Spanish Nurses' Knowledge about Palliative Care. A National Online Survey

Background: Nurses can find people with advanced diseases or in their last days of life during their professional careers and in many different care settings. For this reason, they need to have at least a basic level of palliative care education since they are the professional cohort treating these patients in a very close way. This research aims to determine the level of knowledge in palliative care of Spanish nurses and establish any possible difference based on their experience and training in palliative care. (2) Methods: A cross-sectional design using survey methods (distributed an online questionnaire) aimed at Spanish registered nurses. A validated questionnaire (PCQN-SV) was used to determine the level of knowledge in palliative care; information on some variables to characterize the population was also collected (experience and education in palliative care, years of professional experience, academic level, and others). Uni and bivariate descriptive analyses were performed. A binary logistic regression model was also developed to identify those variables that influenced obtaining results higher than the population's average. (3) Results: Spanish nurses have a medium-low level of knowledge in palliative care, higher in those who have previous experience or education in this area. Statistically significant differences were also found according to the area in which their caring activity was developed. (4) Conclusions: It is necessary to implement strategies for the basic training of nursing professionals in palliative care to offer quality care to people in advanced stages of illnesses or at the end of their lives

Intervención multidisciplinar en el manejo de la disnea en personas con patologías crónicas no malignas en situación avanzada

El presente trabajo muestra una revisión crítica de un artículo en que se presentan los resultados de un ensayo clínico realizado en un hospital de Reino Unido para estudiar los resultados de una intervención con enfoque paliativo utilizada en el manejo de la disnea en pacientes con enfermedades crónicas en fases avanzadas. Tras el resumen del artículo, destacando los principales resultados obtenidos, se presenta la revisión crítica del artículo, en la que se ha intentado analizar tanto el diseño como la metodología utilizada en el ensayo clínico, como las implicaciones para la práctica de enfermería y especialmente en el ámbito de los cuidados paliativos

An instrument to measure nurses' knowledge in palliative care: Validation of the Spanish version of Palliative Care Quiz for Nurses

Background Palliative care is nowadays essential in nursing care, due to the increasing number of patients who require attention in final stages of their life. Nurses need to acquire specific knowledge and abilities to provide quality palliative care. Palliative Care Quiz for Nurses is a questionnaire that evaluates their basic knowledge about palliative care. The Palliative Care Quiz for Nurses (PCQN) is useful to evaluate basic knowledge about palliative care, but its adaptation into the Spanish language and the analysis of its effectiveness and utility for Spanish culture is lacking. Purpose To report the adaptation into the Spanish language and the psychometric analysis of the Palliative Care Quiz for Nurses. Method The Palliative Care Quiz for Nurses-Spanish Version (PCQN-SV) was obtained from a process including translation, back-translation, comparison with versions in other languages, revision by experts, and pilot study. Content validity and reliability of questionnaire were analyzed. Difficulty and discrimination indexes of each item were also calculated according to Item Response Theory (IRT). Findings Adequate internal consistency was found (S-CVI = 0.83); Cronbach's alpha coefficient of 0.67 and KR-20 test result of 0,72 reflected the reliability of PCQN-SV. The questionnaire had a global difficulty index of 0,55, with six items which could be considered as difficult or very difficult, and five items with could be considered easy or very easy. The discrimination indexes of the 20 items, show us that eight items are good or very good while six items are bad to discriminate between good and bad respondents. Discussion Although in shows internal consistency, reliability and difficulty indexes similar to those obtained by versions of PCQN in other languages, a reformulation of the items with lowest content validity or discrimination indexes and those showing difficulties with their comprehension is an aspect to take into account in order to improve the PCQN-SV. Conclusion The PCQN-SV is a useful Spanish language instrument for measuring Spanish nurses' knowledge in palliative care and it is adequate to establish international comparisons

Health Assets, Vocation and Zest for Healthcare Work. A Salutogenic Approach to Active Coping among Certified Nursing Assistant Students

People's health assets (HA) mapping process and design dynamization strategies for it are paramount issues for health promotion. These strategies improve the health heritage of individuals and communities as both the salutogenic model of health (SMH) and health assets model (HAM) defend. Connecting and mobilizing HA and strengthens the 'sense of coherence' (SOC) are both related to enhancing stress active and effective coping strategies. This study aims to describe the HA present in a population of certified nursing assistant students (n = 921) in Spain and then to explore their relationships with the SOC, the motivation to choose healthcare studies and their academic performance. A great variety of HA were identified and mapped. Findings showed that individuals with greater motivation towards self-care and 'caring for others' as internal HA, possessed higher SOC levels and a strong vocation for healthcare work. Differences in HA were identified according to gender, age and employment situation. Consistent connections between the care-relation factor and vocational factor with interpersonal and extrapersonal HA were reported. Evidence and results substantiated the salutogenic and asset-based approach as a proper strategy to strengthen SOC, dynamize their HA map, reinforce the sense of calling and enable Certified Nurse Assistant (CNA) students to buffer against caregiving-related stress and thrive in their professio

Contents of the Sexual and Reproductive Health Subject in the Undergraduate Nursing Curricula of Spanish Universities: A Cross-Sectional Study

Background: Nursing students must receive adequate training in Sexual and Reproductive Health (SRH), which could allow them to acquire sufficient knowledge to solve the future SRH needs of everyone. In this study, the contents of the SRH subject in the undergraduate nursing curricula of 77 Spanish universities were examined to determine what SRH training nursing students are receiving. Methods: The contents of the SRH subject of all the curricula that were available online were reviewed. The distribution of the contents (topics) in the two areas (reproductive health and sexual health) was analyzed, and the prevalence of each topic was established. It was also determined whether there were differences between public (n = 52) and private universities (n = 25). Results: The training of nursing students focuses mainly on the area of Reproductive Health (15 topics). Most of the topics of this area had a prevalence greater than 50%. Although the area of Sexual Health had 14 topics, most of these topics had a low prevalence (<20%), especially in private universities. Conclusions: It was found that there is considerable variation in the distribution and prevalence of SRH topics between universities. The contents of the area of Reproductive Health are usually prevalent in most of the curricula. However, the contents of the area of Sexual Health are minimal in most of the universities. An organizational effort is required to determine and standardize the contents of SRH that nursing students should receive in Spain to avoid inequalities in their training. Guaranteeing homogeneous SRH contents will avoid deficit situations that could affect people's car

Conocimientos en cuidados paliativos de los profesionales de enfermería de un hospital español

Objetivo: determinar o nível de conhecimento em cuidados paliativos do pessoal de Enfermagem de um hospital espanhol de terceiro nível. Método: estudo transversal descritivo. Foram coletados dados sobre resultados na versão espanhola do questionário Palliative Care Quiz for Nurses (PCQN), aspectos sociodemográficos, nível de formação e experiência dos participantes em cuidados paliativos. Foi realizada análise descritiva univariada e bivariada, considerando-se estatisticamente significativo um valor de p < 0,05 em todos os casos. Resultados: participaram 159 profissionais, (idade média 39,51 anos ± 10,25, com 13,96 anos ± 10,79 de experiência profissional) 54,7% possuíam experiência em cuidados paliativos e 64,2%, formação (majoritariamente básica). A média de acertos no questionário foi de 54%, com diferenças estatisticamente significativas em função da formação e experiência no âmbito dos cuidados paliativos dos participantes. Conclusões: embora os participantes mostrem um conhecimento suficiente sobre cuidados paliativos, eles se beneficiariam de um programa de formação específico, orientado em função das concepções errôneas identificadas mediante o questionário, que tem mostrado ser um instrumento útil no diagnóstico de necessidades formativas dos profissionais no âmbito dos cuidados paliativos.Objetivo: determinar el nivel de conocimientos en cuidados paliativos del personal de Enfermería de un hospital español de tercer nivel. Método: estudio transversal descriptivo. Los siguientes datos fueron recolectados junto con los resultados de la versión española del cuestionario Palliative Care Quiz for Nurses (PCQN): aspectos sociodemográficos, nivel de formación y experiencia de los participantes en cuidados paliativos. Se realizó análisis descriptivo univariado y bivariado, considerándose estadísticamente significativo un valor de p < 0,05 en todos los casos. Resultados: participaron 159 profesionales, (edad media 39,51 años ± 10,25; experiencia profesional 13,96 años ± 10,79), 54,7% tenían experiencia en cuidados paliativos y 64,2%, formación (la mayoría con formación básica). La media de aciertos en el cuestionario fue de 54%, con diferencias estadísticamente significativas derivadas de la formación y experiencia de los participantes en el ámbito de los cuidados paliativos. Conclusiones: aunque los participantes mostraron un conocimiento suficiente sobre cuidados paliativos, se beneficiarían con un programa de formación específico, orientado en función de las concepciones erróneas identificadas mediante el cuestionario, que ha mostrado ser un instrumento útil en el diagnóstico de necesidades formativas de los profesionales en el ámbito de los cuidados paliativos.Objective: to determine the level of knowledge in palliative care of nursing staff at a Spanish tertiary care hospital. Method: descriptive, cross-sectional study. Data were collected about the results of the Spanish version of the Palliative Care Quiz for Nurses (PCQN), sociodemographic aspects, education level and experience in the field of palliative care. Univariate and bivariate descriptive analysis was applied. Statistical significance was set at p < 0.05 in all cases. Results: 159 professionals participated (mean age 39.51 years ± 10.25, with 13.96 years ± 10.79 of professional experience) 54.7% possessed experience in palliative care and 64.2% educational background (mainly basic education). The mean percentage of hits on the quiz was 54%, with statistically significant differences in function of the participants’ education and experience in palliative care. Conclusions: although the participants show sufficient knowledge on palliative care, they would benefit from a specific training program, in function of the mistaken concepts identified through the quiz, which showed to be a useful tool to diagnose professionals’ educational needs in palliative care

Knowledge and Attitudes towards Palliative Care : Validation of the Spanish Version of Questionnaire on Palliative Care for Advanced Dementia

Background: Palliative care is essential in the care of people with advanced dementia, due to the increasing number of patients requiring care in the final stages of life. Nurses need to acquire specific knowledge and skills to provide quality palliative care. The questionnaire on Palliative Care for Advanced Dementia (qPAD) is useful for assessing knowledge and attitudes toward palliative care, but its adaptation to the Spanish language and analysis of its effectiveness and usefulness for the Spanish culture is lacking. Objective: To report on the Spanish language adaptation and psychometric analysis of the qPAD. Methods: The Questionnaire on Palliative Care for Advanced Dementia Spanish version (qPAD-SV) was obtained from a process that included translation, back-translation, comparison with other language versions, expert review, and pilot study. Content validity, criterion validity, and reliability of the questionnaire were analyzed. The difficulty and discrimination indices of items composing the knowledge subscale were also calculated. Results: Adequate content validity index obtained after the analysis of qPAD-SV by a heterogeneous group of experts was found (overall CVI = 0.96; 0.95 for the Knowledge subscale and 0.99 for the Attitudes subscale). Significant correlations with the Palliative Care Knowledge test (rho = 0.368, p < 0.001) and Self-Efficacy in Palliative Care Scale (rho = 0.621, p < 0.001) show an adequate criterion validity. Cronbach's alpha coefficients for the Knowledge subscale (0.60) and the Attitudes subscale (0.91) supported the reliability of the qPAD-SV. The questionnaire had an overall difficulty index of 0.71, with three items that could be considered difficult or very difficult, and eleven items that could be considered very easy. Discussion: Although it shows internal consistency, validity, and difficulty indices similar to those obtained by qPAD versions in other languages, a reformulation of the items with lower content validity or discrimination indices and those that show difficulties in their comprehension is an aspect to be taken into account to improve this tool. Conclusions: The qPAD-SV is a useful instrument in Spanish to measure the knowledge of Spanish nurses in palliative care and is suitable for international comparisons

Spanish Version of the Scale 'Eventos Adversos Associados às Práticas de Enfermagem' (EAAPE): Validation in Nursing Students

Healthcare carried out by different health professionals, including nurses, implies the possible appearance of adverse events that affect the safety of the patient and may cause damage to the patient. In clinical practice, it is necessary to have measurement instruments that allow for the evaluation of the presence of these types of events in order to prevent them. This study aims to validate the 'Eventos adversos associados às práticas de enfermagem' (EAAPE) scale in Spanish and evaluate its reliability. The validation was carried out through a cross-sectional study with a sample of 337 nursing students from the University of Valencia recruited during the 2018-19 academic year. An exploratory factor analysis was carried out using principal components and varimax rotation. The factor analysis extracted two factors that explained 32.10% of the total variance. Factor 1 explains 22.19% and refers to the 'adverse results' of clinical practice (29 items), and factor 2 explains 9.62% and refers to 'preventive practices' (24 items). Both factors presented high reliability (Cronbach's alpha 0.902 and 0.905, respectively). The Spanish version of the EAAPE is valid and reliable for measuring the perception of adverse events associated with nursing practice and the presence of prevention measures

Self-Perception of Dependence as an Indicator of Smartphone Addiction¿Establishment of a Cutoff Point in the SPAI-Spain Inventory.

Background: In recent years, the abusive use of the smartphone has reached a situation that could be considered pathological. In this sense, different instruments to assess this problematic use or addiction to the smartphone are used. One of these instruments is the Smartphone Addition Inventory (SPAI), which has been validated in the Spanish language (SPAI-Spain). The main difficulty of these scales is to establish a cut-off point that determines such mobile addiction. On the other hand, self-perception was used in different addictions as a predictor of the problem. Aim: The objective of this study was to establish the cut-off point in the scores of the SPAI-Spain, using as a reference the self-perception of addiction values. Methods: A receiver operating characteristics (ROC) analysis was carried out, establishing as the cut-off point the one that presented a higher value of Youden J, indicative of its sensitivity and specificity. Results: 2958 participants from the university community completed the SPAI-Spain questionnaire. Differences in SPAI-Spain scores were found among age groups and gender, even though not all of them were statistically significant. When using the self-perception of smartphone addiction as the benchmark value, a score of 44 was established as the cutting point of the SPAI-Spain questionnaire, with a Youden J corresponding to 0.416. Conclusions: The implementation of a cut-off point of the SPAI-Spain questionnaire makes it an instrument that allows early identification of those individuals at risk of addiction, as well as the establishment of preventive and/or intervention measure

Knowledge about Palliative Care and Attitudes toward Care of the Dying among Primary Care Nurses in Spain

Objective: To analyze the knowledge in palliative care and the attitudes toward caring for the dying of nurses who carry out their professional activity in primary care in Spain. Design: A cross-sectional descriptive observational study was carried out among Spanish primary care centers. Participants: A total of 244 nurses who had completed their primary care work and agreed to participate in this study were included. Main measurements: The level of knowledge in palliative care was analyzed using the PCQN-SV scale, and attitudes toward care of the dying were measured with the FATCOD-S scale, both of which are instruments that are validated in Spain. Results: Regarding the level of knowledge in palliative care, at a global level, the results revealed that 60% of the answers in the PCQN-SV were correct, with different results for each of the three subscales that compose it. When analyzing the attitudes of primary care nurses toward the care of the dying, an average of 132.21 out of 150 was obtained, representing a positive attitude. On the other hand, when analyzing these results in terms of knowledge and attitudes according to the population's characteristics, we see that participants with both experience and training in palliative care present a better level of knowledge and a higher score regarding their attitudes toward care of the dying. However, the differences are only significant regarding the level of knowledge in palliative care. When analyzing the data from the two scales together, it is noteworthy that the participants with the most positive attitudes (highest scores on the FATCOD-S) also have the highest percentages of correct answers on the PCQN-SV. Keywords: palliative care; knowledge; primary care; nursing; care of the dyin