Hernández Méndez, Solanger

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Hernández Méndez, Solanger

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Hernández Méndez, Solanger

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Universidad de Murcia. Departamento de Atención Sociosanitaria

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Open Access
Reducing loneliness and social isolation through the HELPeN telephone-call program: results from a randomized controlled trial in older adults living in the community
(MDPI, 2026) Hernández López, María Jesús; García González, Jessica; Leal Costa, César; Ramos Morcillo, Antonio Jesús; Díaz García, Isidora; López Pérez, María Verónica; Hernández Méndez, Solanger; Ruzafa Martínez, María; Enfermería; Facultades de la UMU::Facultad de Enfermería
Background/Objectives: Loneliness is a significant public health issue among older adults, especially in rural and socioeconomically vulnerable groups. Telephone-based interventions have become a scalable, cost-effective way to reduce social isolation, although evidence of their long-term effects on various health outcomes remains limited. This study aimed to assess how effective HELPeN, a structured telephone program delivered by trained nursing students, is in decreasing loneliness and enhancing psychosocial and cognitive health in community-living older adults. Methods: A randomized controlled trial was conducted with 119 older adults (≥65 years) residing in the community. Participants were allocated to either an intervention group (n = 65), which received weekly structured telephone calls over 9 months, or a control group (n = 54), which received standard care. Outcomes were evaluated at baseline (M0), mid-intervention (M1–M3), and 3 months after the intervention (M4). The primary outcomes measured included loneliness and perceived social support. Secondary outcomes comprised functional status, comorbidities, depressive symptoms, quality of life, sleep quality, and cognitive function. The data were analyzed using repeated-measures ANOVA with Greenhouse–Geisser correction. Results: Significant group interactions over time were identified for loneliness (F = 5.92, p = 0.001, η2 = 0.067), social support (F = 3.39, p = 0.023, η2 = 0.043), depressive symptoms (F = 3.87, p = 0.019, η2 = 0.046), and cognitive status (F = 5.35, p = 0.002, η2 = 0.063). No significant differences were found for functional status, comorbidity, sleep quality, or quality of life. Conclusions: The HELPeN program demonstrated significant effectiveness in reducing loneliness and social isolation, and in improving emotional, cognitive, and sleep-related outcomes in older adults. As a low-cost and scalable model, this intervention strengthens the role of nursing students in addressing social determinants of health and may be integrated into community and public health strategies targeting vulnerable aging populations.
Open Access
Prevalence of unwanted loneliness and associated factors in people over 65 years of age in a health area of the Region of Murcia, Spain: HELPeN Project
(MDPI, 2024-09-21) Hernández López, María Jesús; Hernández Méndez, Solanger; Leal Costa, César; Ramos Morcillo, Antonio Jesús; Díaz García, Isidora; López Pérez, María Verónica; García González, Jessica; Ruzafa Martínez, María; Enfermería; Facultades de la UMU::Facultad de Enfermería
Background/Objectives: Population aging poses many challenges to public health, highlighting loneliness and social isolation as severe problems that affect the physical and mental health of older adults. During the COVID-19 pandemic, these became aggravated. The objective of the present study was to assess the prevalence of loneliness and its relationship with social isolation, depression, cognitive deterioration, sleep quality, and the level of physical mobility and functioning of older adults in Health Area 3 of the Region of Murcia. Methods: A descriptive, observational, and cross-sectional study was performed. The inclusion criteria were age ≥ 65, living in Health Area 3 of the Region of Murcia, and not being institutionalized. The following variables were evaluated: sociodemographic variables, loneliness (UCLA scale), social isolation (DUFSS), depression (GDS), cognitive deterioration (Pfeiffer), sleep quality (PSQI), and mobility (Barthel index). A univariate and multivariate regression model was created to examine how the dependent variable was related to the independent variables. Results: A total of 102 older adults participated in the study. Of these, 31.4% perceived unwanted loneliness and 14.7% low social support. The multivariate regression analysis showed that social isolation, geriatric depression, and cognitive deterioration were significant predictors of loneliness. Conclusions: The findings highlight the importance of developing multifaceted interventions that address not only social isolation but also other interrelated factors such as depression, cognitive deterioration, and sleep quality. The strategies should be centered on community programs and support networks. It is fundamental to perform longitudinal studies to better understand the causal relationships between these variables.
Open Access
Percepción del entorno laboral de las enfermeras del Área III de Salud de Lorca tras la implantación del programa de guías de práctica clínica "Centros Comprometidos con la Excelencia en Cuidados"
(2018-01-09) Hernández Méndez, Solanger; Ruzafa Martínez, María; Ramos Morcillo, Antonio Jesús; Facultad de Enfermería
INTRODUCCIÓN: Las organizaciones sanitarias esperan obtener cada vez mejores resultados en salud de la población a la que atienden. Entre otros aspectos, se requiere que las enfermeras se propongan conseguir la excelencia en los cuidados que prestan. Esto pasa por la actualización constante del conocimiento y habilidades y por la aplicación de las mejores prácticas. Se requiere de un adecuado entorno laboral que favorezca un clima de trabajo adecuado, que apoye las prácticas basadas en la mejor evidencia científica, que habilite los mecanismos para proveer cuidados de calidad y con seguridad y, mejorar así la satisfacción de los profesionales con su trabajo. OBJETIVOS: Conocer si existen cambios en la percepción del entorno laboral que tienen las enfermeras del área III de Salud de Lorca de la Comunidad Autónoma de Murcia tras aplicar el Programa de implantación de Guías de Práctica Clínica “Centros Comprometidos con la Excelencia en Cuidados (CCEC®)”. METODOLOGÍA: Estudio observacional, transversal que compara datos de calidad y seguridad de los cuidados de enfermería y la percepción del entorno laboral de los profesionales de enfermería del área III de Salud de Lorca en 2012 (M0) y 2016 (M1). Se puso en marcha el Programa de implantación de Guías de Práctica Clínica “Centros Comprometidos con la Excelencia en Cuidados (CCEC®)”. La población formada inicialmente por 390 participantes en el año 2012 y 395 en 2016, 100% del personal de enfermería y matronas adscritos a la División de Enfermería. Profesionales de enfermería de atención hospitalaria y comunitaria que tenían algún tipo de relación laboral con el Servicio Murciano de Salud, Área III en el momento de realizar el estudio y que se encontraban en servicio activo. Variables sociodemográficas, laborales, actitud ante la PBE, sobre percepción del entorno y satisfacción laboral, así como percepción de los profesionales de la calidad de los cuidados que prestan y seguridad del paciente. Instrumentos para la recogida de datosconstituido por 5 bloques que contenían los cuestionarios: Enfermería Basada en la Evidencia Actitud (CAPEBE). Ruzafa-Martínez (2011); Clima organizacional, Koys & Decottis (1991) y Satisfacción de los Profesionales de Enfermería y Percepción de la Calidad de los Cuidados y de la Seguridad del Paciente.Resultados significativos estadísticamente para p<0,05. Los datos se introdujeron en una base de datos y el análisis se efectuó con el paquete estadístico SSPS para Windows versión 21.0. RESULTADOS:Han participado en total 451 profesionales, 219 en la primera medida (M0) de un total de 363 profesionales de enfermería, tasa de respuesta del 60,33% y 232 en M1, de un total de 368 profesionales, tasa de respuesta del 63,04%. 75% (159) de los profesionales mujeres y en la segunda el 74,2% (170), (Ji cuadrado 0,034; p = 0,854). La percepción de los profesionales de enfermería sobre el porcentaje de aplicación de la PBE en su entorno clínico es de un 55,11% (IC 95% 51,2 – 58,9) de media en 2012 y 55,41% (IC 95% 52,2 – 58,5) en 2016 (U de Mann-Withney 24810,0; p = 0,723). Las puntuaciones más bajas en el clima organizacional se observan en las dimensiones “Reconocimiento” y “Presión”. Las puntuaciones más altas se observan en las dimensiones “Confianza” y “Apoyo”. Están muy satisfechas con la elección de enfermería como profesión y las enfermeras muy satisfechas es algo superior en M1 (Ji cuadrado 4,71; p = 0,194). 76% de profesionales de M0 y un 82% de M1 señalan que están moderadamente o muy satisfechas con el trabajo actual (Ji cuadrado 4,24; p = 0,237). Trabajar en atención primaria, percibir que los recursos humanos son adecuados, y que se tienen oportunidades de desarrollo profesional se asocia de manera positiva con la percepción de la calidad de los cuidados. CONCLUSIONES: Los resultados del presente estudio nos permiten conocer la situación local, en términos de los perﬁles profesionales y las características laborales de las enfermeras, comparándonos con los contextos regionales, nacionales e internacionales. Así, seremos capaces de gestionar con la mejor información disponible los recursos humanos enfermeros. El Programa de implantación de Buenas Prácticas en Cuidados Centros Comprometidos con la Excelencia en Cuidados®, ha significado un revulsivo en la organización que nos ha obligado a evaluar la organización en general y en particular; el impacto de sus resultados en profesionales y pacientes requiere tiempo, pero nos ha permitido saber en qué situación estamos y que podemos necesitar para mejorar la práctica profesional y los resultados en salud de los pacientes y garantizar unos cuidados de máxima calidad a partir de la experiencia personal y dentro del contexto de la práctica diaria.Este estudio es el primero que se realiza en el contexto español, en el que se evalúa el entorno laboral de las enfermeras tras la implantación del Programa Implantación de Buenas Prácticas en Cuidados en Centros Comprometidos con la Excelencia en Cuidados® y aporta datos sobre las características del ambiente organizacional en el que las enfermeras del Área III de Lorca implantan las evidencias que ofrecen las Guías de Buenas Prácticas de la RNAO®. BACKGROUND:The health organizations hope to achieve better health outcomes for the population they serve. Among other aspects, it is required that nurses intend to achieve excellence in the care they provide. This involves constant updating of knowledge and skills and application of best practices. It requires an adequate working environment that favors an adequate working climate, that supports practices based on the best scientific evidence, that enables the mechanisms to provide quality and safe care and, thus, improve the satisfaction of professionals with their work. AIM:To know if there are changes in the perception of the work environment that nurses in the Health Area III of Lorca of the Community of Murcia after applying the Program of Implementation of Guidelines of Clinical Practice "Best Practices Spotlight Organizations (BPSO®)”. METHOD: Cross-sectional, observational study comparing data on quality and safety of nursing care and perception of the working environment of nursing professionals in Health Area III of Lorca in 2012 (M0) and 2016 (M1). The Program for the Implementation of Guidelines for Clinical Practice "Best Practices Spotlight Organizations (BPSO®)” was establish. The population initially formed by 390 participants in 2012 and 395 in 2016, 100% of nurses and midwives ascribed to the Division of Nursing. Nursing professionals in hospital and community care who had some kind of working relationship with the Murciano Health Service, Area III at the time of the study and who were in active service. Socio-demographic, labor variables, attitude to the EBP, about the perception of the environment and job satisfaction, as well as the perception of the professionals of the quality of the care they provide and patient safety. Data collection instruments consisted of 5 blocks containing the questionnaires: Evidence-Based Nursing Attitude (CAPEBE). Ruzafa-Martínez (2011); Organizational climate, Koys & Decottis (1991) and Satisfaction of Nursing Professionals and Perception of Quality of Care and Patient Safety. Statistically significant results for p <0.05. The data was entered into a database and the analysis was performed with the SSPS statistical package for Windows version 21.0. RESULTS: A total of 451 professionals participated, 219 in the first measure (M0) of a total of 363 nursing professionals, a response rate of 60.33% and 232 in M1, out of a total of 368 professionals, response rate 63.04%. 75% (159) of female professionals and in the second, 74.2% (170), (Chi square 0.034, p = 0.854). The perception of nursing professionals about the percentage of application of EBP in their clinical environment is 55.11% (CI 95% 51.2 - 58.9) on average in 2012 and 55.41% (IC 95 % 52.2-58.5) in 2016 (U of Mann-Withney 24810.0, p = 0.723). The lowest scores in the organizational climate are observed in the dimensions "Recognition" and "Pressure". The highest scores are seen in the "Confidence" and "Support" dimensions. They are very satisfied with the choice of nursing as a profession and highly satisfied nurses are somewhat higher in M1 (Chi square 4.71, p = 0.194). 76% of M0 professionals and 82% of M1 indicate that they are moderately or very satisfied with the current work (Chi square 4,24, p = 0,237). Working in primary care, perceiving that human resources are adequate, and having opportunities for professional development is positively associated with the perception of quality of care. CONCLUSIONS:The results of the present study allow us to know the local situation, in terms of professional profiles and work characteristics of nurses, compared to regional, national and international contexts. Thus, we can manage the human resources of nurses with the best available information. The Clinical Practice Guidelines Implementation Program "Best Practices Spotlight Organizations (BPSO®)" has meant a revulsive in the organization that has forced us to evaluate the organization in general and in particular. The impact of their results on professionals and patients requires time. But it has allowed us to know in what situation we are and what we may need to improve professional practice and results in the health of patients and ensure a high quality care based on personal experience and in the context of daily practice. This is the first research carried out in the Spanish context, which evaluates nurses' work environment after the implementation of the Clinical Practices Program "Best Practices of Outstanding Organizations (BPSO®)" and provides data on the characteristics of the environment In which the nurses of Area III of Lorca implement the evidence offered by the best practice guideline of RNAO®
Open Access
DATA SET HELPeN Project Reducing Loneliness
(2026-03-10) Hernández López, María Jesús; García González, Jessica; Leal Costa, César; Ramos Morcillo, Antonio Jesús; Díaz García, Isidora; López Pérez, María Verónica; Hernández Méndez, Solanger; Ruzafa Martínez, María; Enfermería; Facultad de Enfermería
Open Access
Changes in nurse job outcomes after 4 years of a Best Practice Spotlight Organization® programme implementation in the Spanish National Health Context
(2021-05) Ruzafa Martinez, Maria; Garcia Gonzalez, Jessica; Leal Costa, Cesar; Martínez González, Miguel Ángel; Ramos Morcillo, Antonio Jesús; Hernández Méndez, Solanger; Enfermería
Aim: To evaluate the changes produced after the application of the Best Practice Spotlight Organization® (BPSO® ) Program on the attitude towards the evidence-based practice, the nurses' perception of the organisational climate and nurse outcomes in a health area of the Spanish National Health System. Background: There is limited research that associates strategies of evidence-based practice implementation with changes on the work environment and nurse outcomes. Methods: Cross-sectional study that compared data on the nurses' perception of the work environment. Five guidelines were implemented between 2012 and 2015 in a health area. Data were collected in 2012 and 2016/2017, using a questionnaire consisting of five previously validated tools. X2 , t test, ANOVA and multivariate analysis were carried out. Results: A total of 451 nurses participated. Compared with the baseline evaluation in 2012, several outcomes changed significantly (p < .001), nurses were younger and were more satisfied with "salary", "annual leaves" and "sick leave". The rest of the nurse outcomes were not modified. Conclusions: Nurses' perception of the work environment is favourable, although the application of the BPSO® Program has not produced any major changes. Implications for nursing management: Measures are suggested that are oriented towards the planning of staffing and the increase in the participation of the nursing staff in programmes of implementation of guidelines.
Open Access
Evolución de la adhesión a la higiene de manos: la pandemia un punto de inflexión
(Universidad de Murcia. Servicio de publicaciones, 2025) Salas Cañizares, Alberto; Martínez Pérez, Lucio; Cayuela Verdú, Pedro; Hernández López, María Jesús; Hernández Méndez, Solanger; Ciencias Sociosanitarias
Introduction:Hand hygiene is crucial to prevent nosocomial infections, with the hands of professionals and patients being significant vectors of transmission. The objective of this study was to evaluate adherence to hand hygiene at the Rafael Méndez General University Hospital during the years 2016 to 2022.Methodology: An observational and descriptive study was carried out in medical-surgical hospitalization units, collecting annual data using the Hand Hygiene Technique Observation Form provided by the World Health Organization (WHO). The sample consisted of 1097 professionals.Results: A total of 5416 opportunities were analyzed. The results showed an improvement in hand hygiene through 2021, with a reduction in omission from 64% in 2016 to an overall compliance of 55% in 2020 and 2021. However, in 2022 a significant decline will be observed with 79% of omission. The evolution varied depending on the moment and the category observed.Conclusion: Adherence to hand hygiene at the Rafael Méndez General University Hospital has shown a positive trend with a gradual annual increase until 2021, highlighting 2020 as a turning point. However, the relaxation of post-pandemic measures has decreased compliance. It is recommended to continue promoting training and evaluation actions to improve hand hygiene among health professionals
Open Access
Planteamientos sobre enfermería desde una concepción filosófica
(Servicio de Publicaciones - Universidad de Murcia, 2003) Hernández Méndez, Solanger
Open Access
Effects of a clinical simulation-based training program for nursing students to address social isolation and loneliness in the elderly: a quasi-experimental study
(MDPI, 2023-09-19) Hernández López, María Jesús; Ruzafa Martínez, María; Leal Costa, César; Ramos Morcillo, Antonio Jesús; Díaz García, Isidora; López Pérez, María Verónica; Hernández Méndez, Solanger; García González, Jessica; Enfermería
Introduction: The population of older adults is rapidly increasing worldwide, presentingboth prospects and complexities for society and healthcare professionals to maximize the functionalcapacity of this age group. Social isolation and loneliness significantly affect this population. Theobjective was to determine the effectiveness, satisfaction, and perceptions of the simulation-basededucation practices of a training program for nursing students, which was created to palliate thesocial isolation and loneliness of older adults. Method: A quasi-experimental study was conductedwith nursing students who participated in an online training program using teleservice based on high-fidelity clinical simulation. The program included asynchronous theoretical training and synchronouspractical training using an online platform. Five scenarios were designed using simulated phonecalls to address the social isolation and loneliness of older adults. Results: Twenty-five nursingstudents participated in the program, and they had a mean age of 27.44, with 76% of them beingwomen. After the training program, the participants showed statistically significant improvements(p< 0.05) with respect to their knowledge and attitudes towards older adults, and the programwas adapted to the best educational practices in simulations. Conclusions: Simulation-based onlinetraining efficiently improved the knowledge and attitudes of nursing students towards older adults,improving their ability to address social isolation and loneliness. The high satisfaction and adhesion tothe best educational practices underline the usefulness of high-fidelity online simulations, especiallyin situations in which face-to-face training is not feasible, and accessibility and equilibrium could beguaranteed between work and personal life.
Open Access
DATA SET HELPeN Project Effects Clinical Simulation
(2026-03-10) Hernández López, María Jesús; Ruzafa Martínez, María; Leal Costa, César; Ramos Morcillo, Antonio Jesús; Díaz García, Isidora; López Pérez, María Verónica; Hernández Méndez, Solanger; García González, Jessica; Enfermería; Facultad de Enfermería
Open Access
Consequences of the Covid-19 pandemic on complex multimorbid elderly: Follow-up of a community-based cohort. SAMAC3 Study
(2023) Ruzafa Martinez, Maria; García González, Jessica; Morales Asencio, José Miguel; Leal Costa, Cesar; Albarracín Olmedo, Juana; Ramos Morcillo, Antonio Jesús; Hernández Méndez, Solanger; Enfermería
Background: The restrictions imposed during the management of the pandemic led to lack of care of other health problems. Purpose: To assess changes in the health status of complex multimorbidity elderly, functional and cognitive capacities, perception of the social surroundings, care pro vided by the nurses, including nursing diagnosis and interventions, use of health ser vices, adverse events, and use of devices and technical help during the first 6 months of the Covid-19 pandemic. Design: A 1-year longitudinal cohort study was conducted. Methods: Ninety-seven complex multimorbid elderly attended in primary care were evaluated every 3 months in a health area of the Spanish National Health System (SNHS). The research was called “SAMAC3 study”. Results: Significant negative changes were observed in the functional and cognitive ca pacity of the elderly, and in several nursing diagnoses. A decrease was observed in the frequency of visit to the nurses, hospital admittance, length of hospital stays, and falls. Conclusions: The functional and cognitive capacities of the cohort became worse. However, a significant decrease in the frequency of use of health services was ob served. The nurses detected significant changes in activity-exercise, cognitive perception, and roles-relationships, but their interventions were mostly centered on resolving clinical matters that required immediate attention. Clinical Relevance: The present study allowed us to observe that a situation of social and health stress has worsened the health indicators of multimorbid elderly, and the clinical care of community nurses was insufficient to providing care for the deteriora tion of the physical and cognitive domains.