End-of-Life Care: A Paradigm of Nursing Knowledge

Death is the human experience which best exemplifies the limits of science and technology in their fight against nature. In Western societies, family care of the dying becomes substituted by health professionals and institutions which in turn convert death into anotherproductive process of modern economic life. The phenomenon of death, understood more as failure of life rather than a natural limitation of it, has generated not only a technical culture focused on prolonging life but also a practice culture which is a source of knowledge for health sciences. Man does not control death; we know more about it than ever, but still lack the essential knowledge necessary to shed light on its meaning. As such, it is the isolation and solitude of the dying person, together with the taxonomic frenzy marking procedures and behaviors, which characterize the process

Cos y Cnido. Esencia Hipocrática en la práctica profesional enfermera

El desarrollo de la filosofia y las ciencias humanas en la Greda del siglo V a. de C. supuso en términos de salud un avance cualitativo fundamental, desde un modelo mitológico primigenio, hasta la condición de disciplina clentífica que se mantiene hasta nuestros días. Este artículo analiza la aportación de las dos principales escuelas de salud de la Grecia Clásica, COS y CNIDO, sobre el concepto modemo del cuidado y las bases actuales de la disciplina enfermera. Los autores concluyen, que al contrario de la Escuela de CNIDO, el pensamiento hipocrático de la Escuela de COS ha contribuido sustancialmente no solo a la construcción de la medicina modema, sino también a la Ciencia De los Cuidados Enfermeros

Transferencia de pacientes de cuidados paliativos desde el hospital hasta atención primaria: un estudio cualitativo = Transferring palliative-care patients from hospital to community care: a qualitative study

Aim: To know the experience of case-manager nurses with regard to transferring palliative-care patients from the hospital to their homes. Design: Qualitative phenomenological study carried out in 2014 2015. Setting: Poniente and Almería health districts, which referral hospitals are Poniente Hospital and Torrecárdenas Hospital, respectively. Participants: A purposive sample comprised of 12 case-manager nurses was recruited from the aforementioned setting. Method: Theoretical data saturation was achieved after performing 7 in-depth individual interviews and 1 focus group. Data analysis was performed following Colaizzi’s method. Results: Three themes emerged: (1) ‘Case-management nursing as a quality, patient-centred service’ (2) ‘Failures of the information systems’, with the subthemes ‘‘patients’’ insufficient and inadequate previous information’’ and ‘‘ineffective between levels communication channels for advanced nursing’’; (3) ‘Deficiencies in discharge planning’, with the subthemes ‘‘deficient management of resources on admission’’, ‘‘uncertainty about discharge’’ and ‘‘insufficient human resources to coordinate the transfer’’. Conclusions: Case-manager nurses consider themselves a good-quality service. However, they think there are issues with coordination, information and discharge planning of palliative patients from hospital. It would be useful to review the communication pathways of both care and discharge reports, so that resources needed by palliative patients are effectively managed at the point of being transferred home

Factor de impacto de revistas: ¿amenaza u oportunidad?

Este artículo contiene un resumen de las críticas a la utilización del factor de impacto (FI) como indicador de calidad de las publicaciones y de producción de investigadores. Tales críticas alcanzan a los autores que intentan publicar en revistas con FI, argumentando que así renuncian a la propia identidad, primando su currículum sobre la utilidad de su investigación. En oposición a esas críticas se afirma que unos criterios de evaluación exigentes sirven de estímulo para la internacionalización del sistema científico. Existe consenso en la comunidad académica sobre las imperfecciones del FI y su aceptación como recurso válido y necesario para la evaluación científica, como también en que el debate identitario contribuye poco a resolver la invisibilidad internacional de la investigación de enfermería en español. Se esbozan propuestas que apuestan por aprovechar las fortalezas para incrementar y visibilizar dicha investigación, desarrollar estrategias para incluir y mantener a las revistas en español en el Journal Citation Reports (JCR), fomentar la formación y cooperación interdisciplinar, promover la publicación de investigaciones desarrolladas en los programas de posgrado, y reclamar la apuesta editorial por la indexación de sus revistas en el JCR. Se concluye que, aunque difícil, es posible aumentar la visibilidad de la producción científica de enfermería en español

Young Women’s Attitudes and Concerns Regarding Pornography and Their Sexual Experiences: A Qualitative Approach

Funding: This research received no external funding. The translation of this manuscript was sup- ported by the Research Group CTS-990, University of Jaén (Spain)This study explores female university students’ attitudes toward and concerns about pornography, based on their experience watching it and on sexual encounters with men. It used a qualitative descriptive design. Individual semi-structured interviews were conducted with 22 participants between March and April 2020. Thematic data analysis was performed using COREQ reporting guidelines. Three themes emerged from the data: (1) the sexual learning process, (2) the role of pornography in women’s sexuality, and (3) sexual experiences. Participants reported how they learned about sexuality and how pornography influenced sexual experiences. Self-esteem issues and societal norms regarding hair removal and difficulty saying “no” to unwanted or humiliating sexual practices were found. The young women were not comfortable with women’s representations in mainstream pornography. They blamed pornography for negative sexual experiences and claimed it influenced them and young men. Participants usually assumed submissive roles during sex and permitted aggressive sexual behaviors. The study reveals valuable information on how young women learn about sex and their difficulty in refusing unwanted sexual activities and even aggressive practices. Sexual education programs should include assertiveness training to improve sexual health, consent, and well-being

Efectos de un programa de enfermería de rehabilitación en la aptitud funcional de ancianos institucionalizados

A aptidão funcional é essencial à execução autónoma das atividades de vida diária. A aptidão funcional em idosos inclui vários componentes: força; treino aeróbico; flexibilidade; equilíbrio e composição corporal. Objetivos: Avaliar mudanças na aptidão funcional de idosos institucionalizados através de um programa de enfermagem de reabilitação baseado em exercício físico de moderada intensidade. Metodologia: Desenho pré-teste/pós-teste com grupo de controlo. O programa de intervenção incluiu 3 sessões semanais de 30 minutos cada, durante 6 meses. A aptidão funcional foi avaliada pela bateria de testes Functional Fitness Test (FFT) para idosos. O grupo de intervenção (GI) tinha 15 participantes e o grupo de controlo (GC) 10. Resultados: No GI (85,9 ± 6,1 anos) observámos um aumento significativo (p<0,05) da força de preensão manual; força de flexão do braço; mobilidade, agilidade/equilíbrio dinâmico e do equilíbrio unipodal. No GC (85,8 ± 4,6 anos) não se registaram alterações significativas em qualquer das componentes da aptidão funcional. Conclusão: Os resultados sugerem que os idosos do GI melhoraram a sua aptidão funcional

Newly Qualified Nurses’ Perception of Their Competency Achievement on Leaving University: A Qualitative Study

Thanks to all nurses, nursing students and independent researchers who voluntarily participated in this study.Background: After implementing the Tuning Educational Structures in Europe Project, numerous efforts have been made to define, establish, and evaluate nursing competences. The European Federation of Nurses Association played a key role in enacting the nursing competences included in Directive 2013/55/EU. Nevertheless, assessing competences remains elusive, and there is little research into nurses’ perceptions of the competency training provided by their universities. The purpose of the study was to explore the perceptions and experiences of newly qualified nurses about the competences they acquired during their university education. Methods: A qualitative research study was developed in a Spanish university. Twelve semi-structured interviews with newly qualified nurses were conducted, and two focus groups made up of twelve students were carried out in order to triangulate the results. Participants were recruited through email contact. Interviews focused on clinical training, theoretical content, and the reality of healthcare. Data was analyzed thematically. Results: Two main themes emerged: (1) improving theoretical content and (2) rethinking practical lessons and clinical training. A lack of knowledge about mental health, pharmacology, or critical care has been found; in addition, it was highlighted, among others, the need to improve communication skills in difficult and conflictive situations. Conclusions: Considering the participants’ perception of deficiency in some aspects of most of the competences established by the European Federation of Nurses Association, further research has been suggested to include other stakeholders’ views

Effects of two teaching interventions on nursing students’ acquisition of competence in ECG interpretation

Purpose: Nurse ability to recognise patient arrhythmias could contribute to preventing in-hospital cardiac arrest. Research suggests that nurses and nursing students lack competence in electrocardiogram (ECG) interpretation. The aim of this study was to compare the effects of two training strategies on nursing students’ acquisition of competence in ECG interpretation. Materials and methods: A controlled randomised trial with 98 nursing students. Divided in groups of 12–16, participants were randomly allocated to one of the following 3-h teaching intervention groups: 1) traditional instructor-led (TILG), and 2) flipped classroom (FCG). Participants’ competence in ECG interpretation was measured in terms of knowledge (%), skills (%) and self-efficacy (%) using a specifically designed and previously validated toolkit at pre-test and post-test. Two-way MANOVA explored the interaction effect between ‘teaching group’ and ‘time of assessment’ and its impact on participants’ competence. Within-group differences at pre-test and post-test were explored by carrying out paired t-tests. Between-group differences at pre- and post-test were examined by performing independent t-test analysis. Results: There was a statistically significant interaction effect between ‘teaching group’ and ‘time of assessment’ on participants’ competence in ECG interpretation (F(3,190) = 86.541, p = 0.001; Wilks’ Λ = 0.423). At pre-test, differences in knowledge (TILG = 35.12 ± 12.07; FCG = 35.66 ± 10.66), skills (TILG = 14.05 ± 10.37; FCG = 14.82 ± 14.14), self-efficacy (TILG = 46.22 ± 23.78; FCG = 40.01 ± 21.77) and all other variables were non-significant (p > 0.05). At post-test, knowledge (TILG = 55.12 ± 14.16; FCG = 94.2 ± 7.31), skills (TILG = 36.90 ± 16.45; FCG = 86.43 ± 14.32) and self-efficacy (TILG = 70.78 ± 14.55; FCG = 79.98 ± 10.35) had significantly improved, regardless of the training received (p < 0.05). Nonetheless, participants in the FCG scored significantly higher than participants in the TILG in knowledge, skills and self-efficacy (p < 0.05). Conclusion: Flipping the classroom for teaching ECG interpretation to nursing students may be more effective than using a traditional instructor-led approach in terms of immediate acquisition of competence in terms of knowledge, skills and self-efficacy. Further research on the effects of both teaching strategies on the retention of the competence will be undertaken

Development and psychometric evaluation of the basic electrocardiogram interpretation self-efficacy scale

Purpose: Research suggests that nurses and nursing students lack competence in basic electrocardiogram (ECG) interpretation. Self-efficacy is considered to be paramount in the development of one's competence. The aim of this study was to develop and psychometrically evaluate a scale to assess self-efficacy of nursing students in basic ECG interpretation. Materials and methods: Observational cross-sectional study with a convenience sample of 293 nursing students. The basic ECG interpretation self-efficacy scale (ECG-SES) was developed and psychometrically tested in terms of reliability (internal consistency and temporal stability) and validity (content, criterion and construct). The ECG-SES’ internal consistency was explored by calculating the Cronbach's alpha coefficient (α); its temporal stability was investigated by calculating the Pearson correlation coefficient (r) between the participants’ results on a test–retest separated by a 4-week interval. The content validity index of the items (I-CVI) and the scale (S-CVI) was calculated based on the reviews of a panel of 16 experts. Criterion validity was explored by correlating the participants’ results on the ECG-SES with their results on the New General Self-Efficacy Scale (NGSE). 1 Construct validity was investigated by performing Principal Component Analysis (PCA) and known-group analysis. Results: The excellent reliability of the ECG-SES was evidenced by its internal consistency (α = 0.98) and its temporal stability at the 4-week re-test (r = 0.81; p < 0.01). The ECG-SES’ content validity was also excellent (all items’ I-CVI = 0.94–1; S-CVI = 0.99). A strong, significant correlation between the NGSE and the ECG-SES (r = 0.70; p < 0.01) showed its criterion validity. Corroborating the ECG-SES’ construct validity, PCA revealed that all its items loaded on a single factor that explained 74.6% of the total variance found. Furthermore, known-groups analysis showed the ECG-SES’ ability to detect expected differences in self-efficacy between groups with different training experiences (p < 0.01). Conclusion: The ECG-SES showed excellent psychometric properties for measuring the self-efficacy of nursing students in basic ECG interpretation