IntroductionPatient experience (PX) is now recognized as the third pillar of healthcare quality, with evidences linking PX dimensions to improved clinical outcomes. As health systems shift toward value-based care, understanding which aspects of care citizens value most is essential for aligning services with their expectations and improving health outcomes.MethodologyThis study explores how citizens (n = 78; 29 men, 49 women) prioritize PX dimensions, through a simulation conducted during an open day at a University Hospital. Participants at the PX team's outreach stand received information on seven PX dimensions-Information, Therapeutic education, Physical environment, Participation in service governance, Shared decision-making, Professional accessibility, and Respectful treatment-identified through literature and over 70 focus groups. Each was asked to allocate a simulated 500€ budget across these dimensions using play money. Color-coded envelopes were distributed based on gender identity.ResultsParticipants prioritized Professional accessibility (22%), followed by Therapeutic education (17%) and Respectful treatment (17%). Shared decision-making (12%), Information (11%), Participation (11%), and Physical environment (10%) followed. Gender differences were observed: while both men and women placed highest value on Professional accessibility (21%), men favoured Therapeutic education (19% vs 16%), while women prioritized Respectful treatment (18% vs 14%).ConclusionsThese findings highlight the potential of participatory approaches to reveal citizens' true priorities, informing more targeted, equitable, and people-centred strategies. By aligning PX improvements with dimensions citizens value most, particularly accessibility, education, and respectful care, healthcare systems can enhance both responsiveness and overall quality.

Introduction Obesity in women of reproductive age is a significant risk factor for infertility. Current treatment strategies primarily focus on weight reduction through lifestyle modifications, pharmacological interventions, or surgical procedures. However, there is still a lack of consensus on the most effective approach. Moreover, such interventions have limited effectiveness in maintaining WL and optimizing assisted reproduction results following assisted reproductive techniques, which may lead to stigmatization and negative experiences for patients.Although qualitative evidence regarding preconception and gestational stages has increased, literature specifically addressing women who simultaneously present obesity and infertility, as well as the impact of these conditions on their physical and emotional well-being, remains limited. Aim To explore the care trajectory of women with obesity and infertility. Methods We designed a mixed-methods study involving 10 health care professionals, a focus group and a co-creation workshop with 6 and 8 patients respectively, and an online survey was administered and completed by 33 out of a total of 150 women with obesity and reproductive pathology who were invited to participate (response rate 22%). Results While some aspects of preconception care were positively evaluated, the overall patient journey is complex. We identified four areas for improvement: providing personalized information, offering stigma-free emotional support, ensuring efficient time management, and promoting shared decision-making. Conclusions A comprehensive, multidisciplinary approach emerges as a key element to optimize care and enhance the experience of these women.

Obesity represents a significant public health challenge, particularly in the context of coexisting chronic diseases and multi-morbidity. In Spain, and specifically in Catalonia, primary care plays a central role in prevention and management, yet barriers such as weight-related stigma can compromise care delivery. To evaluate the current state of obesity prevention and management within the health system, with a focus on implications for primary care in Catalonia, including prevalence, stigma, and integration of chronic disease care. A narrative literature review was conducted, including studies, government reports, and policy documents relevant to obesity prevalence, psychosocial factors, and healthcare system strategies. Persistent weight bias among healthcare professionals can delay diagnosis, reduce treatment adherence, and negatively affect patient experience. Integrated, patient-centered care models that consider physical, psychological, and social health have gained traction. Holistic assessment—including behavioral context, mental health, and social determinants alongside cardiorenal metabolic diseases—is central to these approaches. Effective obesity management requires integrated chronic disease management frameworks. Collaborative care models, community-based resources, and equitable health policies are essential. Incorporating patient experience helps identify unmet needs and improve care quality. A system-wide, holistic approach is critical to reducing the burden of obesity and related chronic diseases in Catalonia.

Obesity is a heterogeneous health issue associated with stigma, depression, low self-esteem, body dissatisfaction, mood disorders, and anxiety impacting physical health, and quality healthcare. The aim of this pilot study was to explore the feasibility of using drawing, together with focus group discussions and an illness perception questionnaire, as a methodology to establish dialogue with patients living with obesity. A two-hour workshop was conducted with people living with obesity. Patients completed the Brief Illness Perception Questionnaire (BIPQ) and demographic information, followed by a drawing activity. Quantitative and qualitative data were analyzed using IBM SPSS, Version 27.0. and the MAXQDA software, respectively. Twelve participants (82

Introducción La obesidad en mujeres en edad reproductiva es un factor de riesgo significativo para la esterilidad. Las estrategias actuales de tratamiento se orientan principalmente hacia la reducción ponderal mediante modificaciones del estilo de vida, intervenciones farmacológicas o quirúrgicas. Sin embargo, persiste una falta de consenso sobre la intervención más eficaz. Además, estas estrategias no suelen lograr una pérdida de peso sostenida ni garantizan resultados exitosos tras técnicas de reproducción asistida, lo que puede derivar en experiencias negativas para las pacientes.Si bien la evidencia cualitativa sobre las etapas preconcepcional y gestacional ha aumentado, la literatura específica en mujeres que presentan simultáneamente obesidad y esterilidad, así como el impacto de estas condiciones en su bienestar físico y emocional, continúa siendo limitada. Objetivo Estudiar la trayectoria asistencial de las mujeres con obesidad y esterilidad. Métodos Se diseñó un estudio con enfoque mixto que incluyó la participación de 10 profesionales sanitarios; grupo focal y taller de co-creación con 6 y 8 pacientes respectivamente, además de una encuesta online respondida por 33 de un total de 150 mujeres con obesidad y patología reproductiva. Resultados Aunque algunos aspectos de la atención preconcepcional fueron valorados positivamente, el recorrido asistencial de las pacientes es complejo. Identificamos cuatro áreas de mejora: ofrecer información personalizada, apoyo emocional libre de estigma, gestión eficiente del tiempo y promoción de la toma de decisiones compartida. Conclusiones Un abordaje integral y multidisciplinar se presenta como elemento clave para optimizar la atención y mejorar la experiencia de estas mujeres.

Background/Objectives: Nowadays, endometriosis is considered a chronic inflammatory disease and has a very high impact on women who suffer from it due to the symptoms of pain and infertility, as well as the delay in diagnosis. The objective of our study was to identify the unmet needs of endometriosis patients and to explore opportunities for improvement with respect to health care services for endometriosis patients using a patient training workshop. Methods: A qualitative study with a participatory action research method was performed. A two-day training workshop for patients was designed to allow them to develop the confidence and skills necessary to participate in the identification of unmet needs in their healthcare. Eighteen patients were selected by purposive sampling. After each training session, a debate on a topic of interest was also organized among all the participants. Data collection involved the nominal group technique with triangulation of data for their analysis. Results: The suggestions brought up during the sessions were divided into four areas of work: improvement of patient care, information and communication, training of professionals/patients, and encouragement of patients to participate. This study is a successful novel example of co-production with endometriosis patients and health care professionals and provides valuable information for future improvements in the care of these patients. Conclusions: Co-production between endometriosis patients and healthcare professionals allowed us to identify unmet needs in their healthcare.

Mindfulness-based interventions have been shown to improve the quality of life of cancer patients and are widely recommended. This was a non-randomized, single-center study designed to assess the feasibility and benefits of a mindfulness and compassion program for individuals living with cancer (MCP-C). The primary objective was to evaluate the feasibility of the program, while the secondary objective was to assess its effectiveness in adult cancer patients and their relatives. Before and after completing the program, participants completed the 12-item General Health Questionnaire (GHQ- 12) and the Hospital Anxiety and Depression Scale (HADS). A qualitative study was also conducted using focus groups and a structured qualitative survey. A total of eight courses were delivered, six in person in 2019 and two online in 2020. A total of 153 participants were enrolled, of whom 142 were considered evaluable. Among them, 90 (64.3

Awareness of nutrition’s role in chronic diseases is rising, demanding guidance on the diet-disease relationship. Nutritional practices become crucial for prevention, prompting healthcare professionals (HCP) to respond. The present study assessed a Culinary Medicine (CM) program’s impact on HCP’s Mediterranean diet adherence, food and diet therapy knowledge, food management skills, culinary proficiency, and counseling confidence. A mixed-methods pilot implementation program (PIP) engaged 20 HCP from Hospital Clinic Barcelona at the Alícia Foundation kitchen-lab. Four 8-hour CM sessions, held weekly, covered culinary knowledge emphasizing disease prevention and care. All twenty participants; 86% women, 14% men, 86% aged above 40, 14% between 31 and 39 years, 71% nurses, 7% medical doctors and 21% other occupation, completed the course and fourteen fulfilled pre-and post-program questionnaires. Notably, 86% had prior nutrition training, while only 14% had culinary training. After the program, there was significant improvement in Mediterranean diet adherence ( P < .05). Perceptions on dietary advice usefulness, patient-transferable knowledge acquisition, cooking techniques, and personal cooking skills confidence showed post-course improvements. This study underscores the potential of hands-on CM training in HCP nutrition education, influencing their culinary knowledge. Future studies with larger samples is needed to elucidate CM training’s impact on HCP and potential public health benefits.

La seguridad del paciente constituye una prioridad de los sistemas sanitarios y es especialmente relevante en los pacientes críticos. A pesar de su importancia en los últimos años son muchos los pacientes que sufren eventos adversos (EA) y con repercusiones negativas para pacientes, los profesionales y las instituciones.Se han promovido prácticas seguras y desarrollado estrategias, las cuales se han ido incorporando en las políticas institucionales, mejorando la cultura de seguridad. Pero todavía existen estrategias poco desarrolladas, tales como, incorporar la participación de pacientes y familiares en su seguridad.Hasta hace poco se ha considerado al paciente y familiares como parte pasiva en la recepción de los servicios sanitarios, no como parte activa, ni mucho menos, como una posible oportunidad de mejora en la seguridad frente a los errores que suceden durante la asistencia.El paciente crítico y/o familiares deben estar informados e, idealmente, formados para facilitar una participación activa en su seguridad. No se trata de traspasar la responsabilidad, sino de facilitar y promover su participación reforzando su seguridad.Y los profesionales deben estar comprometidos con su seguridad y facilitar las condiciones para fomentar su participación.Aportamos herramientas y reflexiones para ayudar a profesionales a implementar la participación de pacientes y familiares en la seguridad a su paso por los servicios de medicina intensiva (SMI).

Patient safety is a priority for health systems and is especially relevant for critically ill patients. Despite its relevance in recent years, many patients suffer adverse events with harm and negative repercussions for professionals and institutions.Numerous safe practices have been promoted and strategies have been developed that have been incorporated into institutional policies and thereby improving the safety culture. But there are still underdeveloped strategies, such as incorporating the participation of patients and family members in their safety.Until recently, the patient and family have been considered as a passive part in the reception of health services, not as an active part, much less as a possible opportunity to improve safety against errors that occur during care.The critically ill patient and/or family members must be informed and, ideally, trained to facilitate active participation in their safety. It is not about transferring responsibility, but about facilitating and promoting their participation by reinforcing their safety. And professionals must be committed to their safety and facilitate the conditions to encourage their participation.We provide tools and reflections to help professionals implement the participation of patients and family members in safety as they pass through intensive medicine services.

Introduction: Randomized controlled trials (RCT) have not demonstrated a role for continuous positive airway pressure (CPAP) on the secondary prevention of major cardiovascular events in obstructive sleep apnea (OSA) patients. However, participants in RCTs are substantially different from real-world patients. Therefore, we aimed to assess the effect of CPAP treatment on major cardiovascular events in real-world OSA patients.Methods: Population-based longitudinal observational study including all OSA patients with an active CPAP prescription at the beginning of 2011 in Catalonia, Spain, that terminated CPAP treatment during 2011 and did not have CPAP prescriptions between 2012-2015; and, propensity-score-matched OSA patients that continued CPAP treatment until the end of 2015 or death. Adjusted hazard ratios were used to assess the association between CPAP treatment and overall and cardiovascular mortality, cardiovascular hospitalizations, or major adverse cardiovascular events (MACEs).Results: 3638 CPAP terminators and 10914 propensity-score-matched continuators were included (median age 67 (57–77) years, 71.4% male). During a median follow-up of 47.9 months CPAP continuators showed a lower risk of cardiovascular death than terminators (hazard ratio (HR): 0.61; 95% confidence interval (CI): 0.50–0.75) after adjusting by age, sex and key comorbidities. Similar results were found for cardiovascular hospitalizations (HR: 0.87; 95% CI: 0.76–0.99) and MACEs (HR: 0.84; 95% CI: 0.75–0.95).Conclusion: CPAP treatment continuation could be associated with a significantly lower risk of major cardiovascular events in real-world OSA patients. This result highlights the importance of including real-world patients in studies on OSA.

BACKGROUND:Patient perspectives on their post-operative health are acknowledged as valuable healthcare outcomes and should be scrupulously considered when designing interventions for patient-centered healthcare. Yet, following the COVID-19 lockdown and in the absence of standardized guidelines on how to best provide virtual chronic care to kidney transplant recipients, little is known about how this unique population coped and managed to comply with public health indications during confinement. METHODS:This study addresses this shortcoming by examining the experiences of patients from a tertiary hospital in Spain during the initial weeks of the lockdown decreed by the national government. Specifically, we focus our attention on the perceptions and experiences of these patients by retrieving robust qualitative and quantitative data: the former based on a thematic analysis of focus group transcripts, the latter obtained from a large-scale survey. RESULTS:Our findings identify opportunities for improvement in the quality of care and point to the provisions that might be made when facing future pandemics or lockdown-requiring situations. CONCLUSIONS:As healthcare services navigate evolving landscapes, our findings on the experience of kidney transplant recipients should enable hospital services to improve the quality of care they are able to provide to such patients during periods of restricted mobility, especially those associated with future disease emergencies, and considering that home confinement is often part of the natural course of post-operative care of these patients.

Purpose: To assess the usability and preferences of the contents of mHealth software developed for breast cancer patients as a tool to obtain patient-reported outcomes (PROMs), improve the patient’s knowledge about the disease and its side effects, increase adherence to treatment, and facilitate communication with the doctor. Intervention: an mHealth tool called the Xemio app provides side effect tracking, social calendars, and a personalized and trusted disease information platform to deliver evidence-based advice and education for breast cancer patients. Method: A qualitative research study using semi-structured focus groups was conducted and evaluated. This involved a group interview and a cognitive walking test using Android devices, with the participation of breast cancer survivors. Results: The ability to track side effects and the availability of reliable content were the main benefits of using the application. The ease of use and the method of interaction were the primary concerns; however, all participants agreed that the application would be beneficial to users. Finally, participants expressed their expectations of being informed by their healthcare providers about the launch of the Xemio app. Conclusion: Participants perceived the need for reliable health information and its benefits through an mHealth app. Therefore, applications for breast cancer patients must be designed with accessibility as a key consideration.

Background: Sleep is an essential element for patients’ recovery during a period of hospitalisation. Hospital Clínic de Barcelona has developed the ClíNit project to promote patients’ sleep by identifying elements that affect the quality of sleep and implementing actions to improve rest at night. Objective: Our aim is to select actions to improve sleep quality. Methods: The study population included night-shift nurses from two clinical units where the pilot actions were to be carried out (n: 14). The nurses prioritised actions to improve sleep quality using the methodology proposed by Fogg: clarification, magic wand, crispification, and the focus-mapping technique. Results: Two sessions were organised for each unit and 32 actions considered high impact and easy to implement were proposed, of which 43.75% (14/32) were directly dependent on nurses. It was then agreed to implement four of these pilot studies. Conclusions: One aspect worth highlighting is that using prioritization techniques such as the Fogg technique is a good strategy to implement the general objectives of intervention programmes in large organizations in an easy way.