Pub Date : 2026-01-01DOI: 10.1016/j.aprim.2025.103401
Manoel Felipe Nunes da Rocha , Mirtys Vivianne Pedroza Lopes , Juliana de Castro Nunes Pereira , Sayane Marlla Silva Leite Montenegro
Objectives
This study aims to evaluate the National Immunization Program (NIP) of a city in the interior of Pernambuco in the light of Donabedian's triad.
Methods
An epidemiological, descriptive and observational study focused on analyzing data from 2019 to 2024 from the city of Calçado – PE. It seeks to understand the efficiency of the National Immunization Program (NIP), guided by the question of how to qualify the NIP in logistics and execution of immunobiologicals. The NIP Information System and SISAB were used to collect data. The evaluation is based on the structure, processes and results of vaccine care. The data was analyzed using SPSS software.
Results
Calçado has over 11,000 inhabitants and 100% Family Health Strategy (ESF) coverage. The Primary Health Care (PHC) network has five Basic Health Units (BHU) and two support points in rural areas. Each UBS has vaccination rooms and is coordinated by a health team organized according to Ministry of Health guidelines. The infrastructure of the UBS is inconsistent in relation to the expected standards, with challenges in vaccination rooms and temperature control of vaccines. No new protocols have been created in the last five years. Supervision is carried out on a monthly basis, and the team faces challenges in terms of training and the population's adherence to vaccination.
Conclusion
Vaccination coverage in Calçado is monitored, but there is a lack of structured interaction between the NIP and the teams. Epidemiological surveillance is carried out, and educational actions are promoted, but there is a lack of formal feedback from the population that can help improve services. The study provides a clear view of the NIP's performance in the municipality, allowing us to discuss the quality of the health care offered.
{"title":"Evaluation of the National Immunization Program in a city in the interior of Pernambuco in the light of Donabedian's triad","authors":"Manoel Felipe Nunes da Rocha , Mirtys Vivianne Pedroza Lopes , Juliana de Castro Nunes Pereira , Sayane Marlla Silva Leite Montenegro","doi":"10.1016/j.aprim.2025.103401","DOIUrl":"10.1016/j.aprim.2025.103401","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aims to evaluate the National Immunization Program (NIP) of a city in the interior of Pernambuco in the light of Donabedian's triad.</div></div><div><h3>Methods</h3><div>An epidemiological, descriptive and observational study focused on analyzing data from 2019 to 2024 from the city of Calçado – PE. It seeks to understand the efficiency of the National Immunization Program (NIP), guided by the question of how to qualify the NIP in logistics and execution of immunobiologicals. The NIP Information System and SISAB were used to collect data. The evaluation is based on the structure, processes and results of vaccine care. The data was analyzed using SPSS software.</div></div><div><h3>Results</h3><div>Calçado has over 11,000 inhabitants and 100% Family Health Strategy (ESF) coverage. The Primary Health Care (PHC) network has five Basic Health Units (BHU) and two support points in rural areas. Each UBS has vaccination rooms and is coordinated by a health team organized according to Ministry of Health guidelines. The infrastructure of the UBS is inconsistent in relation to the expected standards, with challenges in vaccination rooms and temperature control of vaccines. No new protocols have been created in the last five years. Supervision is carried out on a monthly basis, and the team faces challenges in terms of training and the population's adherence to vaccination.</div></div><div><h3>Conclusion</h3><div>Vaccination coverage in Calçado is monitored, but there is a lack of structured interaction between the NIP and the teams. Epidemiological surveillance is carried out, and educational actions are promoted, but there is a lack of formal feedback from the population that can help improve services. The study provides a clear view of the NIP's performance in the municipality, allowing us to discuss the quality of the health care offered.</div></div>","PeriodicalId":55435,"journal":{"name":"Atencion Primaria","volume":"58 1","pages":"Article 103401"},"PeriodicalIF":1.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145924389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01DOI: 10.1016/j.aprim.2025.103402
Irantzu Bengoa-Urrengoechea , Isabel Aguilar-Palacio , Diana Valero-Errazu , María José Rabanaque , Mª José Gómez-Poyato , Mª Antonia Sánchez-Calavera , Sara Malo
Objective
To gain insight into the experiences of healthcare managers and professionals during the COVID-19 pandemic, with the aim of identifying barriers and facilitators to healthcare access for chronic patients.
Location
Aragon Health System (SALUD), Aragon, Spain.
Participants
21 managers and 16 healthcare professionals (nurses and doctors) selected using convenience and snowball sampling.
Methods
A qualitative research design involving semi-structured interviews and communicative focus groups based on a communicative methodology was employed. Perceptions were collected regarding barriers to access, the quality of care, digitalisation, territorial inequality, the availability and management of resources, as well as positive experiences and lessons learned.
Results
Three main barriers were identified that hindered equitable access to care, especially for vulnerable patients: the digital divide, rural-urban inequality, and system overload. Among the facilitating factors, digitalisation and interdisciplinary collaboration were found to improve efficiency and coordination between levels of care. The experiences gathered revealed discrepancies between organisational decisions and clinical outcomes, particularly in the care of chronic patients.
Conclusions
The pandemic revealed both structural weaknesses in the health system and opportunities for improvement. Positive innovations must be consolidated through an equitable approach that is tailored to the needs of vulnerable patients.
{"title":"Barreras y elementos facilitadores en el acceso a la atención sanitaria durante la pandemia de COVID-19: valoración de gestores y profesionales sanitarios","authors":"Irantzu Bengoa-Urrengoechea , Isabel Aguilar-Palacio , Diana Valero-Errazu , María José Rabanaque , Mª José Gómez-Poyato , Mª Antonia Sánchez-Calavera , Sara Malo","doi":"10.1016/j.aprim.2025.103402","DOIUrl":"10.1016/j.aprim.2025.103402","url":null,"abstract":"<div><h3>Objective</h3><div>To gain insight into the experiences of healthcare managers and professionals during the COVID-19 pandemic, with the aim of identifying barriers and facilitators to healthcare access for chronic patients.</div></div><div><h3>Location</h3><div>Aragon Health System (SALUD), Aragon, Spain.</div></div><div><h3>Participants</h3><div>21 managers and 16 healthcare professionals (nurses and doctors) selected using convenience and snowball sampling.</div></div><div><h3>Methods</h3><div>A qualitative research design involving semi-structured interviews and communicative focus groups based on a communicative methodology was employed. Perceptions were collected regarding barriers to access, the quality of care, digitalisation, territorial inequality, the availability and management of resources, as well as positive experiences and lessons learned.</div></div><div><h3>Results</h3><div>Three main barriers were identified that hindered equitable access to care, especially for vulnerable patients: the digital divide, rural-urban inequality, and system overload. Among the facilitating factors, digitalisation and interdisciplinary collaboration were found to improve efficiency and coordination between levels of care. The experiences gathered revealed discrepancies between organisational decisions and clinical outcomes, particularly in the care of chronic patients.</div></div><div><h3>Conclusions</h3><div>The pandemic revealed both structural weaknesses in the health system and opportunities for improvement. Positive innovations must be consolidated through an equitable approach that is tailored to the needs of vulnerable patients.</div></div>","PeriodicalId":55435,"journal":{"name":"Atencion Primaria","volume":"58 1","pages":"Article 103402"},"PeriodicalIF":1.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145924301","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01DOI: 10.1016/j.aprim.2025.103399
Maria Miñana-Castellanos , Maria Ramon Granés , Berta Fernández Camins , Elena Navas Méndez , Joan Barrot de la Puente , Carolina Lapena Estella
Objectives
To describe the population with type 2 diabetes mellitus (T2DM) meeting frailty criteria and assess their management based on clinical guidelines (CGL). Patient characteristics, prescribed treatments, adherence to recommendations, and overtreatment prevalence were analyzed.
Design
Cross-sectional observational study using retrospective data.
Setting
SIDIAP database (primary care records, Catalonia, Spain).
Participants
594,777 T2DM patients; other diabetes types were excluded.
Main measures
Sociodemographic, clinical, and treatment characteristics were assessed. Frailty was defined using consensus criteria as the presence of one or more major criteria or two or more minor criteria. Major criteria were defined as a Charlson index >4, a Barthel index < 60, weight status alterations, and cognitive impairment. Minor criteria included age >75 years, MEDEA U4 or U5, established cardiovascular disease, and chronic kidney disease. Medications were classified as indicated or not recommended, based on CGL. Not recommended treatments included insulin and sulfonylureas due to their hypoglycemia risk. Glycemic control (HbA1c) and inappropriate treatments in frail patients were examined. Overtreatment was defined as use of not recommended treatments in patients with correct metabolic control (HbA1c < 7%).
Results
A total of 22.8% of individuals with T2DM met clinical criteria for frailty. Sulfonylureas were the second most frequently prescribed class of glucose-lowering agents after metformin across all groups. Among frail patients, 14% were treated with therapies not recommended by clinical guidelines, primarily insulin (39.4%) and sulfonylureas (29.2%). Overtreatment was observed in over 20% of frail individuals.
Conclusions
Almost 1 every 4 people with T2DM meet frailty criteria. Low adherence to guidelines and a high prevalence of inappropriate treatments and overtreatment were observed. These findings emphasize the need for increased awareness and better guideline implementation to improve care for this vulnerable population.
{"title":"Manejo de la diabetes mellitus tipo 2 en personas con fragilidad en la práctica clínica real","authors":"Maria Miñana-Castellanos , Maria Ramon Granés , Berta Fernández Camins , Elena Navas Méndez , Joan Barrot de la Puente , Carolina Lapena Estella","doi":"10.1016/j.aprim.2025.103399","DOIUrl":"10.1016/j.aprim.2025.103399","url":null,"abstract":"<div><h3>Objectives</h3><div>To describe the population with type 2 diabetes mellitus (T2DM) meeting frailty criteria and assess their management based on clinical guidelines (CGL). Patient characteristics, prescribed treatments, adherence to recommendations, and overtreatment prevalence were analyzed.</div></div><div><h3>Design</h3><div>Cross-sectional observational study using retrospective data.</div></div><div><h3>Setting</h3><div>SIDIAP database (primary care records, Catalonia, Spain).</div></div><div><h3>Participants</h3><div>594,777 T2DM patients; other diabetes types were excluded.</div></div><div><h3>Main measures</h3><div>Sociodemographic, clinical, and treatment characteristics were assessed. Frailty was defined using consensus criteria as the presence of one or more major criteria or two or more minor criteria. Major criteria were defined as a Charlson index<!--> <!-->>4, a Barthel index <<!--> <!-->60, weight status alterations, and cognitive impairment. Minor criteria included age<!--> <!-->>75 years, MEDEA U4 or U5, established cardiovascular disease, and chronic kidney disease. Medications were classified as indicated or not recommended, based on CGL. Not recommended treatments included insulin and sulfonylureas due to their hypoglycemia risk. Glycemic control (HbA1c) and inappropriate treatments in frail patients were examined. Overtreatment was defined as use of not recommended treatments in patients with correct metabolic control (HbA1c<!--> <!--><<!--> <!-->7%).</div></div><div><h3>Results</h3><div>A total of 22.8% of individuals with T2DM met clinical criteria for frailty. Sulfonylureas were the second most frequently prescribed class of glucose-lowering agents after metformin across all groups. Among frail patients, 14% were treated with therapies not recommended by clinical guidelines, primarily insulin (39.4%) and sulfonylureas (29.2%). Overtreatment was observed in over 20% of frail individuals.</div></div><div><h3>Conclusions</h3><div>Almost 1 every 4 people with T2DM meet frailty criteria. Low adherence to guidelines and a high prevalence of inappropriate treatments and overtreatment were observed. These findings emphasize the need for increased awareness and better guideline implementation to improve care for this vulnerable population.</div></div>","PeriodicalId":55435,"journal":{"name":"Atencion Primaria","volume":"58 1","pages":"Article 103399"},"PeriodicalIF":1.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145914132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Global change —including biodiversity loss, land-use alterations and climate change— is reshaping the epidemiology of infectious diseases. These factors facilitate the emergence of new pathogens, interspecies transmission, and the geographical expansion of vectors and reservoirs. Vector-borne diseases such as dengue, malaria and West Nile fever are increasing in both incidence and distribution. Similarly, water- and food-borne diseases (e.g. salmonellosis, cholera) are becoming more frequent, driven by extreme weather events, poor water and sanitation infrastructure, and changes in aquatic ecosystems. In Europe and Spain, autochthonous outbreaks and the re-emergence of previously controlled diseases have been documented. The “One Health” and “Planetary Health” approaches —integrating human, animal and environmental health— are essential, alongside stronger epidemiological surveillance and the adaptation of health systems to this evolving scenario.
{"title":"Impacto del cambio global en la epidemiología de enfermedades infecciosas","authors":"Alejandra Pérez Pérez , Javier Arranz Izquierdo , Miriam Navarro Beltrá","doi":"10.1016/j.aprim.2025.103375","DOIUrl":"10.1016/j.aprim.2025.103375","url":null,"abstract":"<div><div>Global change —including biodiversity loss, land-use alterations and climate change— is reshaping the epidemiology of infectious diseases. These factors facilitate the emergence of new pathogens, interspecies transmission, and the geographical expansion of vectors and reservoirs. Vector-borne diseases such as dengue, malaria and West Nile fever are increasing in both incidence and distribution. Similarly, water- and food-borne diseases (e.g. salmonellosis, cholera) are becoming more frequent, driven by extreme weather events, poor water and sanitation infrastructure, and changes in aquatic ecosystems. In Europe and Spain, autochthonous outbreaks and the re-emergence of previously controlled diseases have been documented. The “One Health” and “Planetary Health” approaches —integrating human, animal and environmental health— are essential, alongside stronger epidemiological surveillance and the adaptation of health systems to this evolving scenario.</div></div>","PeriodicalId":55435,"journal":{"name":"Atencion Primaria","volume":"58 1","pages":"Article 103375"},"PeriodicalIF":1.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145914109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01DOI: 10.1016/j.aprim.2025.103339
Ana González-Díaz , Juan Gómez-Salgado , Nora Suleiman-Martos , José Luis Gómez-Urquiza
{"title":"Más que jugar: el valor terapéutico del juego en la atención integral infantil desde atención primaria","authors":"Ana González-Díaz , Juan Gómez-Salgado , Nora Suleiman-Martos , José Luis Gómez-Urquiza","doi":"10.1016/j.aprim.2025.103339","DOIUrl":"10.1016/j.aprim.2025.103339","url":null,"abstract":"","PeriodicalId":55435,"journal":{"name":"Atencion Primaria","volume":"58 1","pages":"Article 103339"},"PeriodicalIF":1.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145914137","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01DOI: 10.1016/j.aprim.2025.103386
M. Elisa Torres Tejera , María Cristina Almécija Pérez , Marcia Guitián Domínguez , Miriam Navarro Beltrá
Climate change is not only affecting the planet, it is also profoundly impacting our mental health. In these times, talking about how anxiety, stress and other emotional problems are growing due to the consequences of climate change, from distress over natural disasters to sadness over the loss of our ecosystems, is something that has become necessary. Several studies are already putting the spotlight on these effects, showing how millions of people, especially young people, feel worry, uncertainty and even hopelessness about the future. They are also exploring ways to address these problems by connecting people's well-being with care for the planet. In addition, it underscores the importance of public policy including this approach to protect our mental health in the midst of the climate crisis.
{"title":"El impacto silencioso del cambio climático en nuestra salud mental: ansiedad y estrés en un mundo en transformación","authors":"M. Elisa Torres Tejera , María Cristina Almécija Pérez , Marcia Guitián Domínguez , Miriam Navarro Beltrá","doi":"10.1016/j.aprim.2025.103386","DOIUrl":"10.1016/j.aprim.2025.103386","url":null,"abstract":"<div><div>Climate change is not only affecting the planet, it is also profoundly impacting our mental health. In these times, talking about how anxiety, stress and other emotional problems are growing due to the consequences of climate change, from distress over natural disasters to sadness over the loss of our ecosystems, is something that has become necessary. Several studies are already putting the spotlight on these effects, showing how millions of people, especially young people, feel worry, uncertainty and even hopelessness about the future. They are also exploring ways to address these problems by connecting people's well-being with care for the planet. In addition, it underscores the importance of public policy including this approach to protect our mental health in the midst of the climate crisis.</div></div>","PeriodicalId":55435,"journal":{"name":"Atencion Primaria","volume":"58 1","pages":"Article 103386"},"PeriodicalIF":1.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145914120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-27DOI: 10.1016/j.aprim.2025.103434
Luis Fransi Galiana , Juan Carlos Obaya Rebollar , Mar Domingo Teixidor
{"title":"Controversias en atención primaria: uso de betabloqueantes tras un infarto agudo de miocardio","authors":"Luis Fransi Galiana , Juan Carlos Obaya Rebollar , Mar Domingo Teixidor","doi":"10.1016/j.aprim.2025.103434","DOIUrl":"10.1016/j.aprim.2025.103434","url":null,"abstract":"","PeriodicalId":55435,"journal":{"name":"Atencion Primaria","volume":"58 1","pages":"Article 103434"},"PeriodicalIF":1.6,"publicationDate":"2025-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145839781","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-27DOI: 10.1016/j.aprim.2025.103411
Miguel Angel Maria Tablado
{"title":"Efectos secundarios y farmacovigilancia de los agonistas GLP1","authors":"Miguel Angel Maria Tablado","doi":"10.1016/j.aprim.2025.103411","DOIUrl":"10.1016/j.aprim.2025.103411","url":null,"abstract":"","PeriodicalId":55435,"journal":{"name":"Atencion Primaria","volume":"58 2","pages":"Article 103411"},"PeriodicalIF":1.6,"publicationDate":"2025-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145841754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-24DOI: 10.1016/j.aprim.2025.103433
Edwin Gustavo Estrada-Araoz
{"title":"Formación científica y reconocimiento RENACYT en estudiantes de ciencias de la salud","authors":"Edwin Gustavo Estrada-Araoz","doi":"10.1016/j.aprim.2025.103433","DOIUrl":"10.1016/j.aprim.2025.103433","url":null,"abstract":"","PeriodicalId":55435,"journal":{"name":"Atencion Primaria","volume":"58 2","pages":"Article 103433"},"PeriodicalIF":1.6,"publicationDate":"2025-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145835398","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-20DOI: 10.1016/j.aprim.2025.103423
Sara Elena Palacín-Melús , Mario López-Salas , Antonio Yanes-Roldán , Roberto Bernal-Bernal , Elena Melús-Palazón , Cruz Bartolomé-Moreno
<div><h3>Objective</h3><div>To analyze the relationship between negative affectivity and work and social repercussions in female breast cancer survivors in Spain, assessing its impact on quality of life.</div></div><div><h3>Design</h3><div>Multicenter, cross-sectional study using a self-administered online questionnaire (Quality of Life in Adult Cancer Survivors, QLACS).</div></div><div><h3>Setting</h3><div>Spain, between June 2024 and February 2025.</div></div><div><h3>Participants</h3><div>1,293 women aged 18 years and older, breast cancer survivors, who had completed primary treatment (surgery, radiotherapy, and/or chemotherapy) and were disease-free at the time of the study.</div></div><div><h3>Main measurements</h3><div>«Negative affectivity» domain (primary variable): Assessed using a 7-point Likert scale (1: never to 7: always).</div><div>Work-related repercussions: To determine whether women considered they had been «forced» to leave work or be fired due to cancer and its relationship with the primary outcome.</div><div>Correlation between negative affectivity and social avoidance, financial problems, lifestyle habits (tobacco, alcohol, ultra-processed foods), and physical symptoms (pain, fatigue, cognitive problems) and their relationship based on the type of treatment received.</div></div><div><h3>Results</h3><div>Negative affectivity had a median of 4.3 points («almost always»).</div><div>Work-related repercussions (forced to leave work in 15.4% or to be fired in 7.9%) were significantly associated with greater negative affectivity (Kruskal-Wallis<!--> <!-->=<!--> <!-->46.9; p <<!--> <!-->0.001), although the effect size was small (ɛ<sup>2</sup> <!-->=<!--> <!-->0.0447).</div><div>Social avoidance showed a moderate correlation with negative affectivity (Pearson's r<!--> <!-->=<!--> <!-->0.628; p <<!--> <!-->0.001), explaining 39.5% of the variability in social avoidance.</div><div>Financial problems were moderately correlated with negative affectivity (Spearman's<!--> <!-->=<!--> <!-->0.319; p <<!--> <!-->0.001).</div></div><div><h3>Lifestyle habits</h3><div>Negative affectivity increased the likelihood of tobacco use (OR<!--> <!-->=<!--> <!-->1.35; 95% CI: 1.05–1.74) and ultra-processed food use (OR<!--> <!-->=<!--> <!-->1.228; 95% CI: 1.121–1.345), but reduced alcohol consumption (OR<!--> <!-->=<!--> <!-->0.769 for<!--> <!-->>4 times/week; p<!--> <!-->=<!--> <!-->0.018).</div></div><div><h3>Physical symptoms</h3><div>Moderate correlations with pain (Kendall<!--> <!-->=<!--> <!-->0.507), fatigue (Kendall<!--> <!-->=<!--> <!-->0.471), and cognitive problems (Kendall<!--> <!-->=<!--> <!-->0.416; all p <<!--> <!-->0.001).</div><div>Hormone therapy: It was the only treatment significantly associated with negative affectivity (Mann-Whitney U<!--> <!-->=<!--> <!-->179,415; p<!--> <!-->=<!--> <!-->0.032), although with minimal clinical effect (r<!--> <!-->=<!--> <!-->0.0715).</div></div><div><h3>Conclusions</h3><div>Breast can
目的：分析西班牙女性乳腺癌幸存者的负面情绪与工作和社会影响的关系，评估其对生活质量的影响。设计：多中心、横断面研究，采用自我管理的在线问卷（成年癌症幸存者的生活质量，QLACS）。背景：西班牙，2024年6月至2025年2月。参与者：1293名18岁及以上的女性，乳腺癌幸存者，完成了初步治疗（手术、放疗和/或化疗），在研究时无疾病。主要测量：«负面情感»领域（主要变量）：使用7点李克特量表（1：从不到7：总是）进行评估。与工作相关的影响：确定女性是否认为她们因癌症而“被迫”离开工作或被解雇，以及癌症与主要结果的关系。消极情绪与社会回避、经济问题、生活习惯（烟草、酒精、超加工食品）和身体症状（疼痛、疲劳、认知问题）之间的相关性及其基于所接受治疗类型的关系。结果：消极情绪的中位数为4.3分（“几乎总是”）。与工作相关的负面影响（15.4%被迫离职或7.9%被解雇）与更大的负面情绪显著相关（Kruskal-Wallis=46.9; p 2=0.0447）。生活习惯：消极情绪增加了吸烟（OR=1.35; 95% CI: 1.05-1.74）和超加工食品（OR=1.228; 95% CI: 1.121-1.345）的可能性，但减少了饮酒（OR=0.769，每周饮酒4次；p=0.018）。身体症状：与疼痛（Kendall=0.507）、疲劳（Kendall=0.471）和认知问题（Kendall=0.416）中度相关；所有p结论：西班牙乳腺癌幸存者表现出高水平的负面情绪，与工作影响、社交回避和财务问题显著相关。它还与疼痛和认知问题以及是否接受激素治疗密切相关。这些发现强调需要在初级保健中进行多学科随访，处理心理、职业和社会方面的问题，以改善幸存者的生活质量和生活方式。
{"title":"Repercusiones laborales y sociales en la calidad de vida de mujeres supervivientes de cáncer de mama","authors":"Sara Elena Palacín-Melús , Mario López-Salas , Antonio Yanes-Roldán , Roberto Bernal-Bernal , Elena Melús-Palazón , Cruz Bartolomé-Moreno","doi":"10.1016/j.aprim.2025.103423","DOIUrl":"10.1016/j.aprim.2025.103423","url":null,"abstract":"<div><h3>Objective</h3><div>To analyze the relationship between negative affectivity and work and social repercussions in female breast cancer survivors in Spain, assessing its impact on quality of life.</div></div><div><h3>Design</h3><div>Multicenter, cross-sectional study using a self-administered online questionnaire (Quality of Life in Adult Cancer Survivors, QLACS).</div></div><div><h3>Setting</h3><div>Spain, between June 2024 and February 2025.</div></div><div><h3>Participants</h3><div>1,293 women aged 18 years and older, breast cancer survivors, who had completed primary treatment (surgery, radiotherapy, and/or chemotherapy) and were disease-free at the time of the study.</div></div><div><h3>Main measurements</h3><div>«Negative affectivity» domain (primary variable): Assessed using a 7-point Likert scale (1: never to 7: always).</div><div>Work-related repercussions: To determine whether women considered they had been «forced» to leave work or be fired due to cancer and its relationship with the primary outcome.</div><div>Correlation between negative affectivity and social avoidance, financial problems, lifestyle habits (tobacco, alcohol, ultra-processed foods), and physical symptoms (pain, fatigue, cognitive problems) and their relationship based on the type of treatment received.</div></div><div><h3>Results</h3><div>Negative affectivity had a median of 4.3 points («almost always»).</div><div>Work-related repercussions (forced to leave work in 15.4% or to be fired in 7.9%) were significantly associated with greater negative affectivity (Kruskal-Wallis<!--> <!-->=<!--> <!-->46.9; p <<!--> <!-->0.001), although the effect size was small (ɛ<sup>2</sup> <!-->=<!--> <!-->0.0447).</div><div>Social avoidance showed a moderate correlation with negative affectivity (Pearson's r<!--> <!-->=<!--> <!-->0.628; p <<!--> <!-->0.001), explaining 39.5% of the variability in social avoidance.</div><div>Financial problems were moderately correlated with negative affectivity (Spearman's<!--> <!-->=<!--> <!-->0.319; p <<!--> <!-->0.001).</div></div><div><h3>Lifestyle habits</h3><div>Negative affectivity increased the likelihood of tobacco use (OR<!--> <!-->=<!--> <!-->1.35; 95% CI: 1.05–1.74) and ultra-processed food use (OR<!--> <!-->=<!--> <!-->1.228; 95% CI: 1.121–1.345), but reduced alcohol consumption (OR<!--> <!-->=<!--> <!-->0.769 for<!--> <!-->>4 times/week; p<!--> <!-->=<!--> <!-->0.018).</div></div><div><h3>Physical symptoms</h3><div>Moderate correlations with pain (Kendall<!--> <!-->=<!--> <!-->0.507), fatigue (Kendall<!--> <!-->=<!--> <!-->0.471), and cognitive problems (Kendall<!--> <!-->=<!--> <!-->0.416; all p <<!--> <!-->0.001).</div><div>Hormone therapy: It was the only treatment significantly associated with negative affectivity (Mann-Whitney U<!--> <!-->=<!--> <!-->179,415; p<!--> <!-->=<!--> <!-->0.032), although with minimal clinical effect (r<!--> <!-->=<!--> <!-->0.0715).</div></div><div><h3>Conclusions</h3><div>Breast can","PeriodicalId":55435,"journal":{"name":"Atencion Primaria","volume":"58 1","pages":"Article 103423"},"PeriodicalIF":1.6,"publicationDate":"2025-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145806495","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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