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Holistic Approaches to Understanding and Caring for Vulnerable Populations
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Holistic Approaches to Understanding and Caring for Vulnerable Populations

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601).

Deadline for manuscript submissions: closed (30 September 2022) | Viewed by 87857

Special Issue Editors

Dr. Cayetano Fernández-Sola

E-Mail Website
Guest Editor
Department of Nursing, Physiotherapy and Medicine, University of Almeria, 04120 Almeria, Spain
Interests: end-of life care; terminal care; qualitative research; transients and migrants; sexology–gender studies
Special Issues, Collections and Topics in MDPI journals
Dr. José Manuel Hernández Padilla

E-Mail Website
Guest Editor
Department of Nursing, Physiotherapy and Medicine, University of Almeria, 04120 Almeria, Spain
Interests: aging; healthy aging; aged 80 and over; questionnaire design; quantitative research; educational techniques; pedagogy
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

A vulnerable population can be defined as one with a higher-than-average risk of developing health problems by virtue of their socioeconomic status, marginalization, limited access to resources, sociodemographic characteristics, sexual orientation, etc. Amongst others, ethnic minorities, migrants, people in poverty, chronically or terminally ill people, disabled people, and LGTBIQ+ communities are often considered vulnerable populations.

Vulnerability can affect people of all age ranges throughout all stages of life. Understanding and caring for vulnerable children, adults, and older people is a public health challenge worldwide. Holistic approaches from all healthcare disciplines are much needed in order to understand the experiences, needs, and expectations of vulnerable populations so that their care can be individualized.

A variety of research approaches, methodologies, and designs can contribute to comprehensively and holistically improving care for vulnerable populations. We invite colleagues from all healthcare disciplines to submit papers using qualitative, quantitative, or mixed-methods approaches. Submitted papers should focus on improving our understanding of vulnerable populations’ healthcare needs, analyzing the characteristics and/or effects of care programmes delivered for vulnerable populations, or describing educational interventions to improve healthcare professionals’ competence to look after vulnerable populations.

Dr. Cayetano Fernández-Sola
Dr. José Manuel Hernández Padilla
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Vulnerable population
  • Transients and migrants
  • Aging
  • Frail elderly
  • Aged 80 and over
  • Terminal care
  • Chronic disease
  • Mental disease
  • Child
  • Disabled children
  • Battered women
  • Sexual and gender minorities

Published Papers (21 papers)

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12 pages, 606 KiB  
Article
Knowledge, Attitudes and Practices towards Sexual and Reproductive Health and Rights of Girls among Colombian Healthcare Professionals
by Aura Y. Rodríguez-Burbano, Diana M. Galván-Canchila and Rocío de Diego-Cordero
Int. J. Environ. Res. Public Health 2022, 19(19), 12295; https://doi.org/10.3390/ijerph191912295 - 28 Sep 2022
Viewed by 1662
Abstract
This research aims to determine knowledge and attitudes towards sexual and reproductive health and rights of adolescent girls among healthcare professionals working at Café Madrid and Colorados health centers, which are highly vulnerable neighborhoods in Bucaramanga, Santander. To this end, in-depth interviews were [...] Read more.
This research aims to determine knowledge and attitudes towards sexual and reproductive health and rights of adolescent girls among healthcare professionals working at Café Madrid and Colorados health centers, which are highly vulnerable neighborhoods in Bucaramanga, Santander. To this end, in-depth interviews were conducted with a total of eight healthcare professionals from the above health centers using a script based on WHO recommendations on adolescent sexual and reproductive health and rights and recommendations by the DAPRE-Presidential Council for Women’s Equity—CedaVida Foundation. Healthcare professionals were found to have proper technical and legal knowledge, especially regarding comprehensive care packages for survivors, as well as a gender perspective in their professional practice aimed at achieving equity. Knowledge and experience with sexual and reproductive health and rights provide insight into women’s health from unrestrained choice of contraceptive methods to procedures such as abortion within the current legal framework. Their professional work is also affected by potential barriers that may limit their actions when putting their knowledge into practice. Full article
(This article belongs to the Special Issue Holistic Approaches to Understanding and Caring for Vulnerable Populations)
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14 pages, 424 KiB  
Article
Development and Psychometric Assessment of a Questionnaire for the Detection of Invisible Violence against Women
by Iria Dobarrio-Sanz, Anabel Fernández-Vargas, Alba Fernández-Férez, Diana Patricia Vanegas-Coveña, Otilia Vanessa Cordero-Ahiman, José Granero-Molina, Cayetano Fernández-Sola and José Manuel Hernández-Padilla
Int. J. Environ. Res. Public Health 2022, 19(17), 11127; https://doi.org/10.3390/ijerph191711127 - 05 Sep 2022
Viewed by 1963
Abstract
Background. Invisible violence against women (IVAW) can be understood as the set of attitudes, behaviors, and subtle beliefs that men use to subordinate women and that are culturally accepted. These behaviors can be a risk factor for intimate partner violence (IPV), so it [...] Read more.
Background. Invisible violence against women (IVAW) can be understood as the set of attitudes, behaviors, and subtle beliefs that men use to subordinate women and that are culturally accepted. These behaviors can be a risk factor for intimate partner violence (IPV), so it is important to design tools that allow us to detect it early. The aim of this study was to design and psychometrically assess a questionnaire for the detection of invisible violence against women (Q-IVAW). Methodology. A descriptive cross-sectional methodological study carried out in three phases: (1) development of the initial version; (2) pilot study (N = 51); and (3) final validation study (N = 990). The tool’s reliability, validity, and legibility were assessed. To assess reliability, the internal consistency (Cronbach’s α) was analyzed. The validity assessment included an analysis of content, criterion, and construct validity. Results. The EFA revealed that the Q-IVAW was comprised of five factors that explained 55.85% of the total variance found. The Q-IVAW showed very high reliability (α = 0.937), excellent content validity, and good construct validity. The criterion validity analysis showed a moderate correlation between A-IPVAW and Q-IVAW (r = 0.30; p < 0.001). Conclusion. The psychometric assessment of the Q-IVAW yielded good results, which could support the tool’s ability to assess how often women are subjected to inviable violent behaviors by their partners. Full article
(This article belongs to the Special Issue Holistic Approaches to Understanding and Caring for Vulnerable Populations)
12 pages, 743 KiB  
Article
The Perception of African Immigrant Women Living in Spain Regarding the Persistence of FGM
by Ousmane Berthe-Kone, María Isabel Ventura-Miranda, Sara María López-Saro, Jessica García-González, José Granero-Molina, María del Mar Jiménez-Lasserrotte and Cayetano Fernández-Sola
Int. J. Environ. Res. Public Health 2021, 18(24), 13341; https://doi.org/10.3390/ijerph182413341 - 18 Dec 2021
Cited by 2 | Viewed by 2470
Abstract
Approximately 200 million women and girls have undergone female genital mutilation (FGM) worldwide. Migration has spread the practice of FGM around the world, thus making it a global public health issue. The objective of this descriptive qualitative study was to explore the perceptions [...] Read more.
Approximately 200 million women and girls have undergone female genital mutilation (FGM) worldwide. Migration has spread the practice of FGM around the world, thus making it a global public health issue. The objective of this descriptive qualitative study was to explore the perceptions of Sub-Saharan immigrant women in Spain in relation to the causes of the persistence of FGM. In-depth interviews were carried out with 13 female FGM survivors of African origin, followed by inductive data analysis using ATLAS.ti software. Two main themes emerged from the analysis: (1) A family ritual symbolic of purification and (2) a system of false beliefs and deception in favour of FGM. The FGM survivors living in Europe are aware that FGM is a practice that violates human rights yet persists due to a system of false beliefs rooted in family traditions and deception that hides the reality of FGM from young girls or forces them to undergo the practice. The ritualistic nature of FGM and the threat of social exclusion faced by women who have not had it performed on them contributes to its persistence nowadays. Full article
(This article belongs to the Special Issue Holistic Approaches to Understanding and Caring for Vulnerable Populations)
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14 pages, 381 KiB  
Article
Healthcare Professionals’ Perceptions of Loneliness amongst Older Adults: A Qualitative Study
by Iria Dobarrio-Sanz, Crístofer Ruiz-González, Cayetano Fernández-Sola, Pablo Roman, José Granero-Molina and Jose Manuel Hernández-Padilla
Int. J. Environ. Res. Public Health 2021, 18(22), 12071; https://doi.org/10.3390/ijerph182212071 - 17 Nov 2021
Cited by 2 | Viewed by 2843
Abstract
Background: Loneliness amongst older adults is linked to poor health outcomes and constitutes a public health issue worldwide. Healthcare professionals’ perceptions could influence the strategies they implement in order to prevent, detect and manage loneliness amongst older adults. The aim of this study [...] Read more.
Background: Loneliness amongst older adults is linked to poor health outcomes and constitutes a public health issue worldwide. Healthcare professionals’ perceptions could influence the strategies they implement in order to prevent, detect and manage loneliness amongst older adults. The aim of this study was to describe and understand healthcare professionals’ perceptions of loneliness amongst older adults. Methods: A descriptive qualitative study. Twenty-six Spanish healthcare professionals with experience caring for older adults participated in the study. Data were collected between November 2019 and September 2020 using focus groups and in-depth interviews. Data were analysed following a content analysis method using ATLAS.ti software. Results: Healthcare professionals’ perceptions of loneliness amongst older adults is represented by three themes: (1) “when one’s personal life and social context lead to loneliness”; (2) “from abandonment to personal growth: the two faces of loneliness”; and (3) “loneliness as a health issue that needs to be addressed”. Conclusions: Healthcare professionals perceive loneliness as a multifactorial, subjective experience that can trigger different coping mechanisms and negatively affect older people’s health. Healthcare professionals consider that a greater involvement of the whole society is needed in order to fight loneliness amongst older adults as a public health issue. Full article
(This article belongs to the Special Issue Holistic Approaches to Understanding and Caring for Vulnerable Populations)
14 pages, 377 KiB  
Article
Social Support for People with Morbid Obesity in a Bariatric Surgery Programme: A Qualitative Descriptive Study
by María José Torrente-Sánchez, Manuel Ferrer-Márquez, Beatriz Estébanez-Ferrero, María del Mar Jiménez-Lasserrotte, Alicia Ruiz-Muelle, María Isabel Ventura-Miranda, Iria Dobarrio-Sanz and José Granero-Molina
Int. J. Environ. Res. Public Health 2021, 18(12), 6530; https://doi.org/10.3390/ijerph18126530 - 17 Jun 2021
Cited by 4 | Viewed by 2371
Abstract
Background—Morbid obesity (MO) is a chronic metabolic disease affecting physical, psychological and social wellbeing. Bariatric surgery is a reliable method for losing weight in the long term, improving the quality of life, body image and social life of people with MO. Current literature [...] Read more.
Background—Morbid obesity (MO) is a chronic metabolic disease affecting physical, psychological and social wellbeing. Bariatric surgery is a reliable method for losing weight in the long term, improving the quality of life, body image and social life of people with MO. Current literature recognises the importance of social support in controlling weight and coping with MO. The objective of this study was to describe and understand experiences related to social support for patients with MO included in a bariatric surgery programme. Methods—A qualitative descriptive study, where data collection included thirty-one interviews with people diagnosed with MO involved in a bariatric surgery programme. Results—Three main themes emerged from the analysis: (1) accepting the problem in order to ask for help, (2) the need for close support and (3) professional support: opposing feelings. Conclusions—A partner, family and friends are the key pillars of social support for those with MO included in a bariatric surgery programme. Healthcare professionals gave formal support; the bariatric surgery team provided information, trust and assurance. Nurses provided healthcare 24 h a day, making them the main formal support for people in the bariatric surgery programme. Full article
(This article belongs to the Special Issue Holistic Approaches to Understanding and Caring for Vulnerable Populations)
10 pages, 2156 KiB  
Article
Association between Crystalline Silica Dust Exposure and Silicosis Development in Artificial Stone Workers
by Mar Requena-Mullor, Raquel Alarcón-Rodríguez, Tesifón Parrón-Carreño, Jose Joaquín Martínez-López, David Lozano-Paniagua and Antonio F. Hernández
Int. J. Environ. Res. Public Health 2021, 18(11), 5625; https://doi.org/10.3390/ijerph18115625 - 25 May 2021
Cited by 14 | Viewed by 4680
Abstract
Occupational exposure to respirable crystalline silica (SiO2) is one of the most common and serious risks because of the health consequences for the workers involved. Silicosis is a progressive, irreversible, and incurable fibrotic lung disease caused by the inhalation of respirable [...] Read more.
Occupational exposure to respirable crystalline silica (SiO2) is one of the most common and serious risks because of the health consequences for the workers involved. Silicosis is a progressive, irreversible, and incurable fibrotic lung disease caused by the inhalation of respirable crystalline silica dust. A cross-sectional epidemiological study was carried out to assess the occupational risk factors that may contribute to the onset of silicosis in workers carrying out work activities with the inhalation of silica compact dust. The study population consisted of 311 artificial stone workers from the province of Almeria (southeast of Spain). Among them, 64 were previously diagnosed with silicosis and the rest of the participants (n = 247 workers) were not diagnosed with such a disease. The workers showing a greater risk of developing silicosis were those who installed kitchen worktops at consumers’ homes, as they did not use face-masks or were not provided with personal protective equipment (PPE) by their business. The results of this study provide support for the evidence indicating that silicosis is a major emerging health concern for workers in the artificial stone sector. Exposure to crystalline silica dust thus can influence the development of silicosis in those cases where individual and collective protection measures are not used or adequately applied. Full article
(This article belongs to the Special Issue Holistic Approaches to Understanding and Caring for Vulnerable Populations)
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14 pages, 391 KiB  
Article
A New Approach to the Identification of Palliative Care Needs and Advanced Chronic Patients among Nursing Home Residents
by Ana A. Esteban-Burgos, María José Lozano-Terrón, Daniel Puente-Fernandez, César Hueso-Montoro, Rafael Montoya-Juárez and María P. García-Caro
Int. J. Environ. Res. Public Health 2021, 18(6), 3171; https://doi.org/10.3390/ijerph18063171 - 19 Mar 2021
Cited by 12 | Viewed by 2982
Abstract
Background: Proper planning of Palliative Care in nursing homes requires advanced knowledge of the care needs that residents show. The aim of the study was to evaluate Palliative Needs and other conditions such as fragility, complexity, and prognosis and also to suggest new [...] Read more.
Background: Proper planning of Palliative Care in nursing homes requires advanced knowledge of the care needs that residents show. The aim of the study was to evaluate Palliative Needs and other conditions such as fragility, complexity, and prognosis and also to suggest new indicators for the establishment of the resident’s advanced chronic condition. Methods: Cross-sectional study conducted in 149 nursing homes Complex Chronic residents evaluated by trained professionals. Palliative Care Needs, assessed by the NECPAL ICO-CCOMS© tool, and fragility, case and palliative complexity and prognosis were evaluate through a comprehensive assessment. Descriptive analyses and association measures were performed setting the statistical significance at 0.05. Results: More than 50% of the residents had positive Surprise Question and other Palliative Needs and were classified as Advanced Chronic Patients. Distress and/or Severe Adaptative Disorder was the most frequent need shown by the residents and significant differences in levels of frailty and other characteristics, were found between the Positive and the Negative Surprise Question Groups. Statistically significant correlations were also found between aspects of both groups. Conclusions: Nursing homes residents show Palliative Needs regardless of the response to the Surprise Question of the NECPAL tool. Other characteristics such as presence of an intermediate level of frailty are suggested as a new perspective to identify advanced chronic patients among nursing homes residents. Full article
(This article belongs to the Special Issue Holistic Approaches to Understanding and Caring for Vulnerable Populations)
9 pages, 746 KiB  
Article
Effects of a Clinical Simulation Course about Basic Life Support on Undergraduate Nursing Students’ Learning
by María del Mar Requena-Mullor, Raquel Alarcón-Rodríguez, María Isabel Ventura-Miranda and Jessica García-González
Int. J. Environ. Res. Public Health 2021, 18(4), 1409; https://doi.org/10.3390/ijerph18041409 - 03 Feb 2021
Cited by 9 | Viewed by 4459
Abstract
Training in basic life support (BLS) using clinical simulation improves compression rates and the development of cardiopulmonary resuscitation (CPR) skills. This study analyzed the learning outcomes of undergraduate nursing students taking a BLS clinical simulation course. A total of 479 nursing students participated. [...] Read more.
Training in basic life support (BLS) using clinical simulation improves compression rates and the development of cardiopulmonary resuscitation (CPR) skills. This study analyzed the learning outcomes of undergraduate nursing students taking a BLS clinical simulation course. A total of 479 nursing students participated. A pre-test and post-test were carried out to evaluate theoretical knowledge of BLS through questions about anatomical physiology, cardiac arrest, the chain of survival, and CPR. A checklist was used in the simulation to evaluate practical skills of basic CPR. The learning outcomes showed statistically significant differences in the total score of the pre-test and after completing the BLS clinical simulation course (pre-test: 12.61 (2.30), post-test: 15.60 (2.06), p < 0.001). A significant increase in the mean scores was observed after completing the course in each of the four parts of the assessment protocol (p < 0.001). The increase in scores in the cardiac arrest and CPR sections were relevant (Rosenthal’s r: −0.72). The students who had prior knowledge of BLS scored higher on both the pre-test and the post-test. The BLS simulation course was an effective method of teaching and learning BLS skills. Full article
(This article belongs to the Special Issue Holistic Approaches to Understanding and Caring for Vulnerable Populations)
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11 pages, 347 KiB  
Article
Nursing Students’ Attitudes towards Immigrants’ Social Rights
by María Angustias Sánchez-Ojeda, Silvia Navarro-Prado, Adelina Martín-Salvador, Trinidad Luque-Vara, Elisabet Fernández-Gómez and Fernando Jesús Plaza del Pino
Int. J. Environ. Res. Public Health 2020, 17(23), 8875; https://doi.org/10.3390/ijerph17238875 - 29 Nov 2020
Cited by 5 | Viewed by 2492
Abstract
The migrant population has increased in recent years and, as a result, so has cultural diversity. Universities are incorporating specific modules addressing cultural diversity. However, the native population has negative attitudes towards immigrants, as they believe that immigrants receive more social benefits and [...] Read more.
The migrant population has increased in recent years and, as a result, so has cultural diversity. Universities are incorporating specific modules addressing cultural diversity. However, the native population has negative attitudes towards immigrants, as they believe that immigrants receive more social benefits and abuse healthcare services. Nurses may have these attitudes too, which may affect the way they treat patients. The objective of this study was to determine nursing students’ attitudes towards the rights of the migrant population. This is a descriptive ex post facto study using a cross-sectional design, with 821 nursing students in Melilla, Ceuta, and Almeria, Spain. An anonymous questionnaire was used for data collection. Students recognize the same rights for both the immigrant and native populations. More than 80% of the sample upholds the right of undocumented immigrants and their families to access publicly funded healthcare. Attitudes were more positive among students with a Berber background and first-year students. Students approved of the right of immigrants and their families to healthcare and education. The students’ negative attitudes towards the social rights of immigrants need to be addressed with intercultural training to reduce their prejudices as future professionals in a multicultural society. Full article
(This article belongs to the Special Issue Holistic Approaches to Understanding and Caring for Vulnerable Populations)
19 pages, 781 KiB  
Article
Quality of Life and Concerns in Parent Caregivers of Adult Children Diagnosed with Intellectual Disability: A Qualitative Study
by María Inmaculada Fernández-Ávalos, María Nieves Pérez-Marfil, Rosario Ferrer-Cascales, Francisco Cruz-Quintana, Violeta Clement-Carbonell and Manuel Fernández-Alcántara
Int. J. Environ. Res. Public Health 2020, 17(22), 8690; https://doi.org/10.3390/ijerph17228690 - 23 Nov 2020
Cited by 13 | Viewed by 4160
Abstract
Background: Previous studies have confirmed that parenting a child diagnosed with an intellectual disability (ID) can negatively affect the parents’ quality of life in several dimensions. However, fewer have assessed its impact years after the initial diagnosis. The objective of this work was [...] Read more.
Background: Previous studies have confirmed that parenting a child diagnosed with an intellectual disability (ID) can negatively affect the parents’ quality of life in several dimensions. However, fewer have assessed its impact years after the initial diagnosis. The objective of this work was to carry out an in-depth analysis of the current quality of life and concerns of both mothers and fathers of adults diagnosed with ID, having as a reference the moment of the diagnosis. Methods: 16 parents of adult children with ID were evaluated using a semi-structured interview format. A thematic qualitative analysis was carried out by employing ATLAS.ti software. Results: The results suggested that both the emotional and physical well-being of parents, as well as their interpersonal relationships, had declined. In addition, the multiple life changes that had occurred over the time considered in this study, as well as day-to-day worries, had prevented improvements in their quality of life. Conclusions: Several dimensions of the parents’ quality of life were affected years after a child is diagnosed with ID. These included poor physical and psychological health, economic difficulties, lack of social and family support, and lack of time for self-care. Full article
(This article belongs to the Special Issue Holistic Approaches to Understanding and Caring for Vulnerable Populations)
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11 pages, 343 KiB  
Article
Attitudes towards Immigration among Students in the First Year of a Nursing Degree at Universities in Coimbra, Toledo and Melilla
by M Idoia Ugarte Gurrutxaga, María Angustias Sánchez-Ojeda, Antonio Segura-Fragoso, María Lucilia Cardoso and Brígida Molina Gallego
Int. J. Environ. Res. Public Health 2020, 17(21), 7977; https://doi.org/10.3390/ijerph17217977 - 30 Oct 2020
Cited by 5 | Viewed by 2470
Abstract
Increased migration has led to increased prejudice towards immigrant populations. This study aims to analyse attitudes towards immigration among student nurses in three universities, two in Spain and one in Portugal. Methodology: A descriptive, transversal, prospective study was carried out among student [...] Read more.
Increased migration has led to increased prejudice towards immigrant populations. This study aims to analyse attitudes towards immigration among student nurses in three universities, two in Spain and one in Portugal. Methodology: A descriptive, transversal, prospective study was carried out among student nurses (n = 624), using the Attitude towards Immigration in Nursing scale. Results: Nursing students showed some positive attitudes towards immigration, such as that immigrants should have the right to maintain their customs or that immigrants should have free access to healthcare and education, in contrast to some negative attitudes, such as that crime rates have increased due to immigration or that immigrants receive more social welfare assistance than natives. Significant differences in attitudes were revealed between students from the three universities. Discussion: Training in transcultural nursing is necessary for all nursing students in order to reduce negative attitudes towards the immigrant population and increase the awareness and sensitivity of future healthcare staff in caring for patients of all backgrounds. Full article
(This article belongs to the Special Issue Holistic Approaches to Understanding and Caring for Vulnerable Populations)
12 pages, 635 KiB  
Article
Prevalence Rates of Loneliness and Its Impact on Lifestyle in the Healthy Population of Madrid, Spain
by Daniel Cuesta-Lozano, Leticia Carmen Simón-López, Rubén Mirón-González, Montserrat García-Sastre, Daniel Bonito-Samino and Ángel L. Asenjo-Esteve
Int. J. Environ. Res. Public Health 2020, 17(14), 5121; https://doi.org/10.3390/ijerph17145121 - 15 Jul 2020
Cited by 7 | Viewed by 3844
Abstract
Background: The Spanish population presents higher levels of loneliness than citizens of countries in Northern Europe. Numerous studies have linked loneliness to increased morbidity and mortality, but very few studies have associated loneliness with healthy lifestyles. The objectives of this research are to [...] Read more.
Background: The Spanish population presents higher levels of loneliness than citizens of countries in Northern Europe. Numerous studies have linked loneliness to increased morbidity and mortality, but very few studies have associated loneliness with healthy lifestyles. The objectives of this research are to identify the feeling of unwanted loneliness in various age and gender groups in the city of Alcalá de Henares (Madrid, Spain), to determine lifestyle habits in the areas of diet and physical exercise, and to examine the association between lifestyle habits and perceived loneliness. Methods: A cross-sectional, observational and analytical study on the perception of loneliness among men (59.06%) and women (60.06%) in a sample (n = 611) of the general population (N = 198,945), by means of random assignment of a health survey, was conducted. The data were collected using an ad hoc questionnaire. The data were stratified and analyzed with the IBM SSPS® v.25 software package. Results: The frequency of loneliness is stratified by sex and age, and healthy lifestyle habits in terms of diet and physical exercise are analyzed. Conclusions: People with perceived loneliness do not have worse lifestyle habits. However, women living with other people have a higher perception of loneliness than those living alone. Specifically, the perception of loneliness in young adult women could suggest a low level of moderate physical exercise. Full article
(This article belongs to the Special Issue Holistic Approaches to Understanding and Caring for Vulnerable Populations)
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16 pages, 394 KiB  
Article
A Qualitative View of Homecare Support Workers on Unmet Health Needs of People with Dependency
by Jose Manuel Martínez-Linares, Francisco Antonio Andújar-Afán, Rocío Martínez-Yébenes and Olga María López-Entrambasaguas
Int. J. Environ. Res. Public Health 2020, 17(9), 3166; https://doi.org/10.3390/ijerph17093166 - 02 May 2020
Cited by 2 | Viewed by 2458
Abstract
Background: Longevity and population growth generate an increase in the number of people with dependency, who require homecare assistance to meet their health needs. Homecare support workers provide this care in Spain, and they may have unique insights into the unmet health needs [...] Read more.
Background: Longevity and population growth generate an increase in the number of people with dependency, who require homecare assistance to meet their health needs. Homecare support workers provide this care in Spain, and they may have unique insights into the unmet health needs of those receiving homecare assistance. The aim of this study was to determine the unmet health needs of people with dependency based on the perspective of homecare support workers. Methods: Qualitative exploratory-descriptive study. Through convenience sampling, homecare support workers from a Spanish province were selected, following inclusion and exclusion criteria. Four focus groups, transcription and thematic analyses were performed using Atlas.ti. Coding triangulation was carried out, applying criteria for scientific rigour. Results: The six themes obtained were classified into the material, psychoemotional, socioeconomical and psychosocial needs of people with dependency from the point of view of homecare support workers, along with the contributions of improvements and the need of these professionals for continuous training. Conclusions: People with dependency need complex technical assistance, materials, psychological attention due to their situation, and more effective assessments of their health and disability status. Homecare support workers perceive themselves to be essential in these assessments. They ask for psychological assistance, due to the emotional burden of their work, and believe this help would contribute to improving the quality of their service. Homecare support workers perceive that they are capable of performing their job, although they believe that some delegated activities are beyond their levels of competency. Full article
(This article belongs to the Special Issue Holistic Approaches to Understanding and Caring for Vulnerable Populations)
15 pages, 400 KiB  
Article
Economic Problems and Loneliness as Factors Related to Subjective Unmet Health Needs in People with Chronic Diseases and Dependency
by Olga María López-Entrambasaguas, José Manuel Martínez-Linares, Miguel Sola-García, Carmen García-Redecillas and Ana María Díaz-Meco-Niño
Int. J. Environ. Res. Public Health 2020, 17(8), 2924; https://doi.org/10.3390/ijerph17082924 - 23 Apr 2020
Cited by 3 | Viewed by 2229
Abstract
Background: The continuous increase of people with chronic diseases is one of the greatest challenges for healthcare systems worldwide. Population growth and life expectancy means that an increasing number of people with chronic diseases and dependency need some kind of assistance to meet [...] Read more.
Background: The continuous increase of people with chronic diseases is one of the greatest challenges for healthcare systems worldwide. Population growth and life expectancy means that an increasing number of people with chronic diseases and dependency need some kind of assistance to meet their needs. Determining these subjective unmet needs helps to understand the situation of these people. The aim of this study was to explore the perceptions of chronic patients over 65 years of age from the day-care center toward subjective health needs that are not being met by the socio-health system. Methods: Qualitative exploratory-descriptive study. Through convenience sampling, we selected people with chronic diseases and dependency who used day-care centers and met the inclusion criteria. Focus groups were performed. The data were transcribed and a thematic analysis was carried out using Atlas.ti software. Results: The topics resulting from the analysis were classified into dissatisfaction of biological/physiological needs, psychological needs, social needs, and other issues that arose in both groups of participants which referred to the types of needs previously indicated. The issues related to social and psycho-social needs stood out. Conclusions: People with chronic diseases and dependency have their physiological needs covered with the help they receive, but their situation of dependency generates additional costs that worsen their economic situation. However, their greatest need is due to the loneliness they feel and the feeling they have of “being a burden” on their families. Full article
(This article belongs to the Special Issue Holistic Approaches to Understanding and Caring for Vulnerable Populations)
15 pages, 368 KiB  
Article
Hospitalization Experience of Muslim Migrants in Hospitals in Southern Spain—Communication, Relationship with Nurses and Culture. A Focused Ethnography
by Fernando Jesús Plaza del Pino, Verónica C. Cala, Encarnación Soriano Ayala and Rachida Dalouh
Int. J. Environ. Res. Public Health 2020, 17(8), 2791; https://doi.org/10.3390/ijerph17082791 - 17 Apr 2020
Cited by 12 | Viewed by 4139
Abstract
The coast of southern Spain is one of the main entry points for Africans who want to reach Europe; in this area, there is an important immigrant community of African origin, mostly Muslims. The objective of this study is to describe and understand [...] Read more.
The coast of southern Spain is one of the main entry points for Africans who want to reach Europe; in this area, there is an important immigrant community of African origin, mostly Muslims. The objective of this study is to describe and understand the hospitalization experience of Muslim migrants in public hospitals in southern Spain, especially their relationship with the nurses who care for them. Data were collected from May 2016 to June 2017. This study followed the principles associated with focused ethnography. During data collection, open interviews with 37 Muslim patients were conducted. Three themes emerged from the inductive data analysis: lack of communication with nurses, discriminatory experiences at the hospital and their experience of Islam in the hospital. We conclude that caring for Muslim patients requires specific training not only for nurses but also for other health professionals; existing communication problems must be addressed by establishing the role of the intercultural mediator as an idiomatic and cultural bridge between patients and nurses. In addition, hiring health professionals with migrant backgrounds would help convert hospitals into spaces for intercultural coexistence. Full article
(This article belongs to the Special Issue Holistic Approaches to Understanding and Caring for Vulnerable Populations)
12 pages, 363 KiB  
Article
Palliative Care Symptoms, Outcomes, and Interventions for Chronic Advanced Patients in Spanish Nursing Homes with and without Dementia
by Daniel Puente-Fernández, Concepción Petra Campos-Calderón, Ana Alejandra Esteban -Burgos, César Hueso-Montoro, Concepción Beatriz Roldán-López and Rafael Montoya-Juárez
Int. J. Environ. Res. Public Health 2020, 17(5), 1465; https://doi.org/10.3390/ijerph17051465 - 25 Feb 2020
Cited by 4 | Viewed by 3539
Abstract
The aim of this study was to compare the symptomatology, palliative care outcomes, therapeutic procedures, diagnostic tests, and pharmacological treatments for people with dementia (PWD) and without dementia (PW/OD) admitted to Spanish nursing homes. Design: This was a cross-sectional study which is part [...] Read more.
The aim of this study was to compare the symptomatology, palliative care outcomes, therapeutic procedures, diagnostic tests, and pharmacological treatments for people with dementia (PWD) and without dementia (PW/OD) admitted to Spanish nursing homes. Design: This was a cross-sectional study which is part of a long-term prospective follow-up of elderly people performed in nursing homes to measure end-of-life care processes. Participants: 107 nursing home patients with advanced or terminal chronic diseases were selected according to the criteria of the Palliative Care Spanish Society. Setting: Two trained nurses from each nursing home were responsible for participant selection and data collection. They must have treated the residents and had a minimum seniority of 6 months in the nursing home. Measurements: Sociodemographic data; Edmonton Symptom Assessment Scale; Palliative Care Outcome Scale; and prevalence of diagnostic tests, pharmacological treatments, and therapeutic procedures were evaluated. Results: Pain, fatigue, and nausea were found to be significantly higher in the nondementia group and insomnia, poor appetite, and drowsiness were significantly higher in the dementia group. Patient anxiety, support, feeling that life was worth living, self-worth, and practical matters management were higher in the nondementia group. Regarding drugs, use of corticoids was higher in the nondementia group, while use of anxiolytics was higher in the dementia group. Diagnostic procedures such as urine analysis and X-ray were higher in the dementia group. Conclusions: Differences in symptom perception, diagnostic tests, and pharmacological procedures were found between patients with and without dementia. Specific diagnostic tools need to be developed for patients with dementia. Full article
(This article belongs to the Special Issue Holistic Approaches to Understanding and Caring for Vulnerable Populations)

Review

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11 pages, 716 KiB  
Review
Nursing Interventions to Facilitate the Grieving Process after Perinatal Death: A Systematic Review
by Alba Fernández-Férez, Maria Isabel Ventura-Miranda, Marcos Camacho-Ávila, Antonio Fernández-Caballero, José Granero-Molina, Isabel María Fernández-Medina and María del Mar Requena-Mullor
Int. J. Environ. Res. Public Health 2021, 18(11), 5587; https://doi.org/10.3390/ijerph18115587 - 24 May 2021
Cited by 7 | Viewed by 8508
Abstract
Perinatal death is the death of a baby that occurs between the 22nd week of pregnancy (or when the baby weighs more than 500 g) and 7 days after birth. After perinatal death, parents experience the process of perinatal grief. Midwives and nurses [...] Read more.
Perinatal death is the death of a baby that occurs between the 22nd week of pregnancy (or when the baby weighs more than 500 g) and 7 days after birth. After perinatal death, parents experience the process of perinatal grief. Midwives and nurses can develop interventions to improve the perinatal grief process. The aim of this review was to determine the efficacy of nursing interventions to facilitate the process of grief as a result of perinatal death. A systematic review of the literature was carried out. Studies that met the selection criteria underwent a quality assessment using the Joanna Briggs Institute critical appraisal tool. Four articles were selected out of the 640 found. Two are quasi-experimental studies, and two are randomized controlled clinical studies. The interventions that were analyzed positively improve psychological self-concept and role functions, as well as mutual commitment, depression, post-traumatic stress and symptoms of grief. These interventions are effective if they are carried out both before perinatal loss and after it has occurred. The support of health professionals for affected parents, their participation in the loss, expressing feelings and emotions, using distraction methods, group sessions, social support, physical activity, and family education are some of the effective interventions. Full article
(This article belongs to the Special Issue Holistic Approaches to Understanding and Caring for Vulnerable Populations)
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15 pages, 503 KiB  
Review
Implementation Models of Compassionate Communities and Compassionate Cities at the End of Life: A Systematic Review
by Silvia Librada-Flores, María Nabal-Vicuña, Diana Forero-Vega, Ingrid Muñoz-Mayorga and María Dolores Guerra-Martín
Int. J. Environ. Res. Public Health 2020, 17(17), 6271; https://doi.org/10.3390/ijerph17176271 - 28 Aug 2020
Cited by 23 | Viewed by 6772
Abstract
In the last decade, we have seen a growth of Compassionate Communities and Cities (CCC) at the end of life. There has been an evolution of organizations that help construct Community-Based Palliative Care programs. The objective is to analyze the implementation, methodology and [...] Read more.
In the last decade, we have seen a growth of Compassionate Communities and Cities (CCC) at the end of life. There has been an evolution of organizations that help construct Community-Based Palliative Care programs. The objective is to analyze the implementation, methodology and effectiveness of the CCC models at the end of life. We conducted a systematic review following PRISMA ScR Guideline. The protocol was registered on PROSPERO (CRD42017068501). Five databases (MEDLINE, EMBASE, Web of Science, CINAHL and Google Scholar) were searched for studies (from 2000 to 2018) using set eligibility criteria. Three reviewers screened full-texts articles and extracted study data. Outcomes were filled in a registration form which included a narrative synthesis of each article. We screened 1975 records. We retrieved 112 articles and included 31 articles for the final analysis: 17 descriptive studies, 4 interventions studies, 4 reviews and 6 qualitative studies. A total of 11 studies regard the development models of CCC at the end of life, 15 studies were about evaluation of compassionate communities’ programs and 5 studies were about protocols for the development of CCC programs. There is poor evidence of the implementation and evaluation models of CCC at the end of life. There is little and low-/very low-quality evidence about CCC development and assessment models. We found no data published on care intervention in advance disease and end of life. A global model for the development and evaluation of CCC at the end of life seems to be necessary. Full article
(This article belongs to the Special Issue Holistic Approaches to Understanding and Caring for Vulnerable Populations)
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13 pages, 489 KiB  
Review
Treatment of Dysphagia in Parkinson’s Disease: A Systematic Review
by Remedios López-Liria, Jennifer Parra-Egeda, Francisco A. Vega-Ramírez, José Manuel Aguilar-Parra, Rubén Trigueros-Ramos, María José Morales-Gázquez and Patricia Rocamora-Pérez
Int. J. Environ. Res. Public Health 2020, 17(11), 4104; https://doi.org/10.3390/ijerph17114104 - 09 Jun 2020
Cited by 37 | Viewed by 11130
Abstract
The incidence of oropharyngeal dysphagia in Parkinson’s disease (PD) is very high. It is necessary to search for effective therapies that could prevent pneumonia. Previous results should be interpreted cautiously as there is a lack of evidence to support the use of compensatory [...] Read more.
The incidence of oropharyngeal dysphagia in Parkinson’s disease (PD) is very high. It is necessary to search for effective therapies that could prevent pneumonia. Previous results should be interpreted cautiously as there is a lack of evidence to support the use of compensatory or rehabilitative approaches to dysphagia. We reviewed the scientific literature to describe the treatments of dysphagia in PD. A systematic review was performed in PubMed, Scopus, Elsevier, and Medline according to PRISMA standards in 2018. The articles that did not mention dysphagia secondary to PD or used surgical treatment were excluded. Eleven articles met the criteria with information from 402 patients. The review relates to different protocols, such as training in expiratory muscle strength, postural techniques, oral motor exercises, video-assisted swallowing therapy, surface electrical stimulation, thermal stimulation, touch, compensatory interventions, training regime for swallowing, neuromuscular electrical stimulation, Lee Silverman voice treatment, swallow maneuver, airway protection, and postural compensation maneuvers. This review identifies the rationing interventions in each trial, if they are efficient and equitable. Several rehabilitative therapies have been successful. An improvement was seen in the degenerative function (coordination, speed, and volume), quality of life, and social relationships of people with PD. Further investigations concerning the clinical applicability of these therapies based on well-designed randomized controlled studies are needed. Larger patient populations need to be recruited to evaluate the effectiveness, long-term effects, and new treatment techniques. Full article
(This article belongs to the Special Issue Holistic Approaches to Understanding and Caring for Vulnerable Populations)
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14 pages, 938 KiB  
Review
New Technologies to Improve Pain, Anxiety and Depression in Children and Adolescents with Cancer: A Systematic Review
by María Mar Lopez-Rodriguez, Alejandro Fernández-Millan, María Dolores Ruiz-Fernández, Iria Dobarrio-Sanz and Isabel María Fernández-Medina
Int. J. Environ. Res. Public Health 2020, 17(10), 3563; https://doi.org/10.3390/ijerph17103563 - 19 May 2020
Cited by 28 | Viewed by 6997
Abstract
Pain, anxiety, or depression are very prevalent in children and adolescents with cancer, which is a great challenge for health professionals. Several studies pointing out the positive effect of technology on the management of symptoms have been published in recent years. Considering these [...] Read more.
Pain, anxiety, or depression are very prevalent in children and adolescents with cancer, which is a great challenge for health professionals. Several studies pointing out the positive effect of technology on the management of symptoms have been published in recent years. Considering these studies is important in order to reduce the negative impact on the quality of life of this population. This study aimed to analyze the available evidence and to describe the benefits of the new technologies in the treatment of pain, anxiety, and depression in children and adolescents with cancer. A systematic search using six electronic databases was conducted to identify studies using technological interventions with a focus on pain, anxiety, and depression that were published from 2008 to 2018 including oncology patients from 0–18 years old. Out of the 1261 studies that were identified, five studies met the inclusion criteria for this systematic review. Robots were used in two studies, providing amusement and social interventions that showed significant improvements. Virtual reality, a mobile application, and a videogame were used in three studies and obtained beneficial results in pain and anxiety. The studies included in this review suggest that new technologies can be used as an innovative form of non-pharmacological intervention with therapeutic benefits. Full article
(This article belongs to the Special Issue Holistic Approaches to Understanding and Caring for Vulnerable Populations)
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Other

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12 pages, 377 KiB  
Viewpoint
Vulnerable Dignity, Dignified Vulnerability: Intertwining of Ethical Principles in End-of-Life Care
by José María Muñoz Terrón
Int. J. Environ. Res. Public Health 2021, 18(2), 482; https://doi.org/10.3390/ijerph18020482 - 09 Jan 2021
Cited by 5 | Viewed by 2913
Abstract
The aim of this article is to analyze how dignity and vulnerability, as declared principles of bioethics, both can be seen in a new light when they are thought of together, in their intertwining, in order to outline a proposal for an analytical [...] Read more.
The aim of this article is to analyze how dignity and vulnerability, as declared principles of bioethics, both can be seen in a new light when they are thought of together, in their intertwining, in order to outline a proposal for an analytical framework for end-of-life care. It is thus shown, on the one hand, that the demand for respect for the equal dignity of every person, linked by the different anthropological and ethical theories to their autonomy as a rational agent, also refers to their fragile, vulnerable, and interdependent character, as an embodied subjectivity, sustained by a complex web of care. On the other hand, the vulnerability of these selves as others, constituted by the radical appeal of everything that affects them socially, emotionally, sensitively, and by their need for recognition and attention, would be pathological if it did not include the impulse towards autonomy, which, although precarious and connotative, requires dignified and equitable treatment. This intertwining of both principles points to a phenomenological conception of the person as a corporeal social existence, from which a number of studies on the attention to dignity and vulnerability at the end of life are analyzed. Full article
(This article belongs to the Special Issue Holistic Approaches to Understanding and Caring for Vulnerable Populations)
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