https://hdl.handle.net/2072/378085 2026-04-07T12:38:00Z 2026-04-07T12:38:00Z Serra-Sutton, Vicky Fernández-Giner, Luisa Caldeiro , Monica García-Atlès, Anna Espallargues, Mireia https://hdl.handle.net/11351/14396 2026-03-26T05:23:19Z 2026-03-25T13:50:16Z

Barriers, facilitators and unmet needs for achieving a good death and enhancing end-of-life care in the Catalan Health System: a qualitative study Serra-Sutton, Vicky; Fernández-Giner, Luisa; Caldeiro , Monica; García-Atlès, Anna; Espallargues, Mireia Cures pal·liatives; Planificació anticipada de decisions; Qualitat de vida; Final de vida; Cuidados paliativos; Planificación anticipada de decisiones; Calidad de vida; Final de vida; Palliative care; Advance care planning; Quality of Life; End of life; A qualitative study was conducted in Catalonia (Spain), incorporating the views and opinions of relatives, healthcare professionals and patients on what they considered a 'good death'. This study aimed to describe barriers, facilitators and unmet needs related to the achievement of a good death. We recruited adult patients with advanced or chronic conditions, relatives and health and social care professionals involved in end-of-life processes of care, management or strategic planning. All participants took part in a qualitative study. The study was informed by phenomenological, hermeneutical and social constructivist perspectives and included 23 in-depth interviews and three focus group discussions with a total of 31 participants. Fieldwork was conducted between February and April 2022. Data were transcribed and analysed using qualitative thematic content and discourse analysis. Six main themes were identified, comprising 17 subthemes. Facilitators and barriers related to achieving 'a good death' were categorised according to whether they occurred before death or during the dying process. Key facilitators include high-quality palliative care, open communication about death and the ability to choose the place of death. Key barriers included bureaucratic delays, inadequate resources, insufficient professional training and lack of respect for patients' preferences and wishes. Our study highlights the need to understand factors that facilitate or hinder the achievement of a good death and the quality of the dying process. Specifically, understanding individual preferences and unmet needs, enhancing communication, increasing awareness, reducing bureaucratic barriers and ensuring adequate resources are essential to support a more dignified end-of-life experience for patients, caregivers and healthcare professionals.

2026-03-25T13:50:16Z Velasco-Regulez, Borja Gil-Gonzalez, Sergi Cerquides Bueno, Jesus https://hdl.handle.net/11351/14237 2026-02-13T01:34:03Z 2026-02-11T13:49:54Z

The first causal inference analysis of the Catalan Arthroplasty Register shows a positive effect of antibiotic-loaded bone cement on knee prosthesis survival Velasco-Regulez, Borja; Gil-Gonzalez, Sergi; Cerquides Bueno, Jesus Ciment ossi carregat amb antibiòtic; Anàlisi causal de supervivència; Artroplàstia total de genoll; Cemento óseo cargado con antibiótico; Análisis causal de supervivencia; Artroplastia total de rodilla; Antibiotic‐loaded bone cement; Causal survival analysis; Total knee arthroplasty; The survival of a knee prosthesis is one of the most important indicators of the success or failure of a knee arthroplasty. An intervention that could increase prosthetic survival is the use of antibiotic-loaded bone cement (ALBC) during primary surgery, but the evidence for this is not conclusive. The question of whether such an intervention increases prosthetic survival is a causal one, and yet it has never been addressed with causal methods in the observational studies literature. This constitutes a serious limitation, as there is growing evidence that the best-suited framework for addressing causal questions with observational data is causal inference. In the present study, causal inference methods were employed to answer the research question of whether ALBC increases prosthetic survival. In particular, directed acyclic graphs were used for identification and causal survival forests were used to estimate the effect of interest. The rationale behind these methods is provided in the main text, and technical details are provided in Supporting Information: File S3. Data from the Catalan Arthroplasty Register were analysed. ALBC had an effect of increasing the overall prosthetic survival by 8% after 120 months of follow-up. The intervention had a positive effect across all the subgroups of the population defined by confounding variables, but the effect was greater in men, young patients, patients with rheumatoid arthritis or obesity, and patients who smoked or abused alcohol. The chosen causal assumptions had an impact on the obtained results, empirically showing the importance of using a causal framework. ALBC increased knee prosthesis survival among patients in the Catalan public healthcare system. Causal inference methods are the most appropriate for answering causal questions about the effect of ALBC on prosthetic survival when the analysed data are observational.

2026-02-11T13:49:54Z Jodar Solà, Glòria Brugués Brugués, Alba Serra-Sutton, Vicky Espallargues-Carreras, Mireia Trejo Omeñaca, Alex Monguet, Josep Mª https://hdl.handle.net/11351/10524 2025-10-27T09:41:44Z 2023-10-27T07:21:37Z

Opinion on the benefits of nurse prescribing in Catalonia: consensus of health professionals and managers; Opinión sobre los beneficios de la prescripción enfermera en Cataluña: consenso de profesionales de la salud y gestores Jodar Solà, Glòria; Brugués Brugués, Alba; Serra-Sutton, Vicky; Espallargues-Carreras, Mireia; Trejo Omeñaca, Alex; Monguet, Josep Mª Prescripció infermera; Infermeria; Prescripción enfermera; Enfermería; Nurse prescribing; Nursing; Objective: To study the level of agreement among health professionals and managers in Catalonia on the benefits of nurse prescribing (NP). Method: An online Real Time Delphi was conducted to collect the level of agreement of health professionals and managers. Participants voted in a 6-point scale (1 low benefit and 6 high benefit) for 12 items describing benefits of NP. A total of 1332 professionals participated. The level of consensus was calculated applying interquartile ranges of scores and standardized mean differences among subgroups using effect sizes (ES) and their corresponding 95% confidence intervals. Results: The scores indicate a general agreement on the perceived benefits of NP among participants. Standardized differences among scores on the perceived benefits among professionals were small to high (ES range between 0.2 and 1.2) between nurses and medical doctors and high between nurses and pharmacists (ES range: 1.2 and 2.4). Differences between scores of nurses and those of managers or other professionals in the present study were smaller for most voted benefits. Conclusions: The study shows an agreement on the benefits of NP. Nevertheless, when standardized scores are taken into consideration, differences among professionals’ perceptions emerged, and aligned with documented barriers identified in the literature such as corporative aspects, cultural limitations, institutional and organisational inertia, beliefs and unawareness of what NP implies.; Objetivo: Estudiar el nivel de consenso entre profesionales de salud y gestores en Cataluna˜ sobre los beneficios de la prescripción enfermera (PE). Método: Se realizó un Delphi en tiempo real en línea para recoger el nivel de acuerdo de profesionales de la salud y gestores. Las personas participantes votaron en una escala de 6 puntos (1 bajo beneficio y 6 alto beneficio) en 12 ítems que describen los beneficios de la PE. Participaron 1332 profesionales. El nivel de consenso se calculó aplicando rangos intercuartílicos de puntuaciones y diferencias de medias estandarizadas entre subgrupos a partir de tamanos ˜ del efecto (ES) y sus correspondientes intervalos de confianza del 95%. Resultados: Las puntuaciones indican un acuerdo general sobre los beneficios percibidos de la PE entre las personas participantes. Las diferencias estandarizadas entre las puntuaciones sobre los beneficios percibidos entre profesionales fueron de pequenas ˜ a altas (rango ES: 0,2 a 1,2) entre enfermeras ymédicos, y altas entre enfermeras y farmacéuticos (rango ES: 1,2 a 2,4). Las diferencias entre las puntuaciones de profesionales de enfermería y gestión clínica u otros profesionales en el presente estudio fueron menores para los beneficios más votados. Conclusiones: El estudio muestra un acuerdo sobre los beneficios de la PE. Sin embargo, cuando se tienen en cuenta las puntuaciones estandarizadas se encontraron algunas diferencias entre las percepciones de profesionales y se alinearon con las barreras documentadas identificadas en la literatura, como aspectos corporativos, limitaciones culturales, inercia institucional y organizativa, creencias y desconocimiento de lo que implica la PE.; The present study has not received a specific funding. The Agency of Health Quality and Assessment of Catalonia (AQuAS) signed a collaboration agreement with the Council of Nurses and Infermers Colleges of Catalonia (CIIC) and the Family and Community Nursing Association of Catalonia (AIFiCC) to carry out the study. The project was partially financed by AQuAS and the budget of Group 15 of the Spanish scientific network Consorcio Centro de Investigación Biomédica (CIBER) in Epidemiology and Public Health (CIBERESP). The Spanish Biomedical Network- CIBER financed the Health Delphi platform applied in this consensus study. The revision of English grammar was carried out by a native linguist financed by the CCIIC.

2023-10-27T07:21:37Z Solans-Domènech, Maite Carrion-Ribas, Carme Aymerich, Marta Almazán, Cari https://hdl.handle.net/11351/3325 2025-10-27T09:41:42Z 2018-02-21T13:03:15Z

La neuromodulació d’arrels sacres en el tractament de la incontinència fecal Solans-Domènech, Maite; Carrion-Ribas, Carme; Aymerich, Marta; Almazán, Cari Incontinència fecal; Plexe lumbar; Estimulació elèctrica transcutània del nervi; Incontinencia fecal; Plexo lumbosacro; Estimulación eléctrica transcutánea del nervio; Fecal incontinence; Lumbar plexus; Transcutaneous electrical nerve stimulation; L'estimulació de les arrels sacres (ERS) mitjançant un dispositiu mèdic que genera impulsos elèctrics (elèctrode més un estimulador) és un tractament mínimament invasiu de la incontinència fecal (IF), que es planteja com a alternativa terapèutica a les persones que no responen al tractament conservador i tenen un esfínter estructuralment intacte o amb lesions parcials de tots dos esfínters. La incidència i l'impacte personal, familiar, laboral i social de la IF, així com el cost de la ERS fan imprescindible revisar l'eficàcia i seguretat d'aquest tractament per valorar la seva introducció i millorar el tractament de les persones afectades.; La estimulación de las raíces sacras (ERS) mediante un dispositivo médico que genera impulsos eléctricos (electrodo más un estimulador) es un tratamiento mínimamente invasivo de la incontinencia fecal (IF), que se plantea como alternativa terapéutica a las personas que no responden al tratamiento conservador y tienen un esfínter estructuralmente intacto o con lesiones parciales de ambos esfínteres. La incidencia y el impacto personal, familiar, laboral y social de la IF, así como el coste de la ERS hacen imprescindible revisar la eficacia y seguridad de este tratamiento para valorar su introducción y mejorar el tratamiento de las personas afectadas.; Sacral nerve stimulation (SNS) by means of an (electrode and stimulator) electronic device is a minimally invasive treatment for fecal incontinence (FI), which arises as a therapeutic alternative to people who do not respond to conservative treatment and have a structurally intact sphincter or partial lesions of both sphincters. The incidence and the personal, family, work and social impact, together with the cost of SNS, make it imperative to review the effectiveness and safety of this treatment to assess its introduction and improve the quality of care for affected people.

2018-02-21T13:03:15Z