Revistas
Revista:
NURSE EDUCATION IN PRACTICE
ISSN:
1873-5223
Año:
2023
Vol.:
67
Págs.:
103562
Aim: The aims of this paper are (1) to present the results of the development, content validation and imple-mentation study of the Relationship Competencies Guiding Tool; (2) to provide examples of how each item in the tool is reflected in clinical narratives written by nurses and justify the corresponding scores after the evaluation; (3) to present how the language and content of the narratives are interpreted with the tool and to describe an exemplar; and (4) to present barriers to and facilitators of the application of the tool. Background: From a person-centered care approach, the fostering of authentic relationships with patients is key to achieving therapeutic benefits. Therefore, it is essential to help nurses establish meaningful relationships with patients and help them acquire these abilities. Clinical narratives can be used as a way to promote reflective practice and professional competency development among nurses. A tool to evaluate the knowledge, skills, at-titudes and values necessary for developing authentic encounters with patients through clinical narratives was developed, validated and implemented.Design: An instrument-development study comprised of three steps: (1) conceptualization; (2) item generation and content validity; and (3) implementation of the tool and linguistic evaluation.Methods: This study was conducted in three major steps. Step one entailed conceptualization. Step two included the generation of items and content validation. In step three, the tool was used to independently evaluate 25 narratives. One of these narratives was also linguistically analysed to provide a comprehensive view of the interpretative strategies deployed by evaluators.Results: The Relationship Competencies Guiding Tool was developed, validated and implemented. It could help nurses work on nursing relationship-based professional competencies, guided the evaluators in the process of assigning scores to the corresponding items and helped the researchers identify certain barriers and facilitators before and during the narrative evaluation process.Conclusions: The tool has been shown to be clear, relevant and conceptually and linguistically suitable for evaluating clinical narratives. The Relationship Competencies Guiding Tool could be applied to interpret how nurses reflect professional competencies in a clinical narrative as a preliminary step in the construction of a mea-surement tool.Tweetable abstract: From a person-centered relationship-based care approach, clinical narratives can be used to promote professional competencies between nurses. The Relationship Competencies Guiding Tool may help eval-uate the knowledge, skills, attitudes and values necessary for developing authentic encounters with persons/ families, as reflected by nurses' clinical narratives.
Revista:
NUTRITION
ISSN:
0899-9007
Año:
2022
Vol.:
103 - 104
Págs.:
111761
Objectives: Although low-quality diets and smoking are independently associated with higher mortality risk, a joint analysis of both risk factors in relation to mortality has not been sufficiently studied. The aim of this study was to explore the effect modification between level of adherence to a Mediterranean dietary pattern (MedDiet) and smoking status on all-cause, cancer, and cardiovascular mortality.Methods: We conducted a prospective analysis to assess the association between diet and smoking status in the SUN (Seguimiento Universidad de Navarra) cohort study. Deaths were confirmed by review of the National Death Index. Participants were classified into six categories according to the MedDiet (adherence/non-adherence) and their exposure to smoking (never/former/current smoker). Multivariate-adjusted Cox regression models were fitted to estimate hazard ratios (HR) and 95% confidence intervals (CIs) for mortality. During a mean follow-up of 11.5 y (SD 4.5), we observed 18 948 participants (mean age 38.4 y; SD 12.4) and 431 deaths (51.3% cancer deaths). Results: A higher risk for death was found among smokers with a low adherence to the MedDiet (HR, 2.20; 95% CI, 1.45-3.34) compared with never smokers with high adherence to the MedDiet. The P value for supra-multiplicative effect modification was not statistically significant, meaning that the effect of both factors is multiplicative. A higher risk for premature death from cancer was found in smokers and in those nonadherent with the MedDiet.Conclusion: Smoking and poor adherence to the MedDiet exerted a multiplicative effect in increasing allcause mortality and cancer-related mortality in a Spanish population of university graduates.(c) 2022 The Author(s). Published by Elsevier Inc. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)
Revista:
NURSE EDUCATION IN PRACTICE
ISSN:
1471-5953
Año:
2022
Vol.:
58
Págs.:
103277
AIM: To explore nurses' knowledge, skills and personal attributes for competent health education practice and their association with potential influencing factors. BACKGROUND: Clinical nurses are expected to perform effective health education interventions, but they do not feel competent. The self-assessment of the health education competence and its conditional factors is paramount for professional development. DESIGN: A cross-sectional study. METHODS: A total of 458 clinical nurses from two health specialized centers in Spain participated in this study. Data were collected using the Nurse Health Education Competence Instrument and a second self-report questionnaire from January to February 2019. Descriptive statistics, t-test, analysis of variance, Pearson's and Spearman's correlation and multiple linear regression were used to analyse the data. The STROBE guideline was used RESULTS: The mean scores of the knowledge (70.10±15.11), skills (92.14±15.18) and personal attributes scales (32.32±5.89) were found to be low to moderate. The main influencing factors for the health education implementation were lack of education and training (71.4%), lack of time (67.5%) and high workload (67.3%). Nurses with higher educational level and perceived self-efficacy for competently providing health education, more extensive professional experience and previous training in health education rated higher in knowledge, skills and personal attributes. Age and years of experience were negatively correlated with knowledge scores, but positively with the rest of domains of the competence and self-efficacy. The regression models for the overall health education competence's domains were significant (p<0.001) with R2 values ranging from 28.0% to 49.3%. Self-efficacy, previous health education training and working in intensive care units were found to be significant in all cognitive, psychomotor and attitudinal scales. CONCLUSION: Clinical nurses reported on some skills and personal attributes for health education practice, but they seem to lack health education knowledge necessary for a competent practice. This study suggested that effective education and training and supportive organizational cultures are key to enhance nurses' health education competence. Identifying nurses' educational needs on the main domains of the competence and its intrinsic/extrinsic influential factors may assist in both planning and organizing tailored training strategies and in promoting appropriate environments to support a high-quality health education practice TWEETABLE ABSTRACT: Nurses' knowledge, skills and attitudes about health education competence are low to moderate. Training and organizational support are key.
Revista:
JOURNAL OF FAMILY NURSING
ISSN:
1074-8407
Año:
2022
Vol.:
28
N°:
3
Págs.:
277 - 291
The aim of this study was to explore nurses' attitudes and beliefs about the importance of families in nursing care, as well as the barriers and facilitators within the clinical context that influence the implementation offamily nursing in an in-patient oncology service. A cross-sectional study design, incorporating quantitative and qualitative measurements, was used with a sample of nurses in Spain from an oncology service (N = 39). In general, oncology nurses reported positive attitudes and beliefs about the importance of family in nursing care. However, they did not effectively involve the family in their daily clinical practice. This was due to the nurses' lack of clinical skills and competence to work with families as well as contextual factors such as the lack of time and workload that acted as barriers to the implementation of family-oriented care. This study identified areas of improvement that are needed to promote the effective and sustainable implementation of family nursing knowledge in clinical practice settings.
Revista:
JOURNAL OF FAMILY NURSING
ISSN:
1074-8407
Año:
2021
Vol.:
27
N°:
2
Págs.:
124-135
Using constructivist grounded theory, this study explored how family groups respond to Alzheimer's disease in its early stages. Seven family units (N = 22) participated in a series of 26 longitudinal interviews and 14 other family caregivers took part in three focus groups at a later stage for refinement and verification of the findings. Data analysis revealed four types of family dynamics: close dynamics at the start that were maintained throughout the experience, close dynamics at the start which became conflicting, conflicting dynamics at the start which remained problematic, and conflicting dynamic at the start which became closer over time. Factors such as prior relationships and family history, motivation to care, family organization, communication, and the family vision for future shaped the development of these dynamics. This theory of family dynamics in Alzheimer's disease has the potential to inform the development of more adequate early interventions for families living with the illness.
Revista:
REFERÊNCIA
ISSN:
0874-0283
Año:
2021
Vol.:
2021
N°:
6
Págs.:
e21ED6
Revista:
JOURNAL OF ADVANCED NURSING
ISSN:
0309-2402
Año:
2021
Vol.:
77
N°:
2
Págs.:
715 - 728
Aim To develop and psychometrically test the Nurse Health Education Competence Instrument for assessing nurses' knowledge, skills and personal attributes concerning competent health education practice. Design A psychometric instrument development and validation study. Methods A four-step approach was used: Step 1) operational definition based on an up-to-date concept analysis and experts' judgement; step 2) item generation and content validation by expert panel and target population; step 3) item analysis based on acceptability, internal consistency and face validity; and step 4) psychometric evaluation based on construct validity, criterion validity, internal consistency and stability, conducted from January -February 2019 with 458 hospital-care nurses. Results The operational framework and expert groups showed good content validity, resulting in the first version. From the initial 88-item pool, 58 items were retained after item analysis. Exploratory factor analysis revealed three scales concerning the cognitive (three-factor solution with 23 items), psychomotor (two-factor solution with 26 items) and affective-attitudinal (one-factor solution with nine items) competency domains, which respectively accounted for 58%, 53% and 54% of the variance. Known-group study demonstrated significant differences by years working in the service and training received in health education, providing evidence for the measure's sensitivity. The three scales correlated positively ...
Revista:
REFERÊNCIA
ISSN:
0874-0283
Año:
2021
Vol.:
5
N°:
6
Págs.:
e21ED6
Revista:
JOURNAL OF NURSING MANAGEMENT
ISSN:
0966-0429
Año:
2021
Vol.:
29
N°:
5
Págs.:
1130 - 1140
Aim To translate and psychometrically validate the Demand-Control-Support Questionnaire for nurses in Spain. Background Nurses are one of the groups most affected by work-related stress. The combination of high job demands and low control is identified as the main source of stress among nurses. The Demand-Control-Support Questionnaire is a valid and reliable tool for assessing psychosocial stress in the workplace. Methods A two-phase cross-sectional descriptive study. The instrument was translated according to Sousa and Rojjanasrirat guidelines, including forward and backward translations, consensus meetings, pilot testing and expert committee. Structural validity, convergent and discriminative validity, internal consistency and test-retest reliability were assessed in a sample of 247 nurses. Results Exploratory factor analysis verified a three-factor solution with good internal consistency (Cronbach's alpha values ranged from 0.62 to 0.87) and test-retest reliability (intraclass correlation coefficients ranged from 0.65 to 0.85). Conclusions The Spanish version of the Demand-Control-Support Questionnaire seems to be a brief, valid and reliable instrument to measure psychosocial stress in the workplace in nurses. Implications for nursing management The use of the Demand-Control-Support Questionnaire can be of value to inform the design and implementation of appropriate management strategies to foster a more favourable work environment that promotes the well-being of professionals.
Revista:
JOURNAL OF FAMILY NURSING
ISSN:
1074-8407
Año:
2020
Vol.:
26
N°:
3
Págs.:
240 - 253
The beliefs of nursing professionals who care for families experiencing illness are fundamental to the quality of the nurse-family relationship and the level of the nurse's involvement in the therapeutic process of Family Systems Nursing. It is essential to have valid and reliable instruments for assessing nurses' illness beliefs, especially in the Spanish context where no instruments have been identified to date. The Iceland Health Care Practitioner Illness Beliefs Questionnaire (ICE-HCP-IBQ) is a reliable and valid measure of professionals' beliefs about their understanding of the meaning of the illness experience of families. The purpose of this study was to adapt and psychometrically test the Spanish version of the ICE-HCP-IBQ (N= 249 nurses). The exploratory factor analysis showed one-factor solution with good internal consistency (Cronbach's alpha = .91) and test-retest reliability (r= .72,p< .01). This questionnaire is a promising tool for mapping nurse's illness beliefs and monitoring the effectiveness of family nursing educational interventions in the Spanish context.
Revista:
NURSE EDUCATION TODAY
ISSN:
0260-6917
Año:
2020
Vol.:
87
Págs.:
104360
Background: Clinical narratives may be used as a means to improve the acquisition of clinical competences. Even though there are studies that recognize the potential value of clinical narratives to promote nursing professional development, there is no evidence that shows their value as a tool to improve nurses' competences to provide person-centred nursing care.
Purpose: To evaluate the preliminary efficacy of narratives for the development of three nursing professional competences -respect, intentional presence and knowing the person- for providing person-centred care.
Method: Using a pre-post quasi-experimental design, a pilot study with a total of 34 nurses enrolled in a training course of nursing specialization was conducted between September 2016 and June 2017. All the nurses received a multi-component intervention based on the Critical Reflective Inquiry model. The strategies of this programme consisted of writing three narratives, attending two masterclasses, participating in a discussion group, and participating in a face-to-face interview. The NarratUN Evaluation tool was used to assess the outcomes. Changes among nurses were analysed using the Wilcoxon signed Rank test.
Results: The difference in the means between the pre- and post-intervention scores were statistically significant for respect [0.59 (95% CI 0.23-0.95; p = 0.001)], intentional presence [0.75 (95% CI 0.32-1.17; p < 0.0001)] and knowing the person [0.62 (95% CI 0.25-0.99; p = 0.001)]. The difference in the mean score for use of the narrative and reflection also increased significantly [0.65 (95% CI 0.32-0.98, p < 0.001)].
Conclusions: The use of narratives combined with other reflective strategies (masterclass sessions and discussion groups) proved to be effective for the development of professional competences of nurses.
Revista:
ANALES DEL SISTEMA SANITARIO DE NAVARRA
ISSN:
1137-6627
Año:
2019
Vol.:
42
N°:
1
Págs.:
41 - 47
Background. To determine attitudes towards smoking, perception of self-efficacy, and the intention of smoking cessation in college student smokers, and their variation according to the stage of the tobacco cessation process. Methods. Cross-sectional study with 255 college students (18-24 years old) smokers of >= 1 cigarette per week. Instruments used: a personal interview, Fagestrom test, transtheoretical change model, scale of Attitudes, self-efficacy and intention to quit smoking in college smokers and CO in exhaled air. Results. Sample with a majority of women (62%), average age 20.3 years, users of 9.2 cigarettes/day for 5.7 years, with mild dependence on nicotine; 69% were in the stages of pre-contemplation and contemplation. Although smoking was considered to be negative for health and the environment for more than 70%, and 96.7% had negative attitudes towards tobacco, only 45.1% were aware of the associated morbidity and mortality. More than 60% considered tobacco to be a social facilitator, thus anxiety (72.6%) and having friends who smoke (69.4%) are factors considered negative for tobacco cessation. Ninety-one percent believed that they would smoke next year, but 86% stated that they would not be a smoker within five years. One hundred percent of the subjects in pre-contemplation considered that they will smoke during the next year as opposed to 83.5% of those in the stage of preparation. Conclusion. College student smokers show positive attitudes, erroneous beliefs and a low perception of self-efficacy about smoking cessation. All students in the pre-contemplation phase do not even consider smoking cessation in the medium and long term.
Revista:
INTERNATIONAL JOURNAL OF NURSING STUDIES
ISSN:
0020-7489
Año:
2019
Vol.:
94
Págs.:
131 - 138
Objectives: The concept of health education has traditionally focused on enabling people to change unhealthy behaviours and lifestyles. Although, at the theoretical level, there exist definitions of the concept, it remains complex and ambiguous. Furthermore, nurses often confuse the concept with other related terms, such as health information or health promotion. The aim here is to report a concept analysis of health education and elucidate a current definition. Design: Rodgers' evolutionary concept analysis. Data sources: A systematic search was conducted using PubMed and CINAHL for articles written in English or Spanish, published between 1986 and 2017. A manual search was performed, and grey literature was also reviewed. A pre-determined template of study inclusion-related questions assisted the process. Review methods: Rodgers' evolutionary method guided the narrative analysis. The attributes of health education, as well as its antecedents, consequences, related terms and contextual bases were extracted and synthesized. Results: Based on the review of 31 studies on health education, the attributes are a learning process, health-oriented, multidimensional, person-centred and partnership. The antecedents are professional awareness of health education, training of health professionals, available resources, individual's willingness to act, and health as an individual's priority in life. The consequences are the increase in knowledge, skills and/or attitudes; ...
Revista:
PREVENTION SCIENCE
ISSN:
1389-4986
Año:
2019
Vol.:
20
N°:
5
Págs.:
765 - 775
An effective strategy to quit smoking should consider demographic aspects, smoking-related characteristics and psychological factors. This study examined potential predictors of smoking cessation in Spanish college students. A total of 255 college student smokers (18¿24 years old), recruited to a cessation trial (Spain, 2013¿2014), comprised an observational cohort. The main outcome was biochemically verified (urine cotinine) abstinence at the 6-month follow-up. Baseline potential predictors included socio-demographic, smoking-related and psychological variables (Fagerström Test for Nicotine Dependence (FTND), expired monoxide level (CO), intention to quit, previous quit attempts, participation in previous multicomponent programmes and confidence in quitting). Logistic regression models were used to identify potential predictors, the area under the ROC curve (AUC) was used to discriminate the capacity of the predictors and the Hosmer¿Lemeshow goodness-of-fit test was used to assess model calibration. After 6 months of follow-up, variables related to high nicotine dependence, FTND and expired CO levels were associated with lower odds of quitting smoking (OR¿=¿0.69 [95% CI 0.54¿0.89] and 0.84 [0.77¿0.92], respectively). Furthermore, being prepared to change (OR¿=¿3.98 [1.49¿10.64], p¿=¿0.006) and being confident to quit (OR¿=¿4.73 [2.12¿10.55], p¿<¿0.001) were also potential predictors of smoking cessation. The model that combined all these variables had the best predictive validity (AUC¿=¿0.84 [0.78¿0.91], p¿=¿0.693) and showed good predictive capacity (¿2¿=¿10.36, p¿=¿0.241). Findings highlight that, in this population of college student smokers, having a lower level of nicotine dependence, being prepared to quit and having the confidence in the ability to quit were associated with smoking cessation, and these factors had good predictive capacity.
Revista:
TRANSLATIONAL BEHAVIORAL MEDICINE
ISSN:
1869-6716
Año:
2019
Vol.:
9
N°:
1
Págs.:
58 - 66
Background: Although beliefs, self-efficacy and intention to quit have been identified as proximal predictors of initiation or quitting in young adults, few studies have studied how these variables change after a smoking cessation intervention.
Purpose: To evaluate the changes in the beliefs, self-efficacy and intention to avoid smoking, and determine if these are potential mediators in quitting, following a smoking cessation intervention, aimed at tobacco-dependent college students.
Design: Single-blind, pragmatic randomized controlled trial with a 6-month follow-up.
Method: A total of 255 smoker students were recruited from September 2013 to February 2014. Participants were randomly assigned to intervention group (n=133) or to control group (n=122). The students in the intervention group received a multi-component intervention based on the Theory of Triadic Influence. The strategies of this program consisted of a 50-minute motivational interview conducted by a nurse and online self-help material. The follow-up included a reinforcing e-mail and group therapy. The smoking-related Self-efficacy, Belief and Intention scale was used to assess outcomes.
Results: Intention to quit smoking is partial moderator explaining 36.2% of the total effects in smoking cessation incidence. At 6-month follow-up, the differences in the mean scores of self-efficacy and intention related to stopping smoking were significantly higher in the intervention than in the control group.
Conclusions: A multicomponent intervention based on the Theory of Triadic Influence, tailored to college students positively increased the self-efficacy to avoid smoking, and the intention to quit, suggesting intention as potential mediator of quitting.
Revista:
GACETA SANITARIA
ISSN:
0213-9111
Año:
2017
Vol.:
31
N°:
3
Págs.:
269 - 272
The World Health Organization states that health promotion is a key strategy to improve health, and it is conceived as a global process of enabling people to increase control over, and to improve, their health. Health promotion does not focus solely on empowering individuals dealing with their knowledge, attitudes and skills, but it also takes political, social, economic and environmental aspects influencing health and wellbeing into account. The complexity of applying these concepts is reflected in the five paradoxes in health promotion; these arise in between the rhetoric in health promotion and implementation. The detected paradoxes which are described herein involve the patient versus the person, the individual versus the group, disease professionals versus health professionals, disease indicators versus health indicators, and health as an expense versus health as an investment. Making these contradictions explicit can help determine why it is so complex to put the concepts related to health promotion into practice. It can also help to put forward aspects that need further work if health promotion is to put into practice. (C) 2017 SESPAS: Published by Elsevier Espaila, S.L.U.
Revista:
ADDICTION
ISSN:
0965-2140
Año:
2015
Vol.:
110
N°:
10
Págs.:
1676-83
Revista:
GEROKOMOS
ISSN:
1134-928X
Año:
2015
Vol.:
26
N°:
3
Págs.:
94 - 96
Los cuidados al final de la vida se ofrecen en una variedad de contextos en todo el mundo, incluyendo los centros residenciales. El objetivo de este trabajo es profundizar en las necesidades de la familia de un paciente terminal institucionalizado en un centro residencial. Para ello, se presenta un caso clínico que, junto con la evidencia científica, nos ayuda a determinar cuáles son las necesidades de la familia en este momento. El análisis del caso se estructura en cuatro subtemas: necesidad de contacto y comunicación entre la familia y los profesionales sanitarios, necesidad de presencia médica, necesidad de presencia enfermera y necesidades emocionales y sociales. Este trabajo evidencia la importancia de desarrollar, por parte del profesional de enfermería, un plan de identificación y atención de las necesidades familiares. Este enfoque familiar permitirá proporcionar una asistencia de mayor calidad, que derivará en una mejora de la salud de los miembros de la familia.
Revista:
ENFERMERIA INTENSIVA
ISSN:
1130-2399
Año:
2013
Vol.:
24
N°:
2
Págs.:
89-94
Este trabajo evidencia la importancia de instaurar un plan de cuidados protocolizado para los pacientes portadores de asistencia ventricular permanente en la UCI, lo que evitaría complicaciones en el post-operatorio inmediato, reduciría los costes y el tiempo de hospitalización.
Revista:
REVISTA ROL DE ENFERMERIA
ISSN:
0210-5020
Año:
2013
Vol.:
36
N°:
5
Págs.:
52 - 58
Revista:
GEROKOMOS
ISSN:
1134-928X
Año:
2012
Vol.:
23
N°:
4
Págs.:
162 - 168
Revista:
NURSING IN CRITICAL CARE
ISSN:
1362-1017
Año:
2011
Vol.:
16
N°:
4
Págs.:
178-185
The observation of the patient's behaviour during the turning and the physiological changes produced allow professionals to objectify pain in critical patients with verbal communication difficulties. Moreover, our results also highlight the need to administer of additional analgesia before a painful procedure, particularly in post-surgical patients.