Maria Arantzamendi | Universidad de Navarra (original) (raw)
Papers by Maria Arantzamendi
BMC palliative care, Feb 26, 2024
This chapter aims to tackle end of life issues for patients and their families. It will reflect o... more This chapter aims to tackle end of life issues for patients and their families. It will reflect on the process of disease to understand when “end of life” begins and what this stage entails. It will also address adjusting expectations and treatments, symptom management, and emotional and spiritual care at this stage of the disease. Care for end-of-life patients who are dying and their families will additionally be addressed, as well as the attention that healthcare professionals provide to patients and their families in consideration of different religious perspectives.
Journal of Palliative Medicine, Nov 19, 2023
Background: Understanding the principles and practice of research by health care professionals he... more Background: Understanding the principles and practice of research by health care professionals helps to improve the evidence base for palliative care practice and service delivery. Research is a core competency in palliative care that enables the identification and addressing of problems for patients and their families, establishes best practice and improves ways to manage pain, other symptoms, and concerns. This work was undertaken in the research for all palliative care clinicians (RESPACC) Erasmus+ project. Aim: To identify and develop a set of core research competencies within a structured framework for all members of the multidisciplinary palliative team. Design: A multi-method approach was used including rapid review of literature, Nominal Group Technique, and expert consultation. A quiz to self-assess research competencies outlined within the Framework was produced. Results: The Framework includes 17 competencies organized in 7 domains: The clinical context, Scientific thinking and research design, Ethics and regulatory framework for research, Study and site management, Data management and informatics, Communication and relationships, and Research leadership. In the consultation process 6 of the 17 competencies were considered as required by each individual team member, and 3 to be present within the palliative care team. Conclusion: Using a multi-method approach, the first Palliative Care Research Framework identifying core research competencies for palliative care clinicians has been developed. The aim of the framework was not to transform palliative care clinicians into researchers, but to ensure that clinicians understand the important role of research and its integration into clinical practice.
Revista ROL de enfermería, 2002
Index de Enfermería, Dec 1, 2010
Journal of Palliative Medicine, 2023
Background: Understanding the principles and practice of research by health care professionals he... more Background: Understanding the principles and practice of research by health care professionals helps to improve the evidence base for palliative care practice and service delivery. Research is a core competency in palliative care that enables the identification and addressing of problems for patients and their families, establishes best practice and improves ways to manage pain, other symptoms, and concerns. This work was undertaken in the research for all palliative care clinicians (RESPACC) Erasmus+ project. Aim: To identify and develop a set of core research competencies within a structured framework for all members of the multidisciplinary palliative team. Design: A multi-method approach was used including rapid review of literature, Nominal Group Technique, and expert consultation. A quiz to self-assess research competencies outlined within the Framework was produced. Results: The Framework includes 17 competencies organized in 7 domains: The clinical context, Scientific thinking and research design, Ethics and regulatory framework for research, Study and site management, Data management and informatics, Communication and relationships, and Research leadership. In the consultation process 6 of the 17 competencies were considered as required by each individual team member, and 3 to be present within the palliative care team. Conclusion: Using a multi-method approach, the first Palliative Care Research Framework identifying core research competencies for palliative care clinicians has been developed. The aim of the framework was not to transform palliative care clinicians into researchers, but to ensure that clinicians understand the important role of research and its integration into clinical practice.
BMC Palliative Care, 2022
Background: Patients at the end-of-life may experience refractory symptoms of which pain, deliriu... more Background: Patients at the end-of-life may experience refractory symptoms of which pain, delirium, vomiting and dyspnea are the most frequent. Palliative sedation can be considered a last resort option to alleviate one or more refractory symptoms. There are only a limited number of (qualitative) studies exploring the experiences of relatives of sedated patients and their health care professionals (HCPs). The aims of this study protocol are: 1) to elicit the experiences of bereaved relatives and health care professionals of patients treated with palliative sedation and 2) to explore the understanding of the decision-making process to start palliative sedation across care settings in 5 European countries.
Medicina Paliativa, Apr 1, 2018
Cómo citar este artículo: Gallardo N, et al. Revisión narrativa sobre la calidad de vida relacion... more Cómo citar este artículo: Gallardo N, et al. Revisión narrativa sobre la calidad de vida relacionada con la salud en personas con esclerosis lateral amiotrófica. Med Paliat. 2017.
BMC Palliative Care, Jan 28, 2023
Background: Palliative sedation involves the intentional lowering of consciousness at the end of ... more Background: Palliative sedation involves the intentional lowering of consciousness at the end of life. It can be initiated to relieve a patient's burden caused by refractory symptoms at the end of life. The impact of palliative sedation needs to be clinically monitored to adjust the proper dose and regimen of sedative medication to ensure that patients are at ease and comfortable at the end of their lives. Although there is consensus among health care professionals and within guidelines that efficacy of palliative sedation needs to be closely monitored, there is no agreement about how, when, and by whom, this monitoring should be performed. The aim of this study is to evaluate the effects of palliative sedation by measuring the discomfort levels and sedation/agitation levels of the patients at regular timepoints. In addition, the clinical trajectories of those patients receiving palliative sedation will be monitored and recorded.
Methods: The study is an international prospective non-experimental observational multicentre study. Patients are recruited from in-patient palliative care settings in Belgium, Germany, Italy, Spain and the Netherlands. Adult patients with advanced cancer are monitored by using proxy observations of discomfort (DS-DAT) and depth of sedation/agitation levels (RASS-PAL) during palliative sedation. After the palliative sedation period, the care for the specific participant case is evaluated by one of the attending health care professionals and one relative via a questionnaire.
Discussion: This study will be the first international prospective multicenter study evaluating the clinical practice of palliative sedation including observations of discomfort levels and levels of sedation. It will provide valuable information about the practice of palliative sedation in European countries in terminally ill cancer patients. Results from this study will facilitate the formulation of recommendations for clinical practice on how to improve monitoring and comfort in patients receiving palliative sedation.
Trial registration: This study is registered at Clinicaltrials.gov since January 22, 2021, registration number: NCT04719702.
RESULTADOS • Flujograma de la revisión • 9 estudios que recogen la experiencia de 54 enfermeras y... more RESULTADOS • Flujograma de la revisión • 9 estudios que recogen la experiencia de 54 enfermeras y de 63 pacientes con CFAT. • Síntesis de línea de argumento organizada en 4 temas que muestran cómo es la relación enfermera-paciente:
The nurse-patient relationship is key to provide individualized care and to improve the quality o... more The nurse-patient relationship is key to provide individualized care and to improve the quality of life of the Person with Advance and Terminal Cancer (PATC). Moreover, the relationship between the nurse and the person may influence in the global experience of the PATC.
Textbook of Palliative Care, 2019
Revista Panamericana de Pedagogía, 2021
Introducirse en el mundo laboral es costoso y uno de los primeros obstáculos es el déficit compet... more Introducirse en el mundo laboral es costoso y uno de los primeros obstáculos es el déficit competencial que, en ocasiones, presentan los universitarios. Para subsanar el exceso de una teoría descontextualizada, el EEES (Espacio Europeo de Educación Superior) ha auspiciado un cambio metodológico que fomenta una docencia más práctica, ya que el aprendizaje más efectivo es activo y está conectado con la experiencia. De este modo, la enseñanza universitaria se enfoca, entre otros aspectos, en la consecución de resultados de aprendizaje en forma de competencias asociadas al mercado laboral. En este contexto se están ensayando en la universidad [española] metodologías más prácticas y aplicadas, entre ellas, el Aprendizaje-Servicio. El objetivo de este trabajo es conocer si para los empleadores participantes en nuestro estudio, los universitarios que participan en actividades de Aprendizaje-Servicio desarrollan el perfil competencial que buscan, haciéndoles candidatos más atractivos en los...
Revista De Enfermeria, Jun 1, 2002
The objectives of this study have been to obtain an oral cavity Evaluation Guide for patients und... more The objectives of this study have been to obtain an oral cavity Evaluation Guide for patients undergoing high doses of chemotherapy and to develop a Standard Treatment Plan for Mouths. To these ends, the author first carried out a bibliographical search which focused on three areas: chemotherapy complications, oral cavity evaluation scales and mucosity treatments. Afterwards, the authors drew up a "Mucosity Treatment Guide for Patients Undergoing High Dose Chemotherapy Treatment", which includes an oral cavity evaluation guide and a treatment plan.
Journal of Pain and Symptom Management, 2015
Context: The Patient Dignity Inventory (PDI) is an instrument to measure sources of distress rela... more Context: The Patient Dignity Inventory (PDI) is an instrument to measure sources of distress related to dignity at the end of life.
Objectives: To obtain a Spanish version of the PDI and measure psychometric aspects in patients with advanced cancer.
Methods: A back-translation method was used to obtain the Spanish version. Inpatients and outpatients with advanced cancer were included. Patients completed the Spanish versions of the PDI (PDI-s), Edmonton Symptom Assessment System (ESAS), Hospital Anxiety and Depression Scale (HADS), and Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being (FACIT-Sp-12) instruments. The psychometric properties evaluated were internal consistency; concurrent validity between PDI-s/ESAS, PDI-s/HADS, and PDI-s/FACIT-Sp-12; discriminant validity, test-retest reliability, and factor analysis. The usefulness of the instrument also was tested.
Results: A Spanish version of the PDI was obtained. One hundred twenty-four patients completed the study. Cronbach's alpha coefficient for the PDI-s was 0.89. The PDI-s significantly correlated with the ESAS (rs = 0.669; P < 0.001), HADS (rs = 0.788; P < 0.001), and FACIT-Sp-12 (rs = -0.442; P = 0.008). The instrument distinguished outpatients from inpatients and between patients with differing Karnofsky Performance Status scores (rs = -0.328; P < 0.001). The test-retest method indicated excellent reproducibility (intraclass correlation coefficient = 0.931). Factor analysis showed three factors accounting for 79.4% of the variance. Factors were labeled psychological and existential distress, physical symptoms and dependency, and social support. Patients had no difficulties in understanding or completing the questionnaire (mean time to complete: 7.2 minutes).
Conclusion: The Spanish version of the PDI showed adequate psychometric properties when tested with advanced cancer patients. This research provides a three-factor alternative in Spanish to the PDI.
BMC palliative care, Feb 26, 2024
This chapter aims to tackle end of life issues for patients and their families. It will reflect o... more This chapter aims to tackle end of life issues for patients and their families. It will reflect on the process of disease to understand when “end of life” begins and what this stage entails. It will also address adjusting expectations and treatments, symptom management, and emotional and spiritual care at this stage of the disease. Care for end-of-life patients who are dying and their families will additionally be addressed, as well as the attention that healthcare professionals provide to patients and their families in consideration of different religious perspectives.
Journal of Palliative Medicine, Nov 19, 2023
Background: Understanding the principles and practice of research by health care professionals he... more Background: Understanding the principles and practice of research by health care professionals helps to improve the evidence base for palliative care practice and service delivery. Research is a core competency in palliative care that enables the identification and addressing of problems for patients and their families, establishes best practice and improves ways to manage pain, other symptoms, and concerns. This work was undertaken in the research for all palliative care clinicians (RESPACC) Erasmus+ project. Aim: To identify and develop a set of core research competencies within a structured framework for all members of the multidisciplinary palliative team. Design: A multi-method approach was used including rapid review of literature, Nominal Group Technique, and expert consultation. A quiz to self-assess research competencies outlined within the Framework was produced. Results: The Framework includes 17 competencies organized in 7 domains: The clinical context, Scientific thinking and research design, Ethics and regulatory framework for research, Study and site management, Data management and informatics, Communication and relationships, and Research leadership. In the consultation process 6 of the 17 competencies were considered as required by each individual team member, and 3 to be present within the palliative care team. Conclusion: Using a multi-method approach, the first Palliative Care Research Framework identifying core research competencies for palliative care clinicians has been developed. The aim of the framework was not to transform palliative care clinicians into researchers, but to ensure that clinicians understand the important role of research and its integration into clinical practice.
Revista ROL de enfermería, 2002
Index de Enfermería, Dec 1, 2010
Journal of Palliative Medicine, 2023
Background: Understanding the principles and practice of research by health care professionals he... more Background: Understanding the principles and practice of research by health care professionals helps to improve the evidence base for palliative care practice and service delivery. Research is a core competency in palliative care that enables the identification and addressing of problems for patients and their families, establishes best practice and improves ways to manage pain, other symptoms, and concerns. This work was undertaken in the research for all palliative care clinicians (RESPACC) Erasmus+ project. Aim: To identify and develop a set of core research competencies within a structured framework for all members of the multidisciplinary palliative team. Design: A multi-method approach was used including rapid review of literature, Nominal Group Technique, and expert consultation. A quiz to self-assess research competencies outlined within the Framework was produced. Results: The Framework includes 17 competencies organized in 7 domains: The clinical context, Scientific thinking and research design, Ethics and regulatory framework for research, Study and site management, Data management and informatics, Communication and relationships, and Research leadership. In the consultation process 6 of the 17 competencies were considered as required by each individual team member, and 3 to be present within the palliative care team. Conclusion: Using a multi-method approach, the first Palliative Care Research Framework identifying core research competencies for palliative care clinicians has been developed. The aim of the framework was not to transform palliative care clinicians into researchers, but to ensure that clinicians understand the important role of research and its integration into clinical practice.
BMC Palliative Care, 2022
Background: Patients at the end-of-life may experience refractory symptoms of which pain, deliriu... more Background: Patients at the end-of-life may experience refractory symptoms of which pain, delirium, vomiting and dyspnea are the most frequent. Palliative sedation can be considered a last resort option to alleviate one or more refractory symptoms. There are only a limited number of (qualitative) studies exploring the experiences of relatives of sedated patients and their health care professionals (HCPs). The aims of this study protocol are: 1) to elicit the experiences of bereaved relatives and health care professionals of patients treated with palliative sedation and 2) to explore the understanding of the decision-making process to start palliative sedation across care settings in 5 European countries.
Medicina Paliativa, Apr 1, 2018
Cómo citar este artículo: Gallardo N, et al. Revisión narrativa sobre la calidad de vida relacion... more Cómo citar este artículo: Gallardo N, et al. Revisión narrativa sobre la calidad de vida relacionada con la salud en personas con esclerosis lateral amiotrófica. Med Paliat. 2017.
BMC Palliative Care, Jan 28, 2023
Background: Palliative sedation involves the intentional lowering of consciousness at the end of ... more Background: Palliative sedation involves the intentional lowering of consciousness at the end of life. It can be initiated to relieve a patient's burden caused by refractory symptoms at the end of life. The impact of palliative sedation needs to be clinically monitored to adjust the proper dose and regimen of sedative medication to ensure that patients are at ease and comfortable at the end of their lives. Although there is consensus among health care professionals and within guidelines that efficacy of palliative sedation needs to be closely monitored, there is no agreement about how, when, and by whom, this monitoring should be performed. The aim of this study is to evaluate the effects of palliative sedation by measuring the discomfort levels and sedation/agitation levels of the patients at regular timepoints. In addition, the clinical trajectories of those patients receiving palliative sedation will be monitored and recorded.
Methods: The study is an international prospective non-experimental observational multicentre study. Patients are recruited from in-patient palliative care settings in Belgium, Germany, Italy, Spain and the Netherlands. Adult patients with advanced cancer are monitored by using proxy observations of discomfort (DS-DAT) and depth of sedation/agitation levels (RASS-PAL) during palliative sedation. After the palliative sedation period, the care for the specific participant case is evaluated by one of the attending health care professionals and one relative via a questionnaire.
Discussion: This study will be the first international prospective multicenter study evaluating the clinical practice of palliative sedation including observations of discomfort levels and levels of sedation. It will provide valuable information about the practice of palliative sedation in European countries in terminally ill cancer patients. Results from this study will facilitate the formulation of recommendations for clinical practice on how to improve monitoring and comfort in patients receiving palliative sedation.
Trial registration: This study is registered at Clinicaltrials.gov since January 22, 2021, registration number: NCT04719702.
RESULTADOS • Flujograma de la revisión • 9 estudios que recogen la experiencia de 54 enfermeras y... more RESULTADOS • Flujograma de la revisión • 9 estudios que recogen la experiencia de 54 enfermeras y de 63 pacientes con CFAT. • Síntesis de línea de argumento organizada en 4 temas que muestran cómo es la relación enfermera-paciente:
The nurse-patient relationship is key to provide individualized care and to improve the quality o... more The nurse-patient relationship is key to provide individualized care and to improve the quality of life of the Person with Advance and Terminal Cancer (PATC). Moreover, the relationship between the nurse and the person may influence in the global experience of the PATC.
Textbook of Palliative Care, 2019
Revista Panamericana de Pedagogía, 2021
Introducirse en el mundo laboral es costoso y uno de los primeros obstáculos es el déficit compet... more Introducirse en el mundo laboral es costoso y uno de los primeros obstáculos es el déficit competencial que, en ocasiones, presentan los universitarios. Para subsanar el exceso de una teoría descontextualizada, el EEES (Espacio Europeo de Educación Superior) ha auspiciado un cambio metodológico que fomenta una docencia más práctica, ya que el aprendizaje más efectivo es activo y está conectado con la experiencia. De este modo, la enseñanza universitaria se enfoca, entre otros aspectos, en la consecución de resultados de aprendizaje en forma de competencias asociadas al mercado laboral. En este contexto se están ensayando en la universidad [española] metodologías más prácticas y aplicadas, entre ellas, el Aprendizaje-Servicio. El objetivo de este trabajo es conocer si para los empleadores participantes en nuestro estudio, los universitarios que participan en actividades de Aprendizaje-Servicio desarrollan el perfil competencial que buscan, haciéndoles candidatos más atractivos en los...
Revista De Enfermeria, Jun 1, 2002
The objectives of this study have been to obtain an oral cavity Evaluation Guide for patients und... more The objectives of this study have been to obtain an oral cavity Evaluation Guide for patients undergoing high doses of chemotherapy and to develop a Standard Treatment Plan for Mouths. To these ends, the author first carried out a bibliographical search which focused on three areas: chemotherapy complications, oral cavity evaluation scales and mucosity treatments. Afterwards, the authors drew up a "Mucosity Treatment Guide for Patients Undergoing High Dose Chemotherapy Treatment", which includes an oral cavity evaluation guide and a treatment plan.
Journal of Pain and Symptom Management, 2015
Context: The Patient Dignity Inventory (PDI) is an instrument to measure sources of distress rela... more Context: The Patient Dignity Inventory (PDI) is an instrument to measure sources of distress related to dignity at the end of life.
Objectives: To obtain a Spanish version of the PDI and measure psychometric aspects in patients with advanced cancer.
Methods: A back-translation method was used to obtain the Spanish version. Inpatients and outpatients with advanced cancer were included. Patients completed the Spanish versions of the PDI (PDI-s), Edmonton Symptom Assessment System (ESAS), Hospital Anxiety and Depression Scale (HADS), and Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being (FACIT-Sp-12) instruments. The psychometric properties evaluated were internal consistency; concurrent validity between PDI-s/ESAS, PDI-s/HADS, and PDI-s/FACIT-Sp-12; discriminant validity, test-retest reliability, and factor analysis. The usefulness of the instrument also was tested.
Results: A Spanish version of the PDI was obtained. One hundred twenty-four patients completed the study. Cronbach's alpha coefficient for the PDI-s was 0.89. The PDI-s significantly correlated with the ESAS (rs = 0.669; P < 0.001), HADS (rs = 0.788; P < 0.001), and FACIT-Sp-12 (rs = -0.442; P = 0.008). The instrument distinguished outpatients from inpatients and between patients with differing Karnofsky Performance Status scores (rs = -0.328; P < 0.001). The test-retest method indicated excellent reproducibility (intraclass correlation coefficient = 0.931). Factor analysis showed three factors accounting for 79.4% of the variance. Factors were labeled psychological and existential distress, physical symptoms and dependency, and social support. Patients had no difficulties in understanding or completing the questionnaire (mean time to complete: 7.2 minutes).
Conclusion: The Spanish version of the PDI showed adequate psychometric properties when tested with advanced cancer patients. This research provides a three-factor alternative in Spanish to the PDI.
temas de cuidados paliativos y metodología de investigación. Desde 2015 es investigadora del ATLA... more temas de cuidados paliativos y metodología de investigación. Desde 2015 es investigadora del ATLANTES Global Observatory of Palliative Care del Instituto Cultura y Sociedad.