Introduction: Hypertension is a common chronic condition among older adults that negatively affects quality of life and requires effective self-care. Family support and health literacy are key factors influencing self-care behaviors, yet most studies have examined these factors separately and in high-income countries. This study explores their combined impact in a low- to middle-income setting. Objective: To examine the relationship between family support, health literacy, and self-care management among elderly individuals with hypertension. Materials and Methods: This quantitative, cross-sectional study involved 90 purposively selected participants aged ≥ 60 years with medically diagnosed hypertension from the Prolanis Community Health Center, Kedungmundu, Semarang, Indonesia. Inclusion criteria included the ability to communicate and willingness to participate. Data were collected using validated instruments: the House’s Family Support Questionnaire, the HLS-EU-Q16 for health literacy, and the HSMBQ for self-care. Data analysis used Spearman’s rho test with a significance level of 0.05. Results: A strong positive correlation was found between family support and self-care management (p = 0.000, r = 0.689). A weaker but statistically significant correlation was observed between health literacy and self-care (p = 0.045, r = 0.212). Conclusion: Family support plays a critical role in promoting self-care management among older adults with hypertension. While health literacy also contributes, its influence is comparatively weaker. These findings highlight the need for culturally appropriate interventions that strengthen family involvement and improve health literacy to enhance chronic disease management in aging populations.
Introduction: The ethical climate in primary health care (PHC) is essential to ensure a healthy work environment, respectful professional relationships, and the quality and humanization of care provided to users of the healthcare system. Objective: To evaluate the psychometric evidence of the Hospital Ethical Climate Survey—Brazilian version, for the PHC context. Materials and Methods: Methodological study that followed five stages: Adaptation of the instrument to the context; pilot testing of the adapted instrument; content validity; construct validity; and reliability. Before exploratory factor analysis, data adequacy was verified using the Kaiser-Meyer-Olkin (KMO) test, which ranges from 0 to 1, and Bartlett’s sphericity test, with a p-value ˂ 0.001. Exploratory factor analysis considered communality, specificity, and factor loadings. The confirmatory factor analysis was based on the Comparative Fit Index (CFI) and the Tucker-Lewis Index (TLI), both greater than 0.95; the Standardized Root Mean Square Residual (SRMR), with values ≤ 0.08; and the Root Mean Square Error of Approximation (RMSEA), with values ˂ 0.08. Reliability was assessed using Cronbach’s alpha, considered satisfactory when greater than 0.70, and test-retest reliability, using the weighted quadratic Kappa coefficient, whose values are considered excellent when ≥ 0.75. Descriptive statistics were based on the mean and standard deviation. The analyses were conducted using the R program. Results: In the exploratory factor analysis, all factor loadings were greater than 0.40, ranging from 0.40 to 0.82. Confirmatory factor analysis demonstrated the adequacy of the model with five factors and 26 validated items, presenting a CFI of 0.988, TLI of 0.986, RMSEA of 0.084, and SRMR of 0.084, with a 90 % confidence interval (0.084-0.988) and a significant p-value ≤ 0.05. The internal reliability of the overall instrument was 0.94. The weighted quadratic Kappa test-retest ranged from 0.18 to 0.76, and the intraclass correlation coefficient ranged from 0.26 to 0.80. Conclusion: The Brazilian version of the instrument, adapted for PHC, was considered valid and reliable in this sample. The instrument contributes to the advancement of research and practice in the field of ethics in healthcare and nursing in primary care, an area where studies on ethics remain scarce, to promote a healthier and more qualified work environment.
Introduction: Type 2 diabetes mellitus (T2DM) is a non-communicable disease, considered a public health concern due to its impact on global morbidity and mortality. Objective: To develop and validate a nursing intervention (Nursing Outcome Classification [NOC] outcome 1601) and outcome compliance behavior in adults with T2DM. Materials and Methods: Consensus study by specialists, delimited by the phase of development of the educational intervention and the validity of its content. The Content Validity Index (CVI) was used for data analysis, with a CVI ≥ 0.80 considered acceptable. Results: In total, twelve specialists validated the indicators and the nursing intervention. For the adherence behavior (NOC outcome 1601) nursing outcome, thirteen indicators were selected and validated by specialists, and a CVI of 0.91 was obtained. An individualized intervention, consisting of four sessions, was designed to increase knowledge and application of healthy behaviors in patients with T2DM. Conclusion: This study exposes the need for nursing approaches that integrate behavioral and educational components to optimize health outcomes that contribute to a more holistic and patient-centered management of T2DM.
Introduction: Disability due to stroke in older adults requires a caregiver; assuming this role entails life changes, challenges, knowledge, and skills. However, the lack of culturally adapted instruments in Mexico limits the understanding of the transition process to adopting the caregiver role. Objective: To adapt and validate the instrument for the Adoption of the Role of Family Caregiver of a Chronic Patient (ROLE) in the Mexican context. Methodology: Five-stage methodological study: Validation by judges, style correction, pilot test, psychometric properties, and factor analysis. Results: Item validity index, 0.25; validity criterion, 16 % error; content validity index, 9.32. Kendall’s W coefficients: Comprehension [84.667/p= 0.000], clarity [78.693./p= 0.000], relevance [79.893 /p= 0.000], accuracy [78.693/p= 0.000]. Final version, criterion validity using Kaiser-Meyer-Olkin analysis is 0.78. Bartlett’s sphericity [X2 = 592.3, gl = 205, p = 0.000]. Confirmatory factor analysis showed an adequate fit of the model: CFI = 0.70; TLI = 0.66; AIC= 732.3; RMSEA = 0.087 CI [0.079/0.095]). Final internal consistency of 0.79 by Cronbach’s alpha. Conclusion: The adaptation of the ROL instrument in Mexico maintains the 22 items distributed across five domains and is a valid and reliable tool for measuring the adoption of the caregiving role.
Objective: To evaluate the impact of implementing artificial intelligence (AI) tools on patient safety perception and the reduction of clinical errors in care at two hospitals in Peru. Materials and Methods: A quasi-experimental quantitative design was used, with a non-randomized control group. Measurements were taken before and after the intervention. The sample consisted of 80 nurses (experimental group n=40; control group n=40), selected by purposive non-probability sampling from two public hospitals in Latin America. The experimental group used an AI-based Clinical Decision Support System (CDSS-AI) for 12 weeks. Validated tools were used to assess nurses’ self-reported nursing errors and patient safety perception. Results: CDSS-AI intervention had a positive impact on participants in the experimental group, significantly improving patient safety perception and reducing the reported incidence of clinical errors. However, technical, ethical, and organizational challenges remain, exacerbated by the limited availability of explainable AI (XAI) models and insufficient training for healthcare workers in safely integrating these technologies into their workflows. Conclusion: Integrating AI into nursing services can be an important tool for improving patient safety, provided it is implemented within a clear ethical and regulatory framework, prioritizing algorithmic transparency, and encouraging active participation of professionals in the design and oversight of these systems.
Introduction: Neonatal hospitalization is a critical experience for mothers. Migration can increase uncertainty levels; it is for this reason that knowing this reality is of utmost importance and interest for Nursing. Objective: To describe uncertainty levels among migrant women and the associated factors. Materials and Methods: A quantitative, descriptive, cross-sectional, and correlational study with convenience sampling in which the participants were 181 Venezuelan mothers over 14 years old without acute health conditions and who had their children hospitalized. The Parents-Children Uncertainty scale was applied; this tool has adequate psychometric properties to be used in Colombia, with a Cronbach’s alpha value of 0.86. Descriptive statistics, correlational analysis and a regression model were applied for data analysis. Results: The uncertainty levels were high in 93.92 % of the cases and presented a correlation with hospitalization time (sig. 0.050) and migratory status (sig. 0.006). The following variables explained the uncertainty levels: hospitalization days (sig. 0.004); birth weight (sig. 0.016); gestational age (sig. 0.054); and number of prenatal control appointments (sig. 0.004). Searching for information outside the hospital setting reduced the uncertainty levels (sig. 0.059). Conclusion: Uncertainty levels are high among migrant mothers, and the associated factors point to the need to provide clear information, particularly in the case of mothers in irregular migratory situations and with children undergoing prolonged hospitalizations; guidelines on the use of educational resources should be offered.
Introduction: Alcohol consumption among older adults is increasing, which has an impact on their physical, emotional, cognitive and social health. Therefore, it is necessary to identify possible protective factors, such as spirituality and religiosity, to contribute relevant knowledge to the nursing care of geriatric patients. Objective: To determine the relationship between spirituality, religiosity, and alcohol consumption among older adults. Materials and Methods: This descriptive-correlational study involved a sample of 286 adults aged over 60 from Nuevo Laredo, Tamaulipas, Mexico. Stratified random probability sampling was employed. The following instruments were used: the Brief and Portable Mental Status Questionnaire; the Personal Data and Alcohol Consumption Prevalence Form; the Spiritual Perspective Scale; the Duke University Religion Index; and the Michigan Alcoholism Screening Test Geriatric Version. Data were collected in two medical clinics and three development and wellness centers. Results: A negative but significant correlation was found between spirituality (rs = -0.368, p < 0.01) and religiosity (rs = -0.473, p < 0.01) and alcohol consumption. Conclusions: Spirituality and religiosity are associated with lower alcohol consumption among older adults. These findings enable the development of cultural interventions aimed at promoting the health of older adults, thereby improving their quality of life and overall well-being.
Introduction: About 1.2 million adolescents die each year from preventable causes worldwide. It is worrying that health professionals frequently lack the empathy, skills, and sensitivity to engage with adolescents, often treating them as mere cases. The Respectful Adolescent Care (RAC) intervention can be effectively applied in clinical practice to ensure that adolescents receive compassionate, non-judgmental, and appropriate care as per their unique needs. Using its principles, nurses can create a safe and supportive environment where adolescents feel heard and respected. Objectives: To assess the impact of a RAC intervention on nurses’ knowledge, attitude, and practice (KAP). Methodology: A quasi-experimental, non-randomized, non-equivalent control group design was adopted. A total of 100 registered nurses meeting the inclusion criteria were selected using a convenience sampling technique. Data was collected using a structured knowledge questionnaire, an attitude rating scale, and a practice observation checklist. Descriptive and inferential statistics were used. Results: Most nurses were aged 30-39 years (46% experimental, 38% control) and predominantly female (78% experimental, 62% control). The RAC intervention significantly improved nurses’ knowledge (mean 22.1 vs. 16.0; mean diff. 6.1), attitude (t = 11.44, p = 0.001***), and practice (χ² = 48.07, p = 0.001***), with 58% achieving good practice; KAP scores were positively correlated (knowledge-attitude r = 0.38, knowledge-practice r = 0.47, practice-attitude r = 0.55; p = 0.001***), and gains were significantly associated with age, experience, and prior in-service training. Conclusion: The study supports implementing RAC-based guidelines and policies to standardize respectful adolescent care in hospital and community nursing practices.
Investing in strengthening nursing in Colombia is necessary, and striving for excellence is indeed possible. This presents a challenge that transforms and strengthens the role of nursing in healthcare institutions, based on the best evidence available worldwide and the experience of the Fundación Santa Fe de Bogotá. Through the development and incorporation of clinical and strategic leadership models, shared governance, and continuing education, it demonstrates how nursing can positively impact quality, safety, the patient experience, and the practice itself, which together constitute world-class professional practice. Today, it is possible to affirm that excellence in nursing in Colombia is a strategy that transforms realities, elevates care, and strengthens the country. Excellence in nursing is a key strategy for strengthening health systems, improving clinical outcomes, and dignifying the profession. Colombia must move forward with national policies that promote quality training, clinical leadership, and fair working conditions. Investing in nursing today is a guarantee of universal coverage, resilience, and equity in the future.
Introduction: Chronic kidney disease is a growing public health problem with a high mortality rate. Patients undergoing hemodialysis face physical, emotional, and social challenges, highlighting the importance of understanding how family functionality influences their self-care agency. Objective: To describe and correlate family functionality and self-care among hemodialysis patients at a secondary-level hospital. Materials and Methods: Observational, descriptive, cross-sectional, and correlational research. The study population consisted of 60 users, i.e., all patients treated at the hemodialysis service of the Isidro Ayora General Hospital in Loja, Ecuador. To analyze family and self-care functionality, the Family APGAR and the ASA Self-Care Agency Assessment scales were used. Spearman’s Rho was used to determine the relationship between the two variables. Results: 58 % of participants had normal family functioning, while 42 % had dysfunction (30 % mild, 7 % moderate, and 5 % severe). In terms of self-care, 67 % showed a high level, 32 % a medium level, and 1 % a low level. There is a strong positive relationship between family functioning and self-care (r = 0.743, p < 0.01). Conclusions: Self-care is related to functional family environments, so it is necessary to develop nursing interventions focused on education and strengthening family support networks. The cross-sectional design of the study was a limitation in establishing causality and changes over time, an aspect that should be considered in future research.
Introduction: Consolidating oncology navigation programs is required as a strategy to address system-fragmentation barriers, facilitate access to treatment, and educate patients on shared decision-making. Objective: To develop a professional navigation program for cancer patients undergoing chemotherapy, to promote appropriate symptom management and foster self-management. Materials and Methods: A methodological research study was conducted to develop a navigation program using the ADDIE methodology, which comprises analysis, design, development, implementation, and evaluation, with only the first three elements being addressed. Content validity was assessed by eight clinical oncology experts. Results: The program adopts the conceptual framework of professional navigation. Eight sessions were designed to address the dimensions of facilitating continuity of care and promoting patient empowerment. Content validity with experts showed high acceptability (CVC 0.82) and usefulness (CVC 0.8) of the intervention, as well as coherence with the conceptual framework. Conclusion: A chemotherapy navigation program was obtained that addresses self-management behaviors and the management of treatment-related symptoms. It is necessary to continue its implementation and evaluation through an experimental study.
Introduction: Blood transfusion is common, but transfusion reactions, often caused by human error, can be prevented. Nurse-led programs improve patient safety with safe nursing practices. This unprecedented study maps nursing care in blood transfusion, an underexplored theme in the literature. It aims to identify knowledge gaps and propose new approaches, contributing to nursing and other fields of healthcare, promoting safe care standards and interdisciplinary practices for excellence in transfusion care. Objective: To map the scientific production related to nursing care for adults undergoing blood transfusion in the light of patient safety. Materials and Methods: This is a scoping review based on the JBI methodology, covering seven databases, following the checklist of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. Studies published from 2017 to 2024 were included; the descriptors ‘nursing care’ and ‘blood transfusion’ were used; 515 primary studies were initially included that covered nursing care for adult patients undergoing blood transfusion, in any language, with different methodological approaches. The review was registered on the Open Science Framework platform. Results: A total of 19 primary studies were selected. The most prevalent types of nursing care highlighted in this review are hand hygiene, the use of personal protective equipment, checking and verifying medical prescriptions, double-checking during blood collection and administration, monitoring vital signs, and advising patients on the signs and symptoms of transfusion reactions. Conclusion: In the synthesis conducted, it is concluded the adoption of nursing care standards based on good practices is vital for effective patient safety and reduces the risks and complications associated with blood transfusion procedures.
Introduction: Dysfunctional family processes are associated with negative outcomes in the school performance of children and adolescents, as well as in behavioral and health aspects of their lives. Objective: To develop the nursing process in the care of the families of Nursing students. Materials and Methods: Through a descriptive study, families were assessed using family health instruments (genogram, family APGAR, and ecomap). The North American Nursing Diagnosis Association domain assessment taxonomy, the nursing intervention classification, and the nursing outcome classification were then used for diagnosing, developing and implementing a care plan according to their needs. Results: A total of 101 families were assessed with an average of 3.6 ± 1.1 persons per family, of which 71.3% resided in Cali. Most of the families were nuclear (84.1%), and the most frequent life cycle was expansion (58.4%). The most frequent nursing diagnosis was dysfunctional family processes, with a perception of family dysfunction being around 39.6%; it was identified that as the family moves forward through the successive stages of the life cycle, the members’ perception of family dysfunction increases (p = 0.0176). Another diagnosis was impaired social interaction. The nursing care plan included family support, promotion of family unity, empowerment of socialization, and social skills. Conclusions: The nursing process for the care of families was developed; families expressed satisfaction with the process and willingness to strengthen their self-care based on the tools received.
Introduction: The disabilities caused by leprosy, in addition to being stigmatizing, interfere in the emotional, social, and productive stability of the person affected. For this reason, it must be prevented during treatment and post-discharge, when support for self-care is essential. In this context, it is crucial to use educational technologies that encourage the understanding and incorporation of daily care. Objective: To highlight the contributions of educational technologies used to promote self-care in people affected by leprosy. Materials and Methods: This is a systematic review conducted in December 2022, in the SciELO, Cochrane Library, Embase, Lilacs, PubMed, Scopus, and Web of Science databases as well as in the gray literature, in which the Catalogue of Theses and Dissertations of the Coordination for the Improvement of Higher Education Personnel (Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - Capes), ProQuest, and OpenGrey were searched. The eligibility criteria consisted of primary studies with people aged 15 or over affected by leprosy; healthcare professionals who provided guidance on self-care to people affected by leprosy; the use of educational technologies to guide self-care; and the contributions of their use to the improvement of self-care. Results: In total, five studies were included; all the manuscripts presented interventions via oral communication; there was a significant improvement in adherence to self-care regarding the face, hands, and feet; in addition, there was a minimization of hospital admissions with increased levels of independence when performing activities of daily living. Conclusion: The educational technologies were significant, as there was an increase in the frequency of self-care practices and in adherence to leprosy treatment.
Introduction: Promoting active aging is essential to ensuring quality of life and autonomy for older people. Work, as a key dimension in this process, contributes to socialization, strengthening identity, and maintaining the physical and mental health of this population. Objective: To understand social representations of work among older people during the social isolation imposed by the COVID-19 pandemic. Materials and Methods: This is a qualitative study conducted with 50 active or retired older people linked to an aging institute at a Brazilian federal university. People aged 60 years or older, with preserved cognition and availability to participate, were included. Data collection, which ended due to theoretical saturation, used semi-structured interviews with the free word association technique, using the term “work” as an inducer. The textual corpus was processed by Iramuteq software, adopting similarity analysis, and interpreted in light of the Social Representation Theory. Three researchers participated in the analysis and discussion of the data; however, the findings were not validated with the participants. Results: Four categories emerged: Economic-Functional; Subjective and Emotional; Relational and Socialization; and Cognitive and Personal Development. The results indicate multiple dimensions assigned to work by older people, going beyond the economic dimension. Conclusions: The findings reinforce the role of work as a structuring component of active aging and point to the need to formulate policies and practices that promote the social inclusion and appreciation of this population.
Type 1 diabetes mellitus is a chronic condition that impacts the quality of life of adolescents and their families, and its management requires changes and adjustments to their lifestyle. Whittemore and Roy's adaptation theory provides a framework for understanding this process, as it focuses on how individuals respond to health challenges through adaptation, with particular emphasis on education and family support. Nursing plays a key role in applying this perspective to promote self-care and autonomy, highlighting the importance of a comprehensive approach in settings such as schools, clinical care, and households.
Introduction: Advanced age is one of the most prevalent predisposing factors in cases of delirium, particularly in older patients hospitalized in intensive care units. Due to population aging and demographic transition, this study presents a specific sample analysis of a population subgroup. Objectives: To determine the prevalence of delirium in older patients hospitalized in the intensive care unit and to verify correlations with clinical and sociodemographic predictor variables. Materials and Methods: This is a cross-sectional study conducted in the countryside of the state of Pernambuco, Brazil, between July and November 2023. Older people aged 60 years or older (according to Brazilian law) and hospitalized for at least 24 hours were included. The Richmond Agitation-Sedation Scale (RASS) was used to screen sedation levels, and the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) was used to assess delirium. Results: The sample consisted of 83 older patients hospitalized in the intensive care unit. The prevalence rate of delirium was 36.1 %, with a strong association with the predictor “use of mechanical restraint in bed”. Multivariate analysis showed that the use of mechanical restraint in bed increases the odds of delirium in older people by 21.5 times (OR = 21.542; 95 % CI: 6.663-69.641). Conclusions: Reducing the use of mechanical restraint, adequately monitoring sedation, and preventing delirium are essential strategies for reducing healthcare costs and providing a more humane experience for patients and their families.
Introduction: Communication between nursing professionals and the families of critically ill patients is an essential aspect of quality care. Therefore, measuring this communication is an important factor in improving healthcare. The objective was to determine the communication activities performed by nursing professionals with the families of critically ill patients and their association with sociodemographic variables. Materials and Methods: This was an analytical cross-sectional study with a purposeful sample of 100 intensive care nursing professionals from the Colombian Andean Region. The instrument Nursing Activities to Communicate with the Families of Critically Ill Patients was used, which consists of 16 items and has an overall Cronbach’s alpha of 0.92. Descriptive statistics and bivariate analysis were applied; the significance level was set at 0.05. Results: Nursing professionals “almost always” develop communication activities aimed at transmitting information and “sometimes” activities focused on identifying and satisfying psycho-spiritual needs. The variables most associated with communication activities were the number of patients assigned and the educational level (p < 0.05). Conclusions: Information is a priority for the families of critically ill patients, so communication activities related to physical, emotional, cultural, and relational aspects are essential in nursing care. However, some variables can limit communication. Communication activities by nursing professionals should be strengthened to enhance the quality of care provided to the families of critically ill patients.
Introduction: Obstetric violence has recently been recognized in Ecuador as a type of gender-based violence against women during pregnancy, childbirth, or the postpartum period, affecting mothers, their children, families, and society in general. This study was conducted to justify the importance of including the topic of obstetric violence prevention in the training of health professionals in Ecuador. Objective: To linguistically and culturally adapt and validate the Perception of Obstetric Violence in Health Science Students (PercOV-S) instrument. Materials and Method: Methodological study of the adaptation of the instrument created in Spain, developed with the stages of linguistic review by the linguist, content review by eight key informants/experts and two students, and psychometric validation of data collected from 269 students. Results: After the changes, the original instrument retained the same number of items as the PercOV-S instrument, with 20 items of sociodemographic data and 33 items on the perception of obstetric violence, named PercOV-S-A. To validate the pilot test data, confirmatory factor analysis was performed, which explained 52.6% of the variance in three factors or domains: 1) Insensitive and cruel treatment; 2) Normalized violence; and 3) Neglect and manipulation. All factor loadings were greater than 0.42, except for two items. The internal reliability of the questionnaire, by domain, was greater than or equal to 95%. The overall score (3.42) on the PercOV-S-A scale, as well as the scores for the domains (3.53), (2.77), and (3.36), indicated a high perception of obstetric violence. Conclusions: The PercOV-S-A instrument is fully functional for its purpose, after being adapted and validated for the Ecuadorian context.
Introduction: The increase in the number of older people in intensive care units (ICUs) poses a challenge for care providers, as these patients are more vulnerable and fragile, making them prone to unfavorable outcomes. Objective: To understand the significance of ICU stays for older people. Methodology: This is a descriptive qualitative study employing ethnographic tools. Following an exploratory study, ten interviews were conducted and complemented by observation in an ICU and a field diary. There was reflexivity and concurrence between data collection and analysis. The interviews were transcribed, and codes were identified through line-by-line reading, which were used to configure the emerging categories. Rigorous criteria and ethical principles were retained. Results: The meaning that participants assigned to the ICU setting was that of a respectful, enclosed, cold, special room with personalized care for complex or seriously sick patients. Interactions occurred with family, healthcare personnel, and spiritual figures, with diverse meanings, mediated by respectful, kind, special, and affectionate treatment; however, there were moments of inhumane, distant, and indifferent treatment. Care was defined as special, requested, and timely; at other times, it was defined as not received, not identified, not timely, or with some limitations when provided. Conclusion: The meaning of ICU stay for older adults is associated with being cared for and grateful, despite some unfavorable situations in the environment, interactions, and care.
