Palliative care is a crucial discipline that alleviates suffering and enhances the quality of life for patients with life-limiting illnesses and their families. However, there is gap globally between the need for and availability of these services. Integrated health service networks offer a promising solution to address this gap in rural areas, by coordinating care across different levels and sectors. This scoping review aimed at identifying the key characteristics of palliative care networks in rural communities. A broad search without time limits was conducted in four databases. Analysis and synthesis were conducted using Latent Dirichlet Allocation topic modeling. Sixteen studies were included, revealing four key themes regarding the development of palliative care networks in rural areas: community engagement is essential to secure the reach of rural networks, tailored approaches acknowledging diversity enrich these networks, team-centric efforts involving stakeholder coordination ensure successful implementation, and a multifaceted approach-empowering non-traditional stakeholders and incorporating technology resources into primary health services-dynamizes palliative care delivery in rural areas. These findings underscore the potential of collaborative and innovative approaches to enhance the accessibility and effectiveness of palliative care in underserved rural communities. Further cost-effectiveness studies are warranted to better understand the impact these strategies can have on health systems.

This study aimed to identify barriers to access to palliative care through a social mapping approach. In Colombia, the barriers to access to palliative care denote an enormous geographic disparity of resources and health needs, making it necessary to conduct community-based participatory research using an approach such as social mapping. A qualitative research design was used. Stakeholders from health insurance companies, regulatory authorities, regional health secretariats, health care professionals, patient and caregiver organizations, scientific societies, and medical journalists from 7 Colombian regions participated. It involved 3 stages. Stage 1: Semi-structured, audio-recorded interviews were conducted with 36 stakeholders and were subsequently transcribed and analyzed. Stage 2: An electronic survey was conducted to obtain feedback on the first outline of the map and the categories that emerged from stage 1. Stage 3: The nominal group technique was used to analyze and validate the barriers to access to palliative care included in the final map. The COREQ checklist was used. Twenty-seven barriers to access to palliative care related to limited availability of medications, stakeholders’ poor knowledge of regulations, limited formal education in palliative care, few patients’ support networks, patient care fragmentation, few specialized programs of palliative care, and mistaken beliefs about palliative care were identified. Stakeholders’ diverse perspectives and opinions were crucial to understanding the development of palliative care in Colombia and its challenges. Better knowledge about palliative care can open opportunities to overcome the barriers identified in this study, directly impacting access to palliative care.

Introduction: The burden of nursing care has not been defined as a theoretical or operational concept. However, several studies have demonstrated its impact on the quality of care, the increase in adverse events, and the health of nursing staff. Objective: To analyze the attributes, factors, antecedents, and consequences associated with the concept of 'burden of nursing care' in order to clarify its meaning. Materials and Methods: A concept analysis was conducted using Walker and Avant's methodological proposal, which examines a concept's defining characteristics and attributes. Results: The burden of nursing care is the relation between the needs of patients and the time available for direct care, management, and education activities. Both intrinsic and extrinsic patient factors can influence the patient's level of dependency and needs, increasing nursing interventions and hours of care, thereby intensifying the burden of care. Discussion: The burden of nursing care involves patient-centered care with adequate resources. The burden of nursing care demands planning and leadership from nurses. A lack of competencies and experience, combined with institutional inflexibility, increases the burden of nursing care, leading to dissatisfaction and adverse events. Conclusions: The burden of nursing care is a concept that is epistemically grounded in the interactive-integrative view because it focuses on meeting patients' needs through nursing interventions for direct care, management, and education.

Los resultados hacen parte de la tesis titulada “Evaluación de una intervención educativa para fortalecer el cuidado espiritual en el personal de enfermería que trabaja con personas con enfermedad crónica”, para optar el título de Doctora en Enfermería en la Facultad de Enfermería de la Universidad Nacional de ColombiaEl objetivo de este estudio fue determinar la validez y confiabilidad en el contexto colombiano de la Escala de Evaluación de la Espiritualidad y el Cuidado Espiritual, diseñada por McSherry, Draper y Kendrick. Se realizó una investigación metodológica para establecer la validez facial, de contenido, de constructo y la confiabilidad. Para la validez facial participaron n=10, para la de contenido n=8, para la de constructo y la de confiabilidad n=183 enfermeras. La validez facial arrojó un porcentaje de acuerdo del 92% en los criterios de claridad, comprensión y precisión. El índice de validez de contenido (CVI) fue de 0,99. La validez de constructo con rotación Varimax reportó una estructura de cuatro factores. El resultado del Alpha de Cronbach de toda la escala fue de 0,73. De acuerdo con lo anterior, la versión en español de la escala cuenta con pruebas psicométricas suficientes en cuanto a confiabilidad y validez para utilizarse en la determinación de la percepción de la espiritualidad y el cuidado espiritual de enfermeras y enfermeros

Introduction: Hemato-oncology patients will require caregivers to help them in the control of physical symptoms, prescribed therapies, emotional support, among others. Caregivers must prepare themselves, increase their confidence and motivation through self-efficacy in their role since if they feel competent to care, they will be better able to develop accordingly their role, decreasing the chances of being burdened. Materials and Methods: A quantitative quasi-experimental study was conducted with two groups, pre-test and post-test. The objective was to establish the effectiveness of a nursing intervention, when compared to the standard intervention, in modifying self-efficacy and burden in the role of hemato-oncology patients’ caregivers. The General Self-Efficacy Scale and the Zarit Scale were used for the measurement. Results: The intervention is effective in modifying caregivers’ self-efficacy, which can be observed in the comparison between the control group and experimental group, going from 25.8 to 29.8 (p=0.00) in the self-efficacy scale after the intervention, as well as going from 25.5 to 26.3 (p=0.00) in the experimental group. No significant differences were observed concerning the burden of the role of hemato-oncology patients’ caregivers after the intervention. Discussion: An effective intervention from Resnick's nursing theory is provided for practice. Further studies are required to test the effectiveness of the intervention in other settings. Conclusions: Motivational nursing education interventions are relevant in practice and research to modify self-efficacy in hemato-oncology patients’ caregivers. How to cite this article: Penagos Castro Rodmar Vanessa, Vargas-Escobar Lina María. Efectividad de una intervención de enfermería para modificar la autoeficacia y la sobrecarga del cuidador del paciente hemato- oncológico. Revista Cuidarte. 2020; 11(2): e867. http://dx.doi.org/10.15649/cuidarte.867

This is an experimental, quantitative, parallel design study (control and experimental groups) with pre- and post-intervention assessment without blinding, which aimed to determine the effect of an educational intervention delivered to ninety Colombian senior nursing students to strengthen perceptions of spirituality and spiritual care for people with chronic illness. The Spirituality and Spiritual Care Rating Scale (SSCRS) was used as the instrument of measurement. The Wilcoxon test was used for comparisons between two groups, and the Kruskal-Wallis test for the comparison of global scale scores between the intervention group and the control group. To determine the effect of the intervention, Cohen’s d statistic was used. The intervention modified the perceptions of spirituality and spiritual care in the experimental group (median = 80.2, SD = 10.2) compared with their initial perceptions (median = 70, SD = 11.2), p ≤ 0.001. The effect size (ES) of the intervention was 0.63, with a power of 0.80, indicating a moderate and acceptable effect size.