionario sociodemográfico y la escala baremada sobre estrés y control percibido del inventario CRI-A mediante la representación mental de una situación extrema. RESULTADOS: Ninguna de las variables sociodemográficas obtuvo diferencias significativas con relación a la intensidad de estrés generado. Respecto al grado de control percibido, los hombres reportaron mayores puntuaciones promedio que las mujeres. En la comparación de ambas muestras, el personal de emergencias mostró diferencias significativas respecto a la población española en general, con menores puntuaciones medias en el nivel de estrés y también en el grado de control percibido. CONCLUSIONES: Ante la controversia encontrada en la bibliografía respecto al sexo y al estrés generado y al grado de control percibido, la evidencia muestra diferencias en favor de los hombres. En consecuencia, se propone que se implemente formación en gestión emocional y percepción del riesgo. En cuanto a las diferencias encontradas respecto a la población general, también se propone que se establezcan planes de educación enemergencias

INTRODUCTION AND OBJECTIVES: By its very nature, emergencies involve high-risk situations. The aim of this study is to analyse the relationship between the stress generated and the degree of control perceived in emergency personnel with the variables of sex, age, level of studies, professional branch and seniority and, in turn, to compare these results with the data from the Inventory of Coping Responses in Adults (CRI-A) in the general Spanish population. MATERIAL AND METHODS: The study involved 120 professionals and volunteers from different civil and military institutions in the emergency area. A sociodemographic questionnaire was used, as well as the scale on stress and perceived control of the CRI-A Inventory through the mental representation of an extreme situation. RESULTS: None of the sociodemographic variables obtained significant differences in relation to the intensity of the stress generated. Regarding the degree of perceived control, men reported higher average scores than women. When comparing both samples, emergency personnel showed significant differences with respect to the Spanish population in general, with lower average scores in the level of stress and also in the degree of perceived control. CONCLUSIONS: Given the controversy found in the literature regarding sex and the stress generated and degree of perceived control, the evidence shows differences in favor of men. Consequently, it is suggested that training in emotional management and risk perception be implemented. As for the differences found with respect to the general population, it is also suggested that education plans be established in emergencies

Suicidal risk and executive functions in major depressive disorder: a study protocol.

BACKGROUND: Suicide is a serious public health concern. Depression is the main gateway to suicidal behavior. The already established relationship between depression and suicidal risk should now focus on the investigation of more specific factors: recent studies have suggested an association between vulnerability to suicidal behavior and neurocognitive alterations, a nuclear symptom of depression. This project aims to identify alterations in the Executive Functions (EF) of patients suffering a first depressive episode that might constitute a risk factor for suicidal ideation, suicidal attempts and suicide, to allow for more adequate suicide prevention. METHODS: Prospective longitudinal design involving two groups (first depressive episodes with and without alterations in their EF) and four repeated measures (0, 6, 12 and 24 months). The estimated minimum sample size is 216 subjects. The variables and measurement instruments will include socio-demographic variables, clinical variables (age of illness onset, family and personal antecedents, psychopathological and medical comorbidity, suicidal ideation, suicide attempts and completed suicides, severity of depression, including melancholic or atypical, remission of the depressive episode), and neuropsychological variables (EF and decision-making processes evaluated through the Cambridge Neuropsychological Test Automated Battery (CANTAB)). DISCUSSION: First and foremost, the identification of clinical and neuropsychological risk factors associated with suicidal behavior will open the possibility to prevent such behavior in patients with a first depressive episode in the context of clinical practice. Secondly, interventions aimed at cognitive impairment (in particular: EF) derived from the study may be incorporated into strategies for the prevention of suicidal behavior. Finally, impaired neurocognitive function (even in early stages) could become an identifiable endophenotype or "marker" in clinical and neurobiological studies about suicidal behavior in depressive patients.