Elaboración de un test para evaluar competencias prácticas de estudiantes de enfermería en reanimación cardiopulmonar avanzada

[SPA]En una parada cardiorrespiratoria existe un riesgo vital para el paciente, y el enfermero que se enfrente a ella debe tener una formación sólida en su manejo. La simulación de casos clínicos es una metodología docente eficaz en la enseñanza de habilidades prácticas como la Reanimación Cardiopulmonar Avanzada (RCP-A). Sin embargo la evaluación de competencias prácticas es compleja por la dificultad de evaluar una actividad mientras se ejecuta y por la posible variabilidad en los criterios de evaluación del profesor. Objetivo: Elaborar un test de evaluación de compentencias prácticas de estudiantes de enfermería en RCP-A para su utilización en entornos de aprendizaje de simulación. Método: Diseño para la validación de constructo, contenido y validez facial de un test. Primera fase: búsqueda en las principales bases de datos biomédicas de artículos que evaluaran la realización práctica de la RCP. Tras el ánalisis de los instrumentos hallados se elaboró una primera versión con 34 ítems. Segunda fase: revisión, modificación de ítems y elaboración del test definitivo por consenso entre expertos en la enseñanza de RCP (6), y en el diseño y elaboración de cuestionarios (2). Resultados: El test consta de 51 ítems agrupados en 8 dimensiones con 4 posibles respuestas: 4) Correcta, 3) Parcialmente correcta, 2) Incorrecta y 1) No realizada; además presenta una descripción de los criterios de evaluación de cada item. Conclusiones: El test ha sido elaborado a partir de estudios anteriores, siguiendo los criterios aprobados por el European Resuscitation Council en 2010 y por consenso de expertos. Ofrece pruebas suficientes de validez de constructo, contenido y facial. En un segundo estudio se comprobará su fiabilidad mediante pruebas test-retest y consistencia inter e 1712 intra-evaluador, propiedades de uso y apliación del mismo. [ENG]There is a vital risk for a patient after suffering a cardio respiratory arrest. To manage and solve this situation nurses should have a strong education in this area. Clinical case simulation is an effective teaching methodology to learn practical skills in Advanced Cardio Pulmonary Resuscitation (A-CPR). Nevertheless the evaluation of practical competences has high difficulties because of the complexity to evaluate an activity during its performance and the possible variability of the teacher evaluation criteria. Objective: To create a practical competences evaluation test in A-CPR for nursing students to be used in simulation teaching environments. Method: The creation of this test has a design to demonstrate construct, content and facial validity. First phase: bibliographic research in the main biomedical data bases to find articles evaluating A-CPR practical training. After analyzing the instrument found a first version of the questionnaire was elaborate with 34 items. Second phase: a group of 6 experts in teaching A-CPR and 2 experts in questionnaire elaboration made a item revision and modification obtaining the definitive test. Results: The test has 51 items grouped in 8 dimensions with 4 possible answers: 4) correct, 3) partially correct, 2) wrong, 1)Not done. Conclusions: This test has been created from previous studies, following the European Resuscitation Council 2010 criteria and experts consensus. It offers enough construct, content and facial validity proofs. In later studies the reliability of the questionnaire will be test with the test-retest proofs, the inter and intraobserver consistency and its use and application properties.Campus Mare Nostrum, Universidad Politécnica de Cartagena, Universidad de Murcia, Región de Murci

Social Determinants of Health, the Family, and Children’s Personal Hygiene: A Comparative Study

Habits of personal hygiene are mostly acquired during childhood, and are, therefore, influenced by one’s family. Poor hygiene habits are a risk factor for preventable disease and social rejection. Social Determinants of Health (SDH) consist of contextual factors, structural mechanisms, and the individual’s socioeconomic position, which, via intermediary determinants, result in inequities of health and well–being. Dysfunctional family situations may, therefore, be generated by an unequal distribution of factors determining SDH. Little attention has been paid to the influence of the family on personal hygiene and the perception of social rejection in children. We designed a study to examine differences in personal hygiene and in the perception of social rejection between children in reception centers and children living in a family setting. A validated questionnaire on children’s personal hygiene habits was completed by 51 children in reception centers and 454 children in normal families. Hygiene habits were more deficient among the children in reception centers than among the other children in all dimensions studied. Deficient hygiene habits were observed in the offspring of families affected by the main features of social inequality, who were more likely to perceive social rejection for this reason and less likely to consider their family as the greatest influence on their personal hygiene practices

Experiences and Attitudes of People with HIV/AIDS: A Systematic Review of Qualitative Studies

The aim of this article was to explore the experiences and attitudes of people with HIV/AIDS. A systematic review of qualitative studies was carried out. Twenty-seven articles were included, with sample sizes ranging from 3 to 78. Articles from North America, South America, Central America, Europe, and Africa were included. Five topics emerged from the synthesis: feelings about the diagnosis of HIV/AIDS; stigma and HIV/AIDS; changes in sexual behavior after becoming infected; living with the virus; and pregnancy and motherhood in seropositive women. The moment of diagnosis is of vital importance for these people due to feelings such as disappointment, sadness, fear, despair, lack of awareness, and pain. Social support is highly valued among these people and is linked to an improvement in these peoples’ quality of life. Different kinds of stigma accompany people with HIV/AIDS throughout their life, like social stigma, self-stigma, and health professionals’ stigma. Seropositive women who decide to become mothers can feel frustration because they cannot breastfeed. Spirituality helps some people to deal with the fact of being a virus or disease carrier

Perceptions about the Self-Learning Methodology in Simulated Environments in Nursing Students: A Mixed Study

The self-learning methodology in simulated environments (MAES©) is an active method of education. The aim of this study was to analyze the perceptions and opinions of undergraduate and graduate nursing students about the self-learning methodology in simulated environments. A mixed, cross-sectional, descriptive study based on a survey tool made ad hoc (quantitative approach) and an open questionnaire (qualitative approach) was carried out. A sample of 149 undergraduate and 25 postgraduate nursing students were tested. The score was high for all the variables of the questionnaire analyzed: for perception of simulation performance, M = 73.5 (SD = 14.5), for motivation, M = 23.9 (SD = 5.9), for the opinion about facilitators, M = 25.9 (SD = 4.5), and for the promotion of team work, M = 16.9 (SD = 3.4). Five dimensions were identified and evaluated in the qualitative research. The students were pleased with MAES© and had a positive perception, since they considered that MAES© increased their learning

Nurses' sleep quality, work environment and quality of care in the Spanish National Health System: observational study among different shifts

OBJECTIVE: The main objective of this study was to determine the relationship between the characteristics of nurses' work environments in hospitals in the Spanish National Health System (SNHS) with nurse reported quality of care, and how care was provided by using different shifts schemes. The study also examined the relationship between job satisfaction, burnout, sleep quality and daytime drowsiness of nurses and shift work. METHODS: This was a multicentre, observational, descriptive, cross-sectional study, centred on a self-administered questionnaire. The study was conducted in seven SNHS hospitals of different sizes. We recruited 635 registered nurses who worked on day, night and rotational shifts on surgical, medical and critical care units. Their average age was 41.1 years, their average work experience was 16.4 years and 90% worked full time. A descriptive and bivariate analysis was carried out to study the relationship between work environment, quality and safety care, and sleep quality of nurses working different shift patterns. RESULTS: 65.4% (410) of nurses worked on a rotating shift. The Practice Environment Scale of the Nursing Work Index classification ranked 20% (95) as favourable, showing differences in nurse manager ability, leadership and support between shifts (p=0.003). 46.6% (286) were sure that patients could manage their self-care after discharge, but there were differences between shifts (p=0.035). 33.1% (201) agreed with information being lost in the shift change, showing differences between shifts (p=0.002). The Pittsburgh Sleep Quality Index reflected an average of 6.8 (SD 3.39), with differences between shifts (p=0.017). CONCLUSIONS: Nursing requires shift work, and the results showed that the rotating shift was the most common. Rotating shift nurses reported worse perception in organisational and work environmental factors. Rotating and night shift nurses were less confident about patients' competence of self-care after discharge. The most common nursing care omissions reported were related to nursing care plans. For the Global Sleep Quality score, difference were found between day and night shift workers.This study was carried out as part of a project entitled ‘Functioning of the circadian system, working environment, and the organisation of nursing care of hospitals of the National Health System’, financed by the Spanish Health Research Fund (PI 11/00646, Health Ministry), the Ministry of Science and Innovation (SAF2013-49132-C2-1-R) and the Institute of Health Carlos III (RETICEF, RD12/0043/0011, RD12/0043/0006). The project was approved by the Spanish Health Research Fund (Fondo de Investigaciones Sanitarias PI11/00646).S

Evidence-Based Practice competency and associated factors among Primary Care nurses in Spain

©2021. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/ This document is the Published version of a Published Work that appeared in final form in Atención Primaria. To access the final edited and published work see https://doi.org/10.1016/j.aprim.2021.102050Objetivo: Conocer el nivel de competencia en Práctica Basada en la Evidencia (PBE) de las enfermeras de Atención Primaria (AP) en Espana˜ y analizar los factores asociados. Diseno: ˜ Estudio transversal de carácter nacional, realizado en enero-marzo de 2020. Emplazamiento: AP en Espana. ˜ Participantes: Setecientas ochenta enfermeras de AP en activo en el Sistema Nacional de Salud con experiencia profesional mínima de un ano. ˜ Mediciones principales: 1) Variables sociodemográficas, profesionales y de acceso a infor mación científica, y 2) variable de resultado: competencia en PBE (actitud, conocimientos, habilidades y utilización), evaluada mediante el cuestionario EBP-COQ Prof©. Se realizaron análisis bivariados y multivariados mediante regresión lineal. Resultados: La puntuación media en el nivel de competencia en PBE de las enfermeras de AP fue de 131,5 (desviación típica [DT] 17,0). Por dimensiones: actitud 36,8 (DT 3,6); conocimien tos 38,2 (DT 8,9); habilidades 23,0 (DT 3,5) y utilización 33,3 (DT 6,1). Leer más de 3 artículos en el último mes es la variable que tiene más influencia sobre todas las dimensiones del EBP COQ Prof©, seguida de la formación en PBE (más de 150 h) y la tutorización de alumnos de Enfermería. El nivel educativo (máster, especialista y doctorado) se asocia con las dimensio nes conocimientos y habilidades, mientras que trabajar en un centro BPSO® se asocia con la utilización de la PBE Conclusiones: Estos hallazgos pueden orientar a los gestores en los servicios de AP a planificar estrategias que mejoren el nivel de competencia en PBE de las enfermeras, dirigidas princi palmente a lograr una aplicación real en la práctica clínica. No obstante, se hace necesario considerar el posible impacto del sesgo de selección en los resultados.Objective: To describe the Evidence-Based Practice (EBP) competency level in Primary Care (PC) nurses in Spain and to determine the associated factors. Design: Cross-sectional, national survey design, carried out between January and March 2020. Setting: PC in Spain. Participants: Seven hundred eighty PC active nurses in the National Health Service with at least one year of professional experience. Main measurements: (1) Sociodemographic, professional and access to scientific information variables; (2) outcome variable: EBP competency (attitude, knowledge, skills and utilization) assessed through the EBP-COQ Prof© questionnaire. Bivariate and multiple lineal regression analyses were carried out. Results: The mean score for the EBP competency of the PC nurses was 131.5 (standard deviation [SD] 17.0), according to dimensions: attitude 36.8 (SD 3.6); knowledge 38.2 (SD 8.9); skills 23.0 (SD 3.5); and utilization 33.3 (SD 6.1). The number of articles read in the last month has showed the most influence on all the EBP-COQ Prof© dimensions, followed by EBP training (more than 150 h) and nursing students mentoring. The education level (master, specialist and doctorate) is associated with knowledge and skills dimensions, meanwhile belonging to a BPSO® center is associated with the EBP utilization. Conclusions: These findings can guide PC service managers to plan strategies that improve the EBP competency level of the nurses, aimed mainly at achieving real application in clinical practice. However, it is necessary to consider the possible impact of selection bias on the results

Long-Term Dynamic in Nutrients, Chlorophyll a, and Water Quality Parameters in a Coastal Lagoon During a Process of Eutrophication for Decades, a Sudden Break and a Relatively Rapid Recovery

Coastal lagoons are considered among the marine habitats with the highest biological productivity, and support a great variety of human activities and pressures that make them especially vulnerable to trophic imbalances. While dystrophic crises are common in many lagoons, others like the Mar Menor show homeostatic mechanisms, high resilience, and clear waters. This paper analyses the water column descriptors dynamic during the last 22 years in this coastal lagoon, in the context of a eutrophication process produced by an increase in nutrient inputs, mainly derived from agriculture. Despite water column nitrate concentration increased by one order of magnitude, the lagoon maintained homeostatic regulation for two decades, keeping the water transparency and relatively low levels of nutrients and chlorophyll a (Prebreak phase), followed by a sudden change of state in 2016 with an abrupt increase in average nutrients and chlorophyll a concentration and loss of water transparency (Break phase), and a relatively rapid recovery after the reduction of nutrient discharges (Recovery phase). The activation of the regulation mechanisms seems to manifest through an ammonium production in the water column, as a consequence of the activity in the trophic web. The low correlation between chlorophyll a and nutrients concentration, mainly at small spatio-temporal scales, is in disagreement with eutrophication traditional models, and suggests a rapid response of primary producers to nutrient inputs and a zooplankton control in the short-term, which in turn is controlled by the rest of the trophic web components. Homeostatic properties that in the Mar Menor lagoon have provided resistance to eutrophication are based on several mechanisms: channeling its production toward the benthic system (maintaining high biomasses of primary producers, filter feeders, and detritivores), a top-down control of the pelagic trophic web exerted by ichthyoplankton and jellyfish, and exporting surplus production outside the system. Resilience of the system would be based on the high turnover in the species composition related to the restricted connectivity to the sea, the spatio-temporal variability of the environmental conditions, and the multiplicity of spatial–temporal scales involved in lagoon processes. TRIX index was sensitive to the trophic and water quality changes. However, in our study, its current score does not allow to anticipate or alert the eutrophication risk and the trophic breakpoint of the system

Cross-cultural adaptation and psychometric validation of the Vietnamese version of the evidence-based practice competency questionnaire for registered nurses (EBP-COQ Prof©)

Background & Aim: Establishing strategies to enhance evidence-based practice (EBP) requires a reliable instrument for assessing EBP competency. This study focused on translating and validating the Evidence-Based Practice Competency Questionnaire for Registered Nurses (EBP-COQ Prof©) in the Vietnamese context. Methods & Materials: Through a methodological approach, this study performed cross-cultural adaptation and psychometric validation. The study involved 372 nurses selected through convenience sampling. Content validity was established using the Content Validity Index for Items (I-CVI) and the Content Validity Index for Scales (S-CVI). Construct validity was assessed via exploratory (EFA) and confirmatory factor analysis (CFA). Reliability was determined using Cronbach's alpha and the intra-class correlation coefficient (ICC). Criterion validity was examined by comparing EBP-COQ Prof© competency between nurses with and without prior EBP education. Results: The Vietnamese version of EBP-COQ Prof© maintained consistency with the original version following cross-cultural adaptation. Content validity was confirmed with I-CVI> 0.78 and S-CVI/AVE= 0.97. EFA and CFA revealed consistent components with the original version: attitude (8 items), knowledge (11 items), skills (6 items), and utilization (10 items). Cronbach's alpha values were high: attitudes (0.965), knowledge (0.962), skills (0.909), and utilization (0.926). ICC values were also significant: attitudes (0.754), knowledge (0.895), skills (0.823), and utilization (0.966). Nurses with prior EBP education demonstrated higher EBP-COQ Prof© competency. Conclusion: The translated and validated EBP-COQ Prof© provides a robust tool for assessing EBP competency among Vietnamese nurses. Its reliability, validity, and sensitivity to educational effects underscore its potential for promoting EBP in nursing

Mar Menor: una laguna singular y sensible. Evaluación científica de su estado.

Este libro recopila las aportaciones que equipos de investigación de la Universidad de Murcia, Universidad Politécnica de Cartagena, Instituto Geológico-Minero de España, Universidad de Alicante, el Instituto Español de Oceanografía y otros organismos hicieron en las Jornadas Científicas del Mar Menor, celebradas en diciembre de 2014.La información recogida en este libro se estructura en dos grandes bloques, uno de Biología y Ecología del Mar Menor (capítulos 1 al 8) y otro de Condiciones fisicoquímicas e impacto de actividades humanas en la laguna (capítulos 9 al 14). El primer bloque resume buena parte de los estudios ecológicos realizados en el Mar Menor, que han servido para mejorar su conocimiento y también para cambiar antiguas asunciones sobre la naturaleza y el funcionamiento de estos ecosistemas lagunares (Capítulo 1). El segundo capítulo muestra que esta laguna alberga en zonas someras de su perímetro hábitats fundamentales para mantener y conservar tanto especies migratorias como residentes, que es necesario conocer para paliar el impacto de las actividades humanas que les afectan. En este sentido la reducción de la carga de nutrientes y contaminantes orgánicos e inorgánicos que fluyen hacia el Mar Menor puede ayudar a preservar la laguna en mejores condiciones, bien sea tratando las escorrentías (plantas de tratamiento, humedales artificiales u otras técnicas) y recuperar este agua para uso agrícola o evitar su descarga en la laguna (Capítulo 3). Estas actuaciones serán clave para la conservación de especies emblemáticas como el caballito de mar (Capítulo 4) y reducir el impacto de las proliferaciones masivas de medusas que se producen en la laguna desde 1993 (Capítulo 5). En este mismo sentido los cambios acaecidos en la laguna han favorecido la incursión de invertebrados marinos alóctonos (Capítulo 6) y han afectado a la respuesta de la dinámica poblacional de las aves acuáticas a distintas escalas (Capítulo 7). Para completar este bloque se ofrece una perspectiva histórica de la importancia que ha tenido la investigación sobre acuicultura realizada en esta laguna, que ha servido de base para su gran desarrollo actual (Capítulo 8). El segundo bloque se inicia con una evaluación del origen y evolución del Mar Menor desde el punto de vista geológico, y evidencia su vulnerabilidad ante el deterioro que puede sufrir la desaparición de la barrera de cierre y/o su colmatación (Capítulo 9). En el Capítulo 10 se describe la relevancia que tiene la interacción de los acuíferos del Campo de Cartagena con la laguna, que se produce no sólo a nivel superficial sino también subterráneo. Esta interacción permite el acceso de nutrientes a la laguna, a pesar de la cierta capacidad de depuración de los humedales que le circundan, y también de metales traza por los aportes de residuos mineros (Capítulo 11). De hecho los metales traza están presentes en los sedimentos de la laguna, y su distribución se ha caracterizado en la columna sedimentaria relacionándola con la granulometría y el contenido de materia orgánica del sedimento (Capítulo 12). Posteriormente se describe la entrada de diversos contaminantes orgánicos, incluyendo pesticidas y fármacos a través de la rambla del Albujón, y su distribución estacional en agua y sedimento de la laguna (Capítulo 13). Este segundo bloque finaliza con el Capítulo 14 en el que se describe la bioacumulación de hidrocarburos aromáticos policíclicos, pesticidas y fármacos en moluscos y peces del Mar Menor, así como los efectos biológicos que la carga contaminante que accede a través de la rambla del Albujón produce en los organismos que allí habitan. El libro concluye con un breve epílogo redactado por los editores de este libro