Highlights Critical care nurses have had to perform tasks for which they have not received proper training. Nurses have had to manage the fear of becoming infected and spreading it to their families. Moral suffering and emotional exhaustion are major consequences of front-line care. Heavy workloads, high patient-nurse ratios, and lack of rest are causing exhaustion among nurses.

The aim of this study was to explore the experience of Spanish people living with rheumatoid arthritis (RA) and the support these people received from health professionals, particularly nurses. Nineteen patients with >1 year diagnosis, disease activity moderate or severe (DAS28 > 3.2), and already treated with disease-modifying antirheumatic drugs (DMARDs) were interviewed. A thematic analysis was performed to interpret the discourses. The difficulties of symptom management; the need for home-adaptations, the difficulties of living with a deteriorating self-image; and the reluctant reliance on medication to control their disease were the main themes that emerged from the discourse analysis of this study. Nurses appeared to have a limited role in RA patients care, and focused primarily on giving information and training for biological therapies. RA patients in Spain would benefit from having contact with specialist nurses who could empower them to self-manage their disease, as happens in other countries.

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Background: Aim: To evaluate the effectiveness of an online nursing consultation through the Internet platform Red Sinapsis (RS) in improving the perceived quality of life of patients with fibromyalgia (FM). Method: Eighty patients with FM were randomized to an intervention group (n = 40) or control group (n = 40). The intervention group (IG) was monitored by a nursing specialist through the online platform RS while the control group (CG) received standard follow-up at the clinic. The Fibromyalgia Impact Questionnaire (FIQ) and 36-item Short-Form Health Survey (SF-36) were used at baseline, 6-month, and 12-month follow-up. Results: The IG showed a 65% improvement in the perception of their general state of health at 12 months into the study, compared with an improvement of 5.6% in the CG ( p < .001). The IG also achieved better results for emotional status, with a maintained improvement throughout the study of more than 2 points in the anxiety variable (from 7.64 to 5.36), that remained constant in the CG. The depression variable also showed constant improvement over the 12 months of the study in the IG, rising from an average of 7.72 (standard deviation [SD] = 2.05) to 5.33 (SD = 1.65), while in the CG a slight deterioration was observed. In both cases, the difference in mood evolution was significant ( p < .001). Conclusions: Online nursing follow-up for people with fibromyalgia improves patients' perceived quality of life related to their welfare and emotional state.Fibromyalgia (FM) is among the diseases causing the highest rate of occupational disability in Spain. Fibromyalgia (FM) is a complex condition that causes pain, fatigue, non-refreshed sleep, mood disturbance and cognitive impairment.

Objective to identify the predictive variables or the massive transfusion triggers in severely traumatized patients through the existing scales.Method a review of the literature was carried out using the Scoping Review method across the electronic databases CINAHL, MEDLINE, LILACS, the Cochrane and IBECS libraries, and the Google Scholar search tool.Results in total, 578 articles were identified in the search and the 36 articles published in the last ten years were included, of which 29 were original articles and 7 review articles. From the analysis, scales for massive transfusion and their predictive triggers were examined.Conclusion the absence of universal criteria regarding the massive transfusion triggers in traumatized patients has led to the development of different scales, and the studies on their validation are considered relevant for the studies about when to initiate this strategy.

Organ transplant techniques open the door to a new definition of death, of the identity of the body and its parts and the limits of life. Considering the cultural, legal, psychological, social and symbolic elements involved in the heart transplant process, a qualitative approach provides new avenues of understanding the clinical process from the patients' perspective.

Background The provision of healthcare during the pandemic caused by the SARS-CoV-2 virus represented a challenge for the management of the resources in the primary care centres. We proposed assessing burnout among the staff of those centres and identifying factors that contributed to its appearance and those that limited it. Methods An observational study which, by means of anonymous questionnaires, collected information about: (i) demographic variables; (ii) the characteristics of each position; (iii) the measures implemented by the medical decision-makers in order to provide care during the pandemic; and (iv) the Burnout Clinical Subtype Questionnaire (BCSQ-36). We performed a descriptive analysis of the burnout mentioned by the staff, and, by means of a multivariate analysis, we identified the factors which influenced it. Using logit models, we analysed whether receiving specific training in COVID-19, feeling involved in decision-making processes, and/or working within different healthcare systems had effects on the development of burnout. Results We analysed the replies of 252 employees of primary care centres in Spain with an average age of 45 (SD = 15.7) and 22 (SD = 11.4) years of experience. 68% of the participants (n = 173) indicated burnout of the frenetic subtype. 79% (n = 200) of the employees had high scores in at least one burnout subtype, and 62% (n = 156) in at least two. Women older than 45 had a lower probability of suffering burnout. Receiving specific training (OR = 0.28; CI95%: 0.11–0.73) and feeling involved in decision-making (OR = 0.32; CI95%:0.15–0.70) each reduced the probability of developing burnout. Working in a different department increased the likelihood of developing burnout of at least one clinical subtype (OR = 2.85; CI95%: 1.38–5.86). Conclusions The staff in primary care centres have developed high levels of burnout. Participation in decision-making and receiving specific training are revealed as factors that protect against the development of burnout. The measures taken to contain the adverse effects of a heavy workload appear to be insufficient. Certain factors that were not observed, but which are related to decisions taken by the healthcare management, appear to have had an effect on the development of some burnout subtypes.