Background: a lack of adequate training in palliative care leads to a greater emotional burden on nurses. Purpose: to assess the effect of a simulation using standardized patients on self-efficacy in palliative care, ability to cope with death, and emotional intelligence among nursing students. Methods: a randomized clinical trial and qualitative study. A total of 264 nursing students in a palliative care module completed the Bugen, trait meta-mood, and self-efficacy in palliative care scales after active participation in the simulation (n = 51), watching the simulation (n = 113), and the control group (n = 100). An ANOVA with a multi-comparative analysis and McNemar’s tests for paired samples were calculated. Active participants were interviewed, and a thematic analysis was conducted. Results: there was an improvement after the assessment in all three groups assessed for coping with death (p < 0.01), emotional intelligence (p < 0.01), and self-efficacy (p < 0.01). In addition, the active group improved more than the observer group and the control group in coping with death, attention, and repair. The students in the interviews identified sadness and an emotional lack of control. Conclusions: the simulation improved nursing students’ self-efficacy in palliative care. This effect was partially stronger in the active group.

Background: Overweight and obesity differ in their repercussions on the health and health-related quality of life (HRQoL) of patients. The objective of this study was to compare physical activity levels and dietary habits before admission and HRQoL at discharge between patients with obesity and overweight. Methods: A cross-sectional study was undertaken among participants in a clinical trial on education for healthy eating and physical activity, enrolling non-diabetic patients admitted to Internal Medicine Departments. These were classified by body mass index (BMI) as having overweight (25–29.9 Kg/m²) or obesity (≥30 kg/m²). Data were gathered on sociodemographic characteristics, clinical variables (medication for anxiety/depression, Charlson Comorbidity Index, length of hospital stay), physical exercise and diet (International Physical Activity and Pardo Questionnaires), and HRQoL (EQ-5D-5L). The study included 98 patients with overweight (58.2% males) and 177 with obesity (52% males). Results: In comparison to patients with obesity, those with overweight obtained better results for regular physical exercise (p = 0.007), healthy diet (p = 0.004), and “emotional eating” (p = 0.017). No between-group difference was found in HqoL scores. Conclusion: Patients with overweight and obesity differ in healthy dietary and physical exercise behaviors. Greater efforts are warranted to prevent an increase in the BMI of patients, paying special attention to their state of mind.

Introduction: Obesity and overweight affect more than one-third of the world’s population and pose a major public health problem. Objective: To evaluate the impact of an educational intervention on dietary habits and physical exercise in patients with overweight admitted to departments of internal medicine, comprising a pre-discharge educational session with follow-up and reinforcement by telephone at 3, 6, and, 12 months post-discharge. Outcome variables were weight, systolic (SBP) and diastolic (DBP) blood pressures, health-related quality of life (HRQOL), hospital readmissions, emergency department visits, and death. Method: A randomized experimental study with a control group was performed in hospitalized non-diabetic adults aged ≥18 years with body mass index (BMI) ≥25 Kg/m². Results and conclusions: The final sample included 273 patients. At three months post-discharge, the intervention group had lower SBP and DPB and improved dietary habits (assessed using the Pardo Questionnaire) and VAS-assessed HRQOL in comparison to the control group but a worse EQ-5Q-5L-assessed HRQOL. There were no between-group differences in hospital readmissions, emergency department visits, or mortality at any time point. Both groups evidenced a progressive improvement over the three follow-up periods in weight, SBP, and dietary habits but a worsening of EQ-5D-5L-value-assessed HRQOL. Discussion: The intervention group showed greater improvements over the short term, but between-group differences disappeared at 6 and 12 months. Weight loss and improvements in key outcomes were observed in both groups over the follow-up period. Further research is warranted to determine whether a minimum intervention with an educational leaflet, follow-up phone calls, and questionnaires on overweight-related healthy habits, as in the present control group, may be an equally effective strategy without specific individual educational input.

The “surprise question” (“Would I be surprised if the patient died within the next 12 months?”) is useful to predict the survival o

Introduction: Palliative needs assessment and referral to advanced palliative care resources are fundamental aspects of complex chronic patients’ care. Primary care Nurse Case Managers play a key role in the care of these patients. Objective: We aimed to describe the experiences of primary care Nurse Case Managers in palliative care needs identification and complex chronic patients’ referral to advanced palliative care resources. Method: This is a qualitative descriptive study with a phenomenological approach. Semi-structured online interviews were conducted with primary care Nurse Case Managers. A thematic analysis was performed using ATLAS.ti software. Results: 20 nurses participated, 16 of whom were women, with a mean age of 52.3 years and an average of 15.9 years of experience in primary care. Regarding “Palliative care Needs Assessment”, four sub-themes have been identified: “What do you understand?”, “How do you assess?”, “Difficulties” and “Alternatives” to current palliative care needs assessment. For the “Palliative Care Referral” theme four sub-themes have been identified: “Criteria”, “Tools”, “Difficulties” and “Alternatives” for referral. Discussion: Palliative needs are identified in patients with incurable diseases when there are no curative treatment options and when quality of life must be prioritized. Symptoms, general condition, progression, and comorbidity are assessed. Open interviews and home visits are essential for assessing the social and family context and the home resources available. Barriers identified include the conspiracy of silence, limited training in non-oncological palliative care, and a lack of staff and caregiver’s understanding of illness situation. The presence of difficult symptoms and a limited life expectancy were identified as key criteria for referral to palliative care. The physician’s assessment, the family’s request, and consultation with specialized teams play a key role in prognosis. Barriers include late referrals, lack of a palliative background, inequity in access to resources, and low visibility of the palliative care needs of non-cancer patients. Conclusions: Significant challenges remain in identifying palliative needs and referral to specialized resources, highlighting the need to optimize resources, strengthen professional training, and improve coordination between levels of care to ensure quality palliative care.