Background: Patients with advanced cancer, receiving at-home palliative care, are subject to numerous symptoms that are changeable and often require attention, a stressful situation that also impacts on the family caregiver. It has been suggested that music therapy may benefit both the patient and the caregiver. We propose a study to analyse the efficacy and cost utility of a music intervention programme, applied as complementary therapy, for cancer patients in palliative care and for their at-home caregivers, compared to usual treatment.Method: A randomised, double-blind, multicentre clinical trial will be performed in cancer patients in at-home palliative care and their family caregivers. The study population will include two samples of 40 patients and two samples of 41 caregivers. Participants will be randomly assigned either to the intervention group or to the control group. The intervention group will receive a seven-day programme including music sessions, while the control group will receive seven sessions of (spoken word) therapeutic education. In this study, the primary outcome measure is the assessment of patients’ symptoms, according to the Edmonton Symptom Assessment System, and of the overload experienced by family caregivers, measured by the Caregiver Strain Index. The secondary outcomes considered will be the participants’ health-related quality of life, their satisfaction with the intervention, and an economic valuation.Discussion: This study is expected to enhance our understanding of the efficacy and cost-utility of music therapy for cancer patients in palliative care and for their family caregivers. The results of this project are expected to be applicable and transferrable to usual clinical practice for patients in home palliative care and for their caregivers. The approach described can be incorporated as an additional therapeutic resource within comprehensive palliative care. To our knowledge, no previous high quality studies, based on a double-blind clinical trial, have been undertaken to evaluate the cost-effectiveness of music therapy. The cost-effectiveness of the project will provide information to support decision making, thereby improving the management of health resources and their use within the health system.Trial registration: The COMTHECARE study is registered at Clinical Trials.gov,NCT04052074. Registered 9 August, 2019.

Introduction: The prevalence of frailty is increasing worldwide, emphasizing the importance of prioritizing healthy ageing. To address this, cost-effective and minimally supervised interventions are being sought. This study aimed to assess the impact of an educational program on frailty status, physical function, physical activity, sleep patterns, and nutritional status in community-dwelling older adults with at least 1 Fried’s frailty criteria.Methods: A 6-month multicentre randomized controlled trial was conducted from March 2022 to February 2023 in 14 health centres located in Cadiz and Malaga, Spain. The educational intervention consisted of 4 group sessions and 6 follow-up phone calls spread over 6 months. The program focused on educating participants about frailty and its impact on health, providing guidelines for physical activity, healthy dietary habits, cognitive training, psychological well-being and social activities. A total of 163 participants, divided into control (n = 80) and educational groups (n = 83) were assessed before and after the intervention.Results: The results showed a significant group-time interaction in the physical function evaluated with a large effect on Short Physical Performance Battery score (η2p = 0.179, −0.1 [−1.2–1.0] points for control group vs. 1.0 [0.0–3.0] points for educational group, p < 0.001), and an effect on the 4-meter gait test ((η2p = 0.122, 0.5 [0.1–0.0] s for control group vs. –0.4 [−0.5– −0.3] s for educational group, p < 0.001), and the 5-repetition sit-to-stand test (η2p = 0.136, 1.0 [0.0–1.2] s for control group vs. −4.3 [−7.0– −2.3] for educational group, p < 0.001). Additionally, the use of accelerometers to assess physical activity, inactivity, and sleep patterns revealed a significant small effect in the number of awakenings at night ((η2p = 0.040, 1.1 [−0.5–3.4] awakenings for control group vs. 0.0 [−2.2–0.0] awakenings for educational group, p = 0.009). The findings also highlighted a significant medium effect regarding malnutrition risk, which was assessed using the Mini-Nutritional Assessment score (η2p = 0.088, −0.7 [−2.3–1.5] points for control group vs. 1.5 [−0.5–3.0] points for educational group, p < 0.001).Discussion: Thus, the 6-month educational program effectively improved physical function, sleep patterns, and nutritional status compared to usual healthcare attendance in community-dwelling older adults with frailty or pre-frailty. These findings underscore the potential of minimally supervised interventions in promoting a healthy lifestyle in this vulnerable population.

Aims and objectives: The aim of the present study is to investigate the professional grief suffered by nurses in various medical units, after coping with the COVID‐19 pandemic for the last 18 months.Background: Addressing and acknowledging the reality of professional grief is of fundamental importance to nurses' mental health, as this condition has both professional and personal consequences.Design: A qualitative, content analysis approach was taken.Methods: Based on 25 interviews with nursing professionals working in different health centers units were performed. The following sampling schemes were used: first, convenience sampling, then nominated sampling, and finally theoretical sampling.Results: From our analysis of the data obtained, three main themes were identified: the impact on nurses of COVID‐19 outcomes; the symptoms of professional grief; and cognitive reactions. These core elements interacted with 12 subtopics, including symptoms of grief and the cognitive impact produced.Conclusions: A large proportion of the nurses consulted in this study have suffered and suffered professional grief and report many related symptoms. In response to the present pandemic and any future occurrence, the question of professional grief needs to be addressed.Relevance to clinical practice: To help them cope better with this type of situation, nurses should receive appropriate training. Moreover, healthcare institutions should be made aware of the problem and be encouraged to offer assistance to address the impact produced on nurses by the deaths of their patients.Clinical relevance: This study shows the impact of professional grief on nurses in the context of the COVID‐19 pandemic. Nurses are affected personally by the deaths of patients and by alterations to their working conditions. In many cases, this grief remains unresolved and its various symptoms persist.

IntroducciónLa sarcopenia se define como la pérdida de masa muscular y su deterioro funcional asociado a la edad, por lo que tiene un alto impacto sobre la calidad de vida. Sin embargo, la prevalencia de la sarcopenia en diabetes mellitus tipo 2 (DM2) no está suficientemente estudiada.ObjetivosAnalizar la prevalencia de sarcopenia en mayores de 65 años con DM2 y la posible influencia de la actividad física, la alimentación, el control glucémico, el sexo, la edad y calidad de vida.MétodosParticiparon 279 pacientes (155 mujeres) de 76,6±6,27 años de edad. Se determinó el perímetro de cintura, cadera, pantorrilla y brazo, el índice de masa corporal, la fuerza de prensión manual, nivel de actividad física, el estado nutricional, la calidad de vida y el control glucémico. La sarcopenia se definió como un índice de masa muscular esquelética menor de 9,2 Kg/m2 en varones y menor de 7,4 Kg/m2 en mujeres.Resultados La prevalencia de sarcopenia en los participantes fue de un 8,33%. Hubo asociación negativa entre el nivel de sarcopenia y la calidad de vida (r =-0,130, p=0,030), actividad física (r= -0,164, p= 0,006), estado nutricional (r =-0,274, p=< 0,001), y sexo masculino (r= -0,137, p=0,022); y positiva para edad (r =0,183, p=0,002).ConclusionesLa prevalencia de la sarcopenia en DM2 es moderada. Se relaciona con importantes factores para la salud, como una menor calidad de vida, menor realización de ejercicio físico y mayor presencia de desnutrición, lo cual parece agravarse en adultos varones de edad avanzada.

The experience of caregiver burden among family members of patients with advanced cancer is a common problem. The aim of this study was to determine whether the burden may be alleviated by means of a therapeutic approach based on self-chosen music. This randomised controlled trial (ClinicalTrials.gov, NCT04052074. Registered 9 August 2019) included 82 family caregivers of patients receiving home palliative care for advanced cancer. The intervention group (n = 41) listened to pre-recorded, self-chosen music for 30 min/day for seven consecutive days, while the control group (n = 41) listened to a recording of basic therapeutic education at the same frequency. The degree of burden was assessed by the Caregiver Strain Index (CSI), calculated before and after the seven-day intervention. According to this measure, caregiver burden fell significantly in the intervention group (CSI change: −0.56, SD 2.16) but increased in the control group (CSI change: +0.68, SD 1.47), with a significant group x moment interaction F(1, 80) = 9.30, p = 0.003, η²_p = 0.11. These results suggest that, in the short term at least, the use of therapy based on self-chosen music alleviates the burden on family caregivers of palliative cancer patients. Moreover, this therapy is easy to administer at home and does not present any problems in practice.