How to Manage the Suffering of the Patient and the Family in the Final Stage of Life: A Qualitative Study.

BACKGROUND: The end of life and death have changed from being issues managed within the family, assumed as part of life, to occur within health institutions for the majority of patients. The amount of patients dying at home has decreased, and the roles of families and communities in death and dying have become involuted, threatening related traditions and knowledge. As a result, a need to promote the end of life at home in this new self-serving society has arisen. In that context, the main objective of this study was to find out what patients and their families need during the end-of-life process in order to feel effectively accompanied at this time. METHODS: With that objective, a descriptive qualitative study was conducted via the content analysis of data from semi-structured interviews and focus groups. This research adhered to the COREQ guidelines. The sample consisted of 36 informants selected via intentional sampling of family members and patients integrated into the Comprehensive Palliative Care Process (PAI Paliativos). RESULTS: The results suggest the existence of several common needs such as communication and presence, including the conspiracy of silence as an important factor generating suffering for both. However, there are specific needs such as autonomy, dignity, and respect for patients, which must be taken into account. CONCLUSIONS: The results of this study will allow us to establish intervention strategies for effective accompaniment of patients' family members at the end of life and the avoidance of ethnocentrism in this process. This study was retrospectively registered with the (nursrep-1194226) on the (21 April 2023).

Nursing students' perceptions of spiritual needs at the end of life. A qualitative study.

Spirituality is defined as the meaning of life, being the very essence of life made up of all of the aspects inherent to it. During end-of-life processes, this need is shown to be particularly altered in patients and yet it is an aspect that the health professionals accompanying patients in this situation report being least equipped to address, alongside therapies that could help to meet these needs, such as art therapy. An exploratory qualitative study was conducted, adheres to the guidelines of COREQ (41). The study population were final year students undertaking a nursing degree at the University of Huelva, Spain. The sample was selected via intentional sampling using snowball recruitment from the study population. Stratification according to gender was performed due to the feminised nature of the population. Sample size was determined progressively during the research, with recruitment ceasing at 13 informants once information saturation was achieved. Inclusion criteria required that participants were to be final year students enrolled on a nursing degree who had provided consent to participate voluntarily in the research. The analysis Realized was interpretive phenomenological (IPA) as described by Smith (43-45). The present study revealed that students perceive their training on spiritual care to be deficient. Despite them reporting that they possess the skills and tools to provide end-of-life care, this is not enough to provide effective accompaniment, given that this moment brings them into touch with their own insecurities. Students verbalized the need to learn strategies to address this shortcoming regarding final accompaniment, for instance, through art, with creativity being one of the skills with the potential to uncover the meaning of life.

Effectiveness of Music Therapy in People Living with Dementia: An Umbrella Review Protocol.

BACKGROUND: Dementia stands out as a neurological disorder which constitutes a progressive decline in cognitive, behavioral, emotional, and social functioning. However, non-pharmacotherapy, such as music therapy, can be combined with pharmacological treatment as a possible strategy to improve functionality regarding the cognitive and non-cognitive dimensions of people diagnosed with dementia. OBJECTIVES: To analyze and synthesize published evidence regarding the effectiveness of music therapy in people diagnosed with dementia, concerning cognitive and non-cognitive outcomes. DESIGN: Descriptive study protocol of an umbrella review. METHODS AND ANALYSIS: An umbrella review method will guide this study, focusing on an extensive search of published systematic reviews and meta-analyses reviews that include randomized controlled trials and other types of trials. Databases for the article search include ISI Web of Knowledge, Scopus, and Joanna Briggs Institute (JBI) EBP database, and EBSCO Host platform (Cochrane Database of Systematic Reviews, MEDLINE, and CINAHL). Two reviewers will independently review all titles and abstracts and identify articles considering the inclusion criteria. Afterward, two reviewers will independently extract relevant information from each article for the characterization table, and evaluate the quality of selected articles using the Measurement Tool for Evaluating Systematic Reviews (AMSTAR) 2 guideline. RELEVANCE TO CLINICAL PRACTICE: Data from this study will aid in designing healthcare workers' training courses, clinical intervention guidelines, and specific intervention protocols that support pharmacological interventions in treating dementia.

Effect of Music Therapy as a Non-Pharmacological Measure Applied to Alzheimer's Disease Patients: A Systematic Review.

The objective of this research was to learn about the effects of music as a non-pharmacological therapeutic intervention applied to Alzheimer's disease. To this aim, we evaluated its results regarding symptomatology and caregiver burden. Methods: This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria. We searched Pubmed/Medline (NLM), Web of Science, Scopus, Cochrane and Google Scholar, including articles from 1 January 2011-20 July 2021, using the keywords "Alzheimer´s disease", "Music therapy", "Caregivers overload", "Amnesia retrograde" and "Clinical evolution". To select the articles our criteria included complete text availability, quantitative research of an experimental nature and studies which, at least, figured in SJR or in JCR. Results: We found a relationship between the application of music therapy in patients with Alzheimer's disease and an improvement regarding symptomatology, as it smoothed down the progress of the disease. Using music therapy in Alzheimer's patients also led to a decrease in caregivers' burden and an increase in their well-being. Conclusions: Our results showed the benefits of music therapy, as it improved both patients' symptomatology and caregivers' burden.

Food as Culture among African Women: Exploring Differences between North and South (Morocco-Senegal).

The goal of this exploratory study was to analyze the influence of culture on African women's diet considering their role as primary caregivers. The analysis differentiated between Moroccan and Senegalese women and identified the key elements that influence their dietary habits and their health. Using a qualitative methodology, we performed a triangulation of data based on a literature review and a panel of experts, all of which served as the basis for the interview script to conduct 14 semi-structured interviews (n = 7 Moroccan and n = 7 Senegalese). This study reflects the substantial relationship between dietary habits, cultural identity, and health that healthcare providers need to acknowledge. It is important for healthcare practitioners to be culturally competent in order to provide holistic and individualized care.

Influence of the COVID-19 Pandemic on Medication Reconciliation in Frail Elderly People at Hospital Discharge: Perception of Healthcare Professionals.

The current demographic panorama in Spain corresponds to an aging population; this situation is characterized by the need to care for an elderly population, which contains polymedicated and pluripathological individuals. Polymedication is a criterion of frailty in the elderly and a risk factor for mortality and morbidity due to the increased risk of drug interactions and medication errors. There are numerous studies that measure reconciliation at hospital discharge and at admission, and even the methodology of reconciliation, but we have not found many studies that measure reconciliation in the context of the COVID-19 pandemic from the point of view of health professionals regarding difficulties and the strategies carried out, which is essential to begin to glimpse solutions. METHODS: This was a qualitative study based on 21 in-depth interviews and two discussion groups, conducted between January and April 2021 (13 nurses and 8 doctors, in rural and urban areas). The discourse was analyzed according to the Taylor-Bodgan model and processed using Atlas.ti software. RESULTS: The areas altered by the health crisis were access to patients, their reconciliation of medication, and changes in the care modality, including the greater use of telephone communication, changes in work organization, and time dedicated to patient care and family work. Difficulties encountered during COVID-19: change in medication format, the specific characteristics of the patient and their pathologies, and difficulties arising from communication with the patient and their family. The strategies applied: the collaboration of home assistants and caregivers, emphasis on patient-health professional communication, and the use of Information and Communication Technologies (ICT). CONCLUSION: The discharge was interrupted by the health crisis caused by COVID-19, in terms of both the traditional access of patients and by the remote care modalities generated by telemedicine.

Dietary Behaviours of University Students during the COVID-19 Pandemic. A Comparative Analysis of Nursing and Engineering Students.

The university stage is a crucial stage that influences the decision-making process of students. At this stage, they acquire dietary habits that are guided by their likes, beauty ideals, biological influences, and economic factors. During the COVID-19 pandemic, universities closed and turned to online teaching, changing their life habits under the duress of confinement. The aim of the present work was to identify the dietary behaviours of nursing and engineering degree students at the University of Huelva during the period of confinement, in addition to identifying the factors influencing these habits. The methodological strategy employed was mixed in nature. In this sense, a cross-sectional descriptive study was first performed, followed by a phenomenological qualitative study that was descriptive in nature. Examination of outcomes revealed the presence of four lines of argument founded on the influence of context, life habits, emotional changes experienced during the COVID-19 pandemic, and the factors facilitating or limiting adaption to this period. Taking into account that confinement, restrictive measures, the absence of family, closeness and affection, and training influenced changes to feeding habits and approaches to consumption, universities could carry out interventions oriented in this line to favour healthy eating habits.

Digital Identities of Young People from the South of Spain: An Online Sexual Differentiation.

Through a mixed methodological approach, we want to know how adolescents aged between 14 and 16 years from the south of Spain express and identify themselves on social networks, with respect to their sex. As such differences can determine gender inequality, we will analyse differences between females and males regarding the expression of identity on social networks. Analysis of obtained results demonstrates that many relevant attributes still emerge such as the socio-cultural representation of gender as sex in social networks. Differences emerged between the identity expressions of females and males which can generate inequalities favouring females and males. This implies a series of repercussions and, ultimately, defines the so-called digital gender divide. Taking into account these results we could intervene in the population of children to carry out prevention activities focused on social networks.

Social Distancing and COVID-19: Factors Associated With Compliance With Social Distancing Norms in Spain.

This article describes patterns of compliance with social distancing measures among the Spanish population during the coronavirus disease-2019 (COVID-19) pandemic. It identifies several factors associated with higher or lower compliance with recommended measures of social distancing. This research is part of a 67-country study, titled the International COVID-19 study on Social & Moral Psychology, in which we use a Spanish dataset. Participants were residents in Spain aged 18 or above. The sample comprises 1,090 respondents, weighted to be representative of the Spanish population. Frequencies, correlations, bivariate analysis, and six models based on hierarchical multiple regressions were applied. The main finding is that most Spaniards are compliant with established guidelines of social distance during the pandemic (State of Alarm, before May 2020). Variables associated more with lower levels of compliance with these standards were explored. Six hierarchical multiple regression models found that compliance with social distance measures has a multifactorial explanation (R 2 between 20.4 and 49.1%). Sociodemographic factors, personal hygiene patterns, and the interaction between personal hygiene patterns and the support for political measures related to the coronavirus brought significant effects on the regression models. Less compliance was also associated with beliefs in some specific conspiracy theories with regard to COVID-19 or general conspiracy mentality (Conspiracy Mentality Questionnaire, CMQ), consumption patterns of traditional mass media (television, paper newspapers, magazines, and radio) and modern means to get informed (online digital newspapers, blogs, and social networks), political ideology, vote, trust in institutions, and political identification. Among the future lines of action in preventing the possible outbreak of the virus, we suggest measures to reinforce trust in official information, mainly linked to reducing the influence of disinformation and conspiracy theories parallel to the pandemic.

[Approaching grief and death in family members of patients with COVID-19: Narrative review]. / Abordaje del duelo y de la muerte en familiares de pacientes con COVID-19: revisión narrativa.

OBJECTIVE: The objective of this review was to synthesize the possible evidence to establish recommendations on the approach of mourning and death in relatives of COVID-19 patients, as well as offering substitute resources for the necessary rituals and procedures in order to build up functional griefs and prevent complicated bereavements. METHOD: A bibliographic research was conducted in MEDLINE, EMBASE, SCIENCEDIRECT, WOS, CINAHL and CUIDEN databases, using MeSH terms, (family, patient, isolation hospitals, grief, death, ceremonial behavior, self-care, affects and social networks) with its corresponding boolean equation. The selected articles have been published in a critical reading through the Critical Assessment Skills Program in Spanish (CASPe). RESULTS: A total of 560 articles were initially found, after applying the selection criteria, 13 studies were included in the analysis, of which 8 were systematic reviews, 3 qualitative studies, 1 cross-sectional prospective pilot study and 1 clinical guide, which allowed identifying strategies for the approach grief and death attending to this moment of exceptionality covid19, influencing the competence management of health professionals in emotional support and accompaniment as well as the monitoring throughout the process, as well as in the communication with the family. CONCLUSION: In the final process of life in COVID-19's time, health professionals must work farewells, alternative funeral rites, spiritual care and early coping that will allow the prevention of complicated grief.

Attitudes of nursing degree students towards end of life processes. A cultural approach (Spain-Senegal).

INTRODUCTION: The concept of death is abstract, complex and has a number of meanings. Thus, its understanding and the approach taken to it depend, to a large extent, on aspects such as age, culture, training and religion. Nursing students have regular contact with the process of death and so it is of great interest to understand the attitudes they have towards it. As we live in a plural society it is even more interesting to not only understand the attitudes of Spanish students but, also, those of students coming from other countries. In the present article, we seek to identify and compare the attitudes held by nursing degree students at Hekima-Santé University (Senegal) and the University of Huelva (Spain) about end of life processes. The study identifies elements that condition attitudes and coping with death, whilst considering curricular differences with regards to specific end of life training. METHOD: A descriptive, cross-sectional and multi-center study was conducted. The overall sample (N = 142) was divided into groups: Hekima-Santé University (Dakar, Senegal) and the University of Huelva (Huelva, Spain). The measurement instruments used were an ad-hoc questionnaire and Bugen´s Coping with Death Scale. RESULTS: Statistically significant differences (p = 0.005, 95%CI) were found in relation to overall Bugen Scale scores. We can confirm that specialized end of life training (University of Huelva, Spain) did not lead to better coping when compared with a population whose academic curriculum did not provide specific training and who engaged in more religious practices (Hekima-Santé University, Senegal). CONCLUSIONS: In cultures where religion not only influences the spiritual dimension of the individual, but acts in the ethical and moral system and consequently in the economic, educational and family sphere, the accompaniment at the end of life transcends the formative plane. Considering the plural society in which we live, the training that integrates the Degree in Nursing with regard to the care of the final process, must be multidimensional in which spirituality and faith are integrated, working emotional and attentional skills, as well as cultural competence strategies in this process.

Adolescents, Ambivalent Sexism and Social Networks, a Conditioning Factor in the Healthcare of Women.

Even though gender equality being present in the social and political sphere, we still encounter aspects that are characteristic of sexism. Such aspects impact upon gender inequality and different types of violence towards women. The present article aims to examine the behaviour of adolescents from Huelva with regards to ambivalent sexism towards women on social networks and their influence on health. Furthermore, we seek to uncover adolescent's perceptions with regards to gender differences in the use of social networks, the relationship between sexism and women's emotional well-being was observed. The study sample was formed by young people aged between 14 and 16 years who were residing in rural and urban zones in the south of Spain. A mixed methods approach was taken. At a quantitative level, a sample of 400 young people was recruited. These were administered a questionnaire about sexism which was composed of two scales and has been validated at a national and international level. At a qualitative level, the study counted on 33 young people who participated in in-depth discussions via interviews and discussion groups. The results showed that sexism emerges in adolescence in the analysed sample from the south of Spain. This favoured a digital gender gap and was reinforced through social networks such as Instagram and Snapchat. Rising awareness and a critical view of the aforementioned sexism was shown on the behalf of females, particularly those from urban backgrounds.

Educational interventions by nurses in caregivers with their elderly patients at home.

INTRODUCTION: The home is the natural setting for the development of informal care. The work that nurses are required to develop in this context (the carer/the elderly dependent/the home) focuses on training and educational activities to assist these two groups, such as demonstrating care activities to help dependent seniors, instruction in self-care techniques and teaching strategies for the use of human and material resources. AIMS: This article analyzes care education interventions performed by nurses, and the factors that facilitate, or limit, health care training. METHODOLOGICAL APPROACH: This is a qualitative, descriptive study designed to be flexible and openly analytical in its approach to the research problem and the dynamic nature of the home environment. Triangulation of the methodological techniques and study subjects was applied. RESULTS: Nursing interventions related to professional attitudes, such as encouraging communication and facilitating teaching; communication interventions in health education and counseling; and technical interventions aimed at improving access to health information and support for the informal carer. Lack of will, the advanced age of the carer, emotional state and work overload are factors that undermine care instruction, which if reversed, would become learning facilitators. The lack of time and resources in the home are the major limiting factors on care teaching, according to nurses. Evidence from our study suggests that care in the home is considered a key primary health care strategy, one in which nurses play a significant role.

Spirituality in Patients at the End of Life-Is It Necessary? A Qualitative Approach to the Protagonists.

Spirituality is the most unknown aspect of palliative care despite being the need that is most altered in the last moments of life. OBJECTIVE: To identify on the one hand the spiritual needs of patients who are at the end of life and on the other hand, the way in which nursing professionals can work to provide effective accompaniment in this process. METHOD: A qualitative study was conducted which applied different data collection techniques. This was done to describe the phenomenon from a holistic perspective in relation to experts' perceptions of the competencies required by health professionals and palliative patients' spiritual needs. Semi-structured interviews were conducted within both populations. In order to analyze the qualitative data collected through interviews, discourse was analyzed according to the Taylor-Bodgan model and processed using Atlas.ti software. RESULTS: Three well-differentiated lines of argument are extracted from the discourse in each of the groups, on the one hand in the group of patients they define the concept of spirituality, system of values and beliefs, and the Factors that influence the spirituality of patients at the end of life (differentiating palliative care areas/other areas) and on the other, the professionals agree with the patients in the line of argument of concept of spirituality although they define more metaphysical categories and the other two lines of argument that result are the spiritual attention in this process and the need for formation in spirituality. CONCLUSIONS: The provision of spiritual care gives meaning to the actions of nursing professionals when it comes to providing end-of-life care, achieving holistic care, humanizing death, and promoting a dignified end.

Pain catastrophizing, kinesiophobia and fear-avoidance in non-specific work-related low-back pain as predictors of sickness absence.

The influence of pain catastrophizing, kinesiophobia and fear-avoidance attitudes towards non-specific low-back pain has been scarcely studied in an occupational insurance provider context. The objective of this work is to ascertain the relationship between these psychosocial variables with work absence, its duration and the disability of subjects with work-related low back pain. This is a descriptive observational methodological strategy. All patients with work-related non-specific low back pain who attended to an occupational health hospital during the study period were included consecutively. Clinical variables of kinesiophobia, pain catastrophizing, fear-avoidance attitudes, disability and pain were collected; sociodemographic variables of sex, age, type of work, educational level, occupational status and duration in days of work absence were recorded. Kinesiophobia (b = 1.43, P = 0.011, r = 0.333), fear-avoidance beliefs in its global dimension (b = 0.910, P = 0.014, r = 0.321), fear-avoidance beliefs in its work dimension (b = 1.255, P = 0.016, r = 0.321) and pain catastrophizing (b = 0.997, P = 0.013, r = 0.340) show individual association with the duration of sickness absence. Kinesiophobia (b = 0.821, P = 0.011, r = 0.30) and fear-avoidance beliefs (b = 1.760, P = 0.016, r = 0.28) are associated with disability (Kinesiophobia, b = 0.880, P = 0.045, r = 0.26; Fear-avoidance beliefs, b = 0.724, P = 0.010, r = 0.34). Kinesiophobia, fear-avoidance beliefs and pain catastrophizing are related to an increase in the duration of work absence and disability in patients with back pain in an occupational insurance provider context.

Acompañamiento a los pacientes al final de la vida durante la pandemia por COVID-19 / Accompaniment of patients at the end of life during the COVID-19 pandemic

OBJETIVOS: Describir el acompañamiento y la despedida de los pacientes en situación de últimos días a nivel hospitalario y residencial y conocer las actitudes profesionales hacia el cuidado de los pacientes al final de su vida durante la pandemia por COVID-19. MÉTODO: Estudio descriptivo transversal dirigido a profesionales de enfermería. La recogida de datos se realizó a través de un cuestionario ad hoc a través de Google Forms, durante abril y mayo de 2020. Se recogieron variables sociodemográficas, laborales, de formación, variables de satisfacción, motivación y estrés laboral y la escala de actitudes hacia el cuidado de pacientes al final de la vida. Se realizó un análisis descriptivo univariante de los sujetos de la muestra y de cada una de las variables estudiadas mediante proporciones, frecuencias, medidas de tendencia central y de dispersión mediante SPSS 22.0. RESULTADOS: Según los profesionales, un porcentaje importante de pacientes con diagnóstico de COVID-19 (38,8 %, n = 110) no han estado acompañados en las últimas 48 horas de vida; este se ha limitado a horas (56,4 %, n = 154). La despedida se ha producido mayoritariamente antes del fallecimiento (44,1 %, n = 143). Gran parte de los profesionales han notado cambios en el acompañamiento y despedida (77,3 %, n = 211), al igual que en su forma de cuidar. Un 52,4 % (n = 143) refieren haber encontrado algún paciente fallecido al entrar en la habitación. CONCLUSIONES: A pesar de la existencia de protocolos de acompañamiento y el esfuerzo de los sanitarios, la soledad ha estado presente en los pacientes durante la pandemia. Los profesionales han modificado el cuidado proporcionado a los pacientes al final de la vida, generando conflictos y actitudes emocionales negativas hacia el cuidado de estos pacientes durante la pandemia. La situación de aislamiento supone un coste emocional para profesionales y familias en duelo, que será importante valorar y estudiar a medio plazo

OBJECTIVES: This study describes how patients were accompanied and bidden farewell in their last few days of life at hospitals and nursing homes. It also describes the attitudes of health professionals towards the care of patients in the last days of life during the COVID-19 pandemic. METHOD: A cross-sectional descriptive study was conducted in nurses. Data collection was done by an ad-hoc questionnaire in April and May 2020 through Google Forms. Collected variables included social demographics, work environment, training, satisfaction variables, motivation, work-related stress, and an attitude towards patients at the end of life scale. A descriptive univariate analysis of the subjects in the sample was carried out using the SPSS 22.0 software including proportions, frequencies, measurements of central tendency, and distribution. RESULTS: According to professionals, an important number of patients diagnosed with Covid-19 (38.8%, n = 110) were not accompanied in their last 48 hours of life. This was limited to a few hours (56.4%, n = 154), and saying goodbye was done in a majority of cases before death (44.1%, n = 143). A great number of professionals have noticed changes in accompanying and saying goodbye (77.3%, n = 211), including their way of caring. A total of 52.4%, n = 143, said that they had found patients dead on entering the room; 53.1%, n = 178 were aware of accompanying protocols. CONCLUSIONS: It is obviously clear that many patients were alone during their last hours in spite of accompaniment protocols and the efforts of the staff looking after them. Professionals have modified the care given to patients at the end of life during the pandemic, generating conflicts and negative emotional attitudes. Isolation has a great emotional cost for the staff and for families during bereavement, which is important to study and evaluate in the mid-term

Influence of Psychosocial and Sociodemographic Variables on Sickness Leave and Disability in Patients with Work-Related Neck and Low Back Pain.

The purpose of this study was to describe the association between psychosocial factors in patients with work-related neck or low back pain (n = 129), in order to study sickness leave, its duration, the disability reported, and to analyze the relationship of these factors with different sociodemographic variables. This was a descriptive cross-sectional study. Data on kinesiophobia, catastrophizing, disability, and pain were gathered. Sociodemographic variables analyzed included sex, age, occupational, and educational level. Other data such as location of pain, sick leave status and duration of sickness absence were also collected. Educational level (p = 0.001), occupational level (p < 0.001), and kinesiophobia (p < 0.001) were found to be associated with sickness leave; kinesiophobia (b = 1.47, p = 0.002, r = 0.35) and catastrophizing (b = 0.72, p = 0.012, r = 0.28) were associated with the duration of sickness leave. Educational level (p =0.021), kinesiophobia (b = 1.69, p < 0.000, r = 0.505), catastrophizing (b = 0.76, p < 0.000, r = 0.372), and intensity of pain (b = 4.36, p < 0.000, r = 0.334) were associated with the degree of disability. In the context of occupational insurance providers, educational and occupational factors, as well as kinesiophobia and catastrophizing, may have an influence on sickness leave, its duration and the degree of disability reported.

Abordaje del duelo y de la muerte en familiares de pacientes con COVID-19: revisión narrativa / Approaching grief and death in family members of patients with COVID-19: Narrative review

OBJETIVO: Realizar una síntesis de la evidencia disponible para establecer recomendaciones sobre el abordaje del duelo y la muerte en familiares de pacientes con COVID-19, así como ofrecer recursos sustitutivos de los rituales y procedimientos necesarios con el fin de favorecer duelos funcionales y prevenir duelos complicados. MÉTODO: Se realizó búsqueda bibliográfica en bases de datos MEDLINE, EMBASE, SCIENCEDIRECT, WOS, CINAHL y CUIDEN, utilizando términos MeSH (family, patient, isolation hospitals, grief, death, ceremonial behavior, self care, affects y social networking) con su ecuación booleana correspondiente. Los artículos seleccionados se sometieron a una lectura crítica a través del Critical Apraisal Skill Programme en español. RESULTADOS: Se encontraron 560 artículos atingentes; tras aplicar los criterios de selección 13 estudios se incluyeron en el análisis, de los cuales 8 eran revisiones sistemáticas, 3 estudios cualitativos, un estudio piloto prospectivo transversal y una guía clínica, que permitieron identificar estrategias para el abordaje del duelo y la muerte atendiendo a este momento de excepcionalidad de la COVID-19, incidiendo en el manejo competencial de los profesionales sanitarios en apoyo emocional y en el acompañamiento, así como en el seguimiento durante todo el proceso y en la comunicación con la familia. CONCLUSIÓN. En el proceso final de la vida en tiempos de la COVID-19 los profesionales sanitarios deben trabajar despedidas, los ritos fúnebres alternativos, la atención espiritual y el afrontamiento precoz que permitirán a su vez la prevención del duelo complicado

OBJECTIVE: The objective of this review was to synthesize the possible evidence to establish recommendations on the approach of mourning and death in relatives of COVID-19 patients, as well as offering substitute resources for the necessary rituals and procedures in order to build up functional griefs and prevent complicated bereavements. METHOD: A bibliographic research was conducted in MEDLINE, EMBASE, SCIENCEDIRECT, WOS, CINAHL and CUIDEN databases, using MeSH terms, (family, patient, isolation hospitals, grief, death, ceremonial behavior, self-care, affects and social networks) with its corresponding boolean equation. The selected articles have been published in a critical reading through the Critical Assessment Skills Program in Spanish (CASPe). RESULTS: A total of 560 articles were initially found, after applying the selection criteria, 13 studies were included in the analysis, of which 8 were systematic reviews, 3 qualitative studies, 1 cross-sectional prospective pilot study and 1 clinical guide, which allowed identifying strategies for the approach grief and death attending to this moment of exceptionality covid19, influencing the competence management of health professionals in emotional support and accompaniment as well as the monitoring throughout the process, as well as in the communication with the family. CONCLUSION: In the final process of life in COVID-19's time, health professionals must work farewells, alternative funeral rites, spiritual care and early coping that will allow the prevention of complicated grief

Vivir con insuficiencia cardíaca crónica: una revisión de estudios cualitativos en la población anciana / Living with chronic heart failure: A review of qualitative studies in the elderly

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