Anàlisi de la competència cultural en infermeria: validació de l’instrument Cultural Competence Assessment

L’objectiu principal de la tesis va ser l’obtenció d’un instrument vàlid, i amb una consistència conceptual, que avalués el constructe de la competència cultural. A partir de la revisió dels diferents models teòrics i dels diferents instruments existents, es va escollir l’escala Cultural Competence Assessment de les autores Schim i Doorenbos (2003). L’anàlisi de l’estructura psicomètrica, la dimensionalitat i la categorització de les puntuacions van, ser alguns dels objectius específics relacionats amb l’adaptació i validació de l’escala. L’estudi es va desenvolupar en tres fases: en la primera, es va traduir i adaptar l’escala Cultural Competence Assessment al castellà; en la segona, es va validar l’escala a professionals de la salut a partir d’un estudi psicomètric; i la tercera part, es va realitzar un estudi transversal amb disseny ex post facto de la competència cultural en una mostra representativa de professionals d’infermera de la província de Tarragona. Aquesta darrera part, pren per objectiu analitzar l’aplicabilitat de l’escala, així com conèixer el desenvolupament de la competència cultural d’aquesta mostra, la qual cosa servirà per detectar les necessitats formatives. els resultats obtinguts, podem concloure que la CCA-S representa un instrument vàlid per avaluar la competència cultural. En aquest estudi em pogut comprovar la utilitat de la CCA-S en l’avaluació de la competència cultural en una mostra representativa de professionals de la infermeria. A més, ha resultat d’utilitat per descriure els elements que intervenen en el desenvolupament de la competència cultural com són una exposició a la diversitat cultural, un major coneixement cultural derivat de formació prèvia, tenir desig cultural i una coherència d’eficàcia en competència cultural. No obstant, en base als resultats obtinguts i les relacions establertes entre les diferents variables, es proposen línies futures de recerca per treballar i fomentar la competència cultural a partir d’estratègies d’investigació acció participativa.El objetivo principal de la tesis fue la obtención de un instrumento válido, y con una consistencia conceptual, que evaluara el constructo de la competencia cultural. A partir de la revisión de los diferentes modelos teóricos y de los diferentes instrumentos existentes, se escogió la escala Cultural Competence Assessment de las autoras Schimer y Doorenbos (2003). El análisis de la estructura psicométrica, la dimensionalidad y la categorización de las puntuaciones van, fueron algunos de los objetivos específicos relacionados con la adaptación y validación de la escala. El estudio se desarrolló en tres fases: en la primera, se tradujo y adaptar la escala Cultural Competence Assessment al castellano; en la segunda, se validó la escala a profesionales de la salud a partir de un estudio psicométrico; y la tercera parte, se realizó un estudio transversal con diseño ex post facto de la competencia cultural en una muestra representativa de profesionales de enfermera de la provincia de Tarragona. Esta última parte, toma por objetivo analizar la aplicabilidad de la escala, así como conocer el desarrollo de la competencia cultural de esta muestra, lo que servirá para detectar las necesidades formativas. los resultados obtenidos, podemos concluir que la CCA-S representa un instrumento válido para evaluar la competencia cultural. En este estudio hemos podido comprobar su utilidad en la evaluación de la competencia cultural en una muestra representativa de profesionales de la enfermería. Además, ha resultado de utilidad para describir los elementos que intervienen en el desarrollo de la competencia cultural como son una exposición a la diversidad cultural, un mayor conocimiento cultural derivado de formación previa, tener deseo cultural y una coherencia de eficacia en competencia cultural. No obstante, en base a los resultados obtenidos y las relaciones establecidas entre las diferentes variables, se proponen líneas futuras de investigación para trabajar y fomentar la competencia cultural a partir de estrategias de investigación acción participativa.The main objective of the thesis was the obtaining of a valid instrument, and with a conceptual consistency, that evaluated the construction of the cultural competition. Based on the review of the different theoretical models and the different existing instruments, the Cultural Competence Assessment scale was selected by authors Schim and Doorenbos (2003). The analysis of the psychometric structure, the dimensionality and the categorization of the scores go, being some of the specific objectives related to the adaptation and validation of the scale. The study was developed in three phases: in the first one, the Cultural Competence Assessment scale was translated and adapted to Spanish; In the second, the scale was validated to health professionals from a psychometric study; and the third part, a cross-sectional study with ex-post facto design of cultural competence was carried out in a representative sample of nursing professionals from the province of Tarragona. This last part, aims to analyze the applicability of the scale, as well as know the development of the cultural competence of this sample, which will serve to detect the training needs. the results obtained, we can conclude that the CCA-S represents a valid instrument for evaluating cultural competence. In this study I was able to verify its usefulness in the evaluation of cultural competence in a representative sample of nursing professionals. In addition, it has been useful in describing the elements that intervene in the development of cultural competence such as an exhibition on cultural diversity, a greater cultural knowledge derived from prior education, a cultural desire and a coherence of efficiency in competition cultural However, based on the results obtained and the relationships established between the different variables, future lines of research are proposed to work and foster cultural competence through participatory action research strategies

Eina d’ajuda a la presa de decisions compartides en anticoncepció: estudi qualitatiu per conèixer opinions i creences sobre els mètodes d’anticoncepció

Anticoncepció; Mètodes anticonceptius; Presa de decisionsAnticoncepción; Métodos anticonceptivos; Toma de decisionesContraception; Contraceptive methods; Decision makingEl present document és el resultat de l’anàlisi qualitativa que es va dur a terme entre novembre del 2019 i juliol del 2020 amb l’objectiu de conèixer les opinions que té la població sobre l’anticoncepció, i més específicament sobre quins aspectes influeixen en l’elecció del mètode anticonceptiu, què esperen les usuàries de les consultes d’anticoncepció, quin és el paper dels homes i com creuen els professionals que es poden millorar les consultes d’anticoncepció. En última instància, l’objectiu final és crear una eina web de decisions compartides que inclogui els mètodes hormonals i els mètodes no hormonals, com per exemple mètodes naturals, mètodes de barrera, mètodes irreversibles i el dispositiu intrauterí (DIU) de coure

A multi-centre, randomized, 3-month study to evaluate the efficacy of a smartphone app to increase caregiver's positive mental health

Background: To assess the effectiveness of a smartphone app-based intervention compared to a regular intervention of caregivers in primary health care institutions. The intervention is aimed at increasing positive mental health and decreasing caregiver's burden. Methods/design: Randomized and controlled trial with an experimental group and a control group. Subjects: 108 caregivers over 18, with a minimum of 4 months of experience as caregivers. Description of the intervention: an intervention with a smartphone app (n = 54) or a regular intervention for caregivers (n = 54). Each caregiver installs a smartphone app and uses it for 28 days. This app offers them a daily activity (Monday-Friday). These activities are related to the Decalogue of Positive Mental Health, which was designed ad hoc by a group of experts. The outcomes will be the score of caregiver burden, the positive mental health and participant satisfaction. These results will be assessed after the first, third and sixth month. Discussion: The results of this study will offer evidence of the effectiveness of an intervention using a free smartphone app. If its effectiveness is proven and the results are acceptable, this could lead to a rethinking of the intervention offered to caregivers in primary care

The effectiveness of a digital shared decision-making tool in hormonal contraception during clinical assessment: study protocol of a randomized controlled trial in Spain

Decision-making tools represent a paradigm shift in the relationship between the clinician and the user/patient. Some of their advantages include patient commitment, the promotion of preferences and values, and increased treatment adherence. This study protocol aims to assess the effectiveness of a decision-making tool in contraception (SHARECONTRACEPT) concerning: a) Improvement in counselling on hormonal contraception at the medical consultation, measured in terms of decreasing decisional conflict and improving knowledge of available contraceptive options; b) Improvement in adherence to treatment measured in terms of: persistence in the chosen treatment, compliance with dose or procedure of use, and ability to deal with incidents related to the use of the contraceptive method; and decreasing unwanted pregnancies and voluntary interruption of pregnancy. The SHARECONTRACEPT tool, developed by previous phases of this project, is available at: http://decisionscompartides.gencat.cat/en/decidir-sobre/anticoncepcio_hormonal/ METHODS/DESIGN: A longitudinal, prospective-type, randomized, controlled community clinical trial, carried out in the clinical contraceptive counselling units of 6 autonomous regions in Spain, with an experimental group and a control group. Description of the intervention: The health professionals participating will be randomly assigned to one of the two groups. Clinicians assigned to the experimental group will perform contraceptive counselling assisted by SHARECONTRACEPT, and those of the control group will follow the conventional contraceptive counselling provided in their clinical unit. It is planned to study 1708 users (control group n = 854 and intervention group n = 854), recruited from women who attend the consultations of the health professionals. The selected users will be followed up for one year. The data will be collected through ad-hoc questionnaires, and validated instruments for measuring decisional conflict and adherence to treatment.info:eu-repo/semantics/publishedVersio

Psychological Well-Being in Nursing Students: A Multicentric, Cross-Sectional Study

In addition to complying with strict academic standards, nursing students must acquire relevant knowledge and skills, and learn how to carry themselves in different and often stressful professional settings. These obligations could severely affect their mental health. The purpose of this study was to examine the mental health status of undergraduate nursing students and related factors. A total of 1368 nursing students from different universities in Spain and Chile were included in this study, which took place over the 2018-2019 academic year. We assessed their levels of stress related to specific learning methodologies and determined their mental health status using the General Health Questionnaire (GHQ-28). The results revealed that the more advanced the course was, the lower the total GHQ-28 score. The stress generated by different types of training activities had a significant effect on the total GHQ-28 score. These results suggest that nursing education could act as a protective factor against mental health disorders. Although a heavy academic workload could lead to higher levels of stress, overall, it seems that mental health is better in more advanced courses than in initial academic years

Anàlisi de la competència cultural en infermeria: validació de l’instrument Cultural Competence Assessment

L’objectiu principal de la tesis va ser l’obtenció d’un instrument vàlid, i amb una consistència conceptual, que avalués el constructe de la competència cultural. A partir de la revisió dels diferents models teòrics i dels diferents instruments existents, es va escollir l’escala Cultural Competence Assessment de les autores Schim i Doorenbos (2003). L’anàlisi de l’estructura psicomètrica, la dimensionalitat i la categorització de les puntuacions van, ser alguns dels objectius específics relacionats amb l’adaptació i validació de l’escala. L’estudi es va desenvolupar en tres fases: en la primera, es va traduir i adaptar l’escala Cultural Competence Assessment al castellà; en la segona, es va validar l’escala a professionals de la salut a partir d’un estudi psicomètric; i la tercera part, es va realitzar un estudi transversal amb disseny ex post facto de la competència cultural en una mostra representativa de professionals d’infermera de la província de Tarragona. Aquesta darrera part, pren per objectiu analitzar l’aplicabilitat de l’escala, així com conèixer el desenvolupament de la competència cultural d’aquesta mostra, la qual cosa servirà per detectar les necessitats formatives. els resultats obtinguts, podem concloure que la CCA-S representa un instrument vàlid per avaluar la competència cultural. En aquest estudi em pogut comprovar la utilitat de la CCA-S en l’avaluació de la competència cultural en una mostra representativa de professionals de la infermeria. A més, ha resultat d’utilitat per descriure els elements que intervenen en el desenvolupament de la competència cultural com són una exposició a la diversitat cultural, un major coneixement cultural derivat de formació prèvia, tenir desig cultural i una coherència d’eficàcia en competència cultural. No obstant, en base als resultats obtinguts i les relacions establertes entre les diferents variables, es proposen línies futures de recerca per treballar i fomentar la competència cultural a partir d’estratègies d’investigació acció participativa.El objetivo principal de la tesis fue la obtención de un instrumento válido, y con una consistencia conceptual, que evaluara el constructo de la competencia cultural. A partir de la revisión de los diferentes modelos teóricos y de los diferentes instrumentos existentes, se escogió la escala Cultural Competence Assessment de las autoras Schimer y Doorenbos (2003). El análisis de la estructura psicométrica, la dimensionalidad y la categorización de las puntuaciones van, fueron algunos de los objetivos específicos relacionados con la adaptación y validación de la escala. El estudio se desarrolló en tres fases: en la primera, se tradujo y adaptar la escala Cultural Competence Assessment al castellano; en la segunda, se validó la escala a profesionales de la salud a partir de un estudio psicométrico; y la tercera parte, se realizó un estudio transversal con diseño ex post facto de la competencia cultural en una muestra representativa de profesionales de enfermera de la provincia de Tarragona. Esta última parte, toma por objetivo analizar la aplicabilidad de la escala, así como conocer el desarrollo de la competencia cultural de esta muestra, lo que servirá para detectar las necesidades formativas. los resultados obtenidos, podemos concluir que la CCA-S representa un instrumento válido para evaluar la competencia cultural. En este estudio hemos podido comprobar su utilidad en la evaluación de la competencia cultural en una muestra representativa de profesionales de la enfermería. Además, ha resultado de utilidad para describir los elementos que intervienen en el desarrollo de la competencia cultural como son una exposición a la diversidad cultural, un mayor conocimiento cultural derivado de formación previa, tener deseo cultural y una coherencia de eficacia en competencia cultural. No obstante, en base a los resultados obtenidos y las relaciones establecidas entre las diferentes variables, se proponen líneas futuras de investigación para trabajar y fomentar la competencia cultural a partir de estrategias de investigación acción participativa.The main objective of the thesis was the obtaining of a valid instrument, and with a conceptual consistency, that evaluated the construction of the cultural competition. Based on the review of the different theoretical models and the different existing instruments, the Cultural Competence Assessment scale was selected by authors Schim and Doorenbos (2003). The analysis of the psychometric structure, the dimensionality and the categorization of the scores go, being some of the specific objectives related to the adaptation and validation of the scale. The study was developed in three phases: in the first one, the Cultural Competence Assessment scale was translated and adapted to Spanish; In the second, the scale was validated to health professionals from a psychometric study; and the third part, a cross-sectional study with ex-post facto design of cultural competence was carried out in a representative sample of nursing professionals from the province of Tarragona. This last part, aims to analyze the applicability of the scale, as well as know the development of the cultural competence of this sample, which will serve to detect the training needs. the results obtained, we can conclude that the CCA-S represents a valid instrument for evaluating cultural competence. In this study I was able to verify its usefulness in the evaluation of cultural competence in a representative sample of nursing professionals. In addition, it has been useful in describing the elements that intervene in the development of cultural competence such as an exhibition on cultural diversity, a greater cultural knowledge derived from prior education, a cultural desire and a coherence of efficiency in competition cultural However, based on the results obtained and the relationships established between the different variables, future lines of research are proposed to work and foster cultural competence through participatory action research strategies

Eina d’ajuda a la presa de decisions compartides en anticoncepció: estudi qualitatiu per conèixer opinions i creences sobre els mètodes d’anticoncepció

Anticoncepció; Mètodes anticonceptius; Presa de decisionsAnticoncepción; Métodos anticonceptivos; Toma de decisionesContraception; Contraceptive methods; Decision makingEl present document és el resultat de l’anàlisi qualitativa que es va dur a terme entre novembre del 2019 i juliol del 2020 amb l’objectiu de conèixer les opinions que té la població sobre l’anticoncepció, i més específicament sobre quins aspectes influeixen en l’elecció del mètode anticonceptiu, què esperen les usuàries de les consultes d’anticoncepció, quin és el paper dels homes i com creuen els professionals que es poden millorar les consultes d’anticoncepció. En última instància, l’objectiu final és crear una eina web de decisions compartides que inclogui els mètodes hormonals i els mètodes no hormonals, com per exemple mètodes naturals, mètodes de barrera, mètodes irreversibles i el dispositiu intrauterí (DIU) de coure

A method to calculate the personal impact of online exercises to improve the positive mental health of family caregivers of chronically ill patients

Background: taking care of chronic or long-term patients at home is an arduous task. Non-professional caregivers suffer the consequences of doing so, especially in terms of their mental health. Performing some simple activities through a mobile phone app may improve their mindset and consequently increase their positivity. However, each caregiver may need support in different aspects of positive mental health. In this paper, a method is defined to calculate the utility of a set of activities for a particular caregiver in order to personalize the intervention plan proposed in the app. Methods: based on the caregivers' answers to a questionnaire, a modular averaging method is used to calculate the personal level of competence in each positive mental health factor. A reward-penalty scoring procedure then assigns an overall impact value to each activity. Finally, the app ranks the activities using this impact value. Results: the results of this new personalization method are provided based on a pilot test conducted on 111 caregivers. The results indicate that a conjunctive average is appropriate at the first stage and that reward should be greater than penalty in the second stage. Conclusions: the method presented is able to personalize the intervention plan by determining the best order of carrying out the activities for each caregiver, with the aim of avoiding a high level of deterioration in any factor

A mobile app-based intervention program for caregivers to promote positive mental health: A randomized controlled trial

Background: While nonprofessional caregivers often experience a sense of fulfillment when they provide care, there is also a significant risk of emotional and physical burnout. Consequently, this can negatively affect both the caregiver and the person being cared for. Intervention programs can help empower nonprofessional caregivers of people with chronic diseases and develop solutions to decrease the physical and psychological consequences resulting from caregiving. However, most clinically tested intervention programs for nonprofessional caregivers require face-to-face training, and many caregivers encounter obstacles that hinder their participation in such programs. Consequently, it is necessary to design internet-based intervention programs for nonprofessional caregivers that address their needs and test the efficacy of the programs. Objective: The aim of this study was to evaluate the effectiveness of a smartphone app-based intervention program to increase positive mental health for nonprofessional caregivers. Methods: This study was a randomized controlled trial of 3 months' duration. A total of 152 caregivers over 18 years of age with a minimum of 4 months' experience as nonprofessional caregivers were recruited from primary health care institutions. Nonprofessional caregivers were randomized into two groups. In the intervention group, each caregiver installed a smartphone app and used it for 28 days. This app offered them daily activities that were based on 10 recommendations to promote positive mental health. The level of positive mental health, measured using the Positive Mental Health Questionnaire (PMHQ), and caregiver burden, measured using the 7-item short-form version of the Zarit Caregiver Burden Interview (ZBI-7), were the primary outcomes. Users' satisfaction was also measured. Results: In all, 113 caregivers completed the study. After the first month of the intervention, only one factor of the PMHQ, F1-Personal satisfaction, showed a significant difference between the groups, but it was not clinically relevant (0.96; P=.03). However, the intervention group obtained a higher mean change for the overall PMHQ score (mean change between groups: 1.40; P=.24). The results after the third month of the intervention showed an increment of PMHQ scores. The mean difference of change in the PMHQ score showed a significant difference between the groups (11.43; P<.001; d=0.82). Significant changes were reported in 5 of the 6 factors, especially F5-Problem solving and self-actualization (5.69; P<.001; d=0.71), F2-Prosocial attitude (2.47; P<.001; d=1.18), and F3-Self-control (0.76; P=.03; d=0.50). The results of the ZBI-7 showed a decrease in caregiver burden in the intervention group, although the results were inconclusive. Approximately 93.9% (46/49) of the app users indicated that they would recommend the app to other caregivers and 56.3% (27/49) agreed that an extension of the program's duration would be beneficial. Conclusions: The app-based intervention program analyzed in this study was effective in promoting positive mental health and decreasing the burden of caregivers and achieved a high range of user satisfaction. This study provides evidence that mobile phone app-based intervention programs may be useful tools for increasing nonprofessional caregivers' well-being. The assessment of the effectiveness of intervention programs through clinical trials should be a focus to promote internet-based programs in health policies