Enfermeras españolas en el extranjero: Estudio comparativo de Reino Unido y España

Tesis Doctoral</jats:p

Pregnancy during the COVID-19 pandemic: A cross-sectional observational descriptive study

Aim: To provide data on the fears of pregnant women during the confinement period and to learn about the factors, which may have exacerbated fear in Spanish pregnant women during the pandemic. Design: A cross-sectional observational and descriptive study. Methods: An anonymous survey was carried out using virtual media in a pregnant population (aged ≥18 years) during the confinement period from 1 April to 1 May 2020. Results: The total sample comprised of 62 individuals, with a mean age of 33.6 ± 3.6 years and a mean gestation time of 23.6 ± 9.8 weeks. All of the women used preventive measures against SARS-CoV-2. The most common preventive measures were social isolation (82.3%, n = 51) and frequent handwashing (69.4%, n = 43). The most common feeling was fear (29%, n = 18). The main fears were related to transplacental infection (27%, n = 16), loneliness during childbirth, and being separated from the newborn (27%, n = 16). In addition, 59.7% (n = 37) considered changing their child-rearing practices after the pandemic

Exploring the microaggression experiences of LGBTQ+ community for a culturally safe care: A descriptive qualitative study

Background: Microaggressions, stigma and minority stress still occur among sexual and gender minorities on an individual, interpersonal, and structural level. Cultural immersion may therefore be an effective strategy in order to find potential healthcare approaches and foster more comprehensive, critical, intersectional, and inclusive care practices. Objective: The aim of this study was to develop insight into the experiences of LGBTQ+ community members to obtain in-depth perceptions of microaggressions and an understanding of their healthcare needs to provide a culturally safe and sensitive care. Design: A qualitative descriptive study was conducted between September to November 2021. Settings: This study was conducted at [Hidden for blinding purposes] with LGBTQ+ community members. Participants: Twenty-one LGBTQ+ individual participated in this study, aged between 18 and 56 years old. Methods: Participants were recruited using a purposive sampling. Responses from semi-structured interviews were studied using a thematic analysis. Methods and findings are reported in line with Standards for Reporting Qualitative Research recommendations. Results: Three themes emerged from the qualitative analysis: (i) experiences to understand the impact of a heteronormative society, (ii) perceptions of engaging with health education and promotion, and (iii) healthcare access, use and experiences within the LGTBQ+ community. Conclusions: This study yields findings about the difficulties that LGBTQ+ community members face in the healthcare system in order to ensure equal care for vulnerable communities and integrate a culturally safe care approach into nursing practice. Certain microaffirmation strategies against social determinants of health such as school-based nursing strategies can help to raise awareness and knowledge among heterosexual peers and reduce cultural invisibility, microaggressions, stigma and minority stress. In order to provide culturally safe care, educators might also explore the inclusion of gender and sexual minority care content in both in-faculty education and ongoing continuing education for nurse practitioners

Applications of Artificial Intelligence in Nursing Care: A Systematic Review

Aim: To synthesise the available evidence on the applicability of artificial intelligence in nursing care. Background: Artificial intelligence involves the replication of human cognitive abilities in machines, allowing to perform tasks that conventionally necessitate human cognition. However, its application in health sciences is a recent one, and its use is currently limited to supporting the diagnosis and prognosis of hospitalised patients, among others. Evaluation: A systematic review was conducted in the PubMed-Medline, Scopus, CINAHL, Web of Science and Nursing & Allied Database databases until September 2022, following the PRISMA guidelines. Key issues: A total of 21 articles were selected for the review. The different application of artificial intelligence in nursing identified comprised (i) advances in early disease detection and clinical decision making; (ii) artificial intelligence-based support systems in nursing for patient monitoring and workflow optimisation; and (iii) artificial intelligence insights for nursing training and education. Conclusion: Artificial intelligence-based systems demonstrated increased autonomy of patients and professionals in care processes such as wound management through guided instructions, improved workflows, and efficiency in terms of time, materials, and human resources. Implications for nursing management: Artificial intelligence applied to nursing practice can be a very useful resource for professionals, managers, and supervisors. It has the potential to change current working flow systems and may serve as a down-to-earth resource to support nursing professionals in their decision-making process that ensures high quality and patient safety care

Experiences of young women in the practice of squirting: a descriptive qualitative study

Background: While female ejaculation is viewed as a potential enhancer of women’s sexual experiences and their relationships with their sexual partners, existing studies to date emphasize the need for further exploration of the squirting phenomenon. The study sought to explore experiences and perceptions about the phenomenon of squirting in young adult women. Methods: A descriptive qualitative study was conducted. Semi-structured, in-depth interviews were conducted between December 2022 and March 2023. Seventeen young adult women who experienced squirting were recruited using a convenience and snowball sampling. ATLAS.ti v.9 software was used for a thematic analysis of the interview data. The study adhered to the recommendations for reporting qualitative research (Standards for Reporting Qualitative Research). Outcomes: The outcomes included (1) exploring factors influencing initial squirting experiences, (2) insights gained through squirting experiences, (3) communication as the cornerstone in sexual relationships, and (4) resources and sources for knowledge on the squirting phenomenon. Results: After the analysis of the results, the following subthemes emerged: (1) first perceptions on squirting, (2) facilitating factors, (3) physical sensations and psychological aspects in squirting experience, (4) sources of information about squirting and (5) addressing squirting in comprehensive sex education. Clinical implications: Frontline healthcare providers should undergo specific training to address anxiety related to squirting among certain individuals and enhance societal awareness while offering emotional support for diverse sexual response variations. Strengths and limitations: Acknowledging limitations in our study of young women’s experiences with squirting, a more diverse sample could provide alternative insights. Despite this, our findings contribute valuable knowledge, suggesting avenues for professional training to promote sexual and reproductive health in a more realistic and sensitive manner. Conclusion: This study explored the emotional and psychological effects of squirting on women’s sexual experiences, ranging from heightened arousal to feelings of humiliation and embarrassment. It emphasized the importance of a partner’s reaction in interpreting the event and the limited understanding of squirting, often influenced by pornography

Examining suicide risk in sexual and gender minority youth: A descriptive observational study on depressive symptoms, social support and self-esteem

Aim: To understand the factors that contribute to the risk of suicide among lesbian, gay, bisexual, transgender, queer, intersex and asexual (sexual minorities) youth. Background: The increase in the likelihood of suicide has made it an urgent issue in public health, particularly among young people, where it now ranks as the fourth leading cause of death. This issue becomes even more significant when focusing on sexual minorities. Methods: A cross-sectional study was performed in targeted young individuals (15–29 years). Several variables were assessed, including suicide risk, self-esteem, presence and severity of depressive symptoms, perceived social support and self-reported levels of anxiety and depression. Results: Statistically significant disparities were observed in suicide risk, presence of depressive symptoms and self-reported levels of anxiety and depression, all of which were more pronounced in sexual minority youth compared to heterosexual cisgender individuals. Likewise, statistically significant differences were noted concerning self-esteem and family support, both of which were lower in sexual minority youth. Conclusion: This study has identified risk factors, such as anxiety, depression and limited social support, as well as protective factors, like higher self-esteem and self-concept. Understanding and addressing all these factors are essential in reducing the elevated rates of suicide among sexual minority youth. Consequently, evidence-based interventions such as Gender and Sexuality Alliances, which empower and create safe spaces for sexual minority youth, possess substantial potential for effectively addressing this issue. Implications for the Profession: Given sexual minorities vulnerability, healthcare pros, especially nurses, must grasp suicide risk factors. They can help by educating, offering care, assessing risk and fighting stigma. This guarantees safety and access to mental health services for at-risk individuals from sexual minorities. Reporting Method: The reporting follows the STROBE checklist. Patient Contribution: People who were invited to participate voluntarily completed a range of questionnaires

A nursing socio-environmental approach for acute pesticide poisoning: A qualitative focus group study

Aim: To explore the experiences and perceptions of final-year nursing students in assessing and managing acute pesticide poisoning using a socio-environmental care approach in a primary health care simulation-based scenario. Design: A qualitative descriptive study was conducted using focus groups. Methods: Twelve focus groups were held, with 114 fourth-year nursing students. The study was carried out from September to November 2021. To grant an in-depth analysis of the collected data, a thematic analysis was used. Results: After our data analysis, three main themes emerged: (i) experiences of an acute pesticide poisoning case in a simulation-based scenario; (ii) environmental health nursing competencies for a culturally-competent practice and (iii) social factors in prevention strategies. Conclusions: Using a socio-environmental care approach with a primary care simulation-based poisoning case can provide a realistic public health clinical experience for local problems and prepare the context for the development of global citizenship values, as well as offer numerous opportunities to facilitate transformative learning, including Sustainable Development Goals (SDGs) into local nursing clinical practice. Impact: Nurse managers, policymakers, and educators must collaborate together to broaden their reach in teaching the role of the environment and social determinants of health through evidence-based care models, as well as actively contributing to the achievement of the SDGs in order to promote “glocal” competencies among nursing professionals

A serious game for online-based objective structured clinical examination in nursing: A qualitative study

Background: The current pandemic has led to unprecedented scenarios worldwide. In this context, educational institutions had to move abruptly from in-person to online classes, having to be flexible and innovative, one of the main concerns being the semester-end examinations in practical modules. Objective: This study aimed to explore nursing students’ perceptions of the use of a serious game-like model in their final online objective structured clinical examination (OSCE). Design: An exploratory phenomenological study was conducted during the COVID-19 pandemic, in particular during June 2020. Settings: This study took place at the University of Almeria with nursing students enrolled in a clinical placement module. Participants: Eighty-nine fourth-year nursing students took part in this study. Methods: Following the educational principles of the OSCE, a virtual OSCE was designed, using the Genially platform, an online platform for creating interactive content, to set up an assessment as a story-telling game-like model. A total of 5 focus groups (FGs) were conducted afterwards via the GoogleMeet platform. In addition, 30 semi-structured interviews were performed via the same platform. The data was analysed using a content analysis approach and supported by the ATLAS.ti 8.4 software. Results: Our finding revealed 2 main themes and 4 sub-themes. The two main themes were (i) generating emotions and feelings in times of virtuality; including emotions and feelings experienced by students during their online assessment process, and (ii) online assessment: a potential alternative to educational barriers; describing the variability of traditional modality, its implications for learning and the acquisition of competences. Conclusions: Serious game-like models, such as the story-telling game proposed, as part of their online OSCE assessment appear to be an appropriate alternative assessment method for face-to-face approaches. This paper adds new evidence on the use of innovative and state-of-art resources as part of nursing OSCE assessments in a new reality for most students and teachers. Serious game-like models in online OSCE may empower students and help them to remove perceived barriers in face-to-face assessments

Cognitive and Emotional Effect of a Multi-species Probiotic Containing Lactobacillus rhamnosus and Bifidobacterium lactis in Healthy Older Adults: A Double‐Blind Randomized Placebo‐Controlled Crossover Trial

As the population ages, cognitive decline becomes more common. Strategies targeting the gut-brain axis using probiotics are emerging to achieve improvements in neuropsychiatric and neurological disorders. However, the beneficial role of probiotics on brain function in healthy older adults remains unclear. Our aim was to evaluate a multi-species probiotic formulation as a therapeutic approach to reduce emotional and cognitive decline associated with aging in healthy adults. A randomized double-blind placebo-controlled crossover trial was conducted. The study involved a 10-week intervention where participants consumed the assigned probiotic product daily, followed by a 4-week washout period before the second condition started. Cognitive function was assessed using the Mini-Mental State Examination (MMSE) and the Psychological Experiments Construction Language Test Battery. At the emotional level, the Beck Depression Inventory (BDI) and the State-Trait Anxiety Inventory (STAI) were used. Thirty-three participants, recruited between July 2020 and April 2022, ingested a multispecies probiotic (Lactobacillus rhamnosus and Bifidobacterium lactis). After the intervention, noticeable enhancements were observed in cognitive function (mean difference 1.90, 95% CI 1.09 to 2.70, p < 0.005), memory (mean difference 4.60, 95% CI 2.91 to 6.29, p < 0.005) by MMSE and digit task, and depressive symptoms (mean difference 4.09, 95% CI 1.70 to 6.48, p < 0.005) by BDI. Furthermore, there were significant improvements observed in planning and problem-solving skills, selective attention, cognitive flexibility, impulsivity, and inhibitory ability. Probiotics administration improved cognitive and emotional function in older adults. Limited research supports this, requiring more scientific evidence for probiotics as an effective therapy for cognitive decline. This study has been prospectively registered at ClinicalTrials.gov (NCT04828421; 2020/July/17)

Experiences with obstetric violence among healthcare professionals and students in Spain: A constructivist grounded theory study

Background: Obstetric violence appears to be a worldwide concern and is defined as a type of gender-based violence perpetrated by health professionals. This violence undermines and harms women’s autonomy. In Spain, 38.3% of women have identified themselves as victims of this type of violence. Aim: To explore current information and knowledge about obstetric violence within the Spanish healthcare context, as well as to develop a theoretical model to explain the concept of obstetric violence, based on the experiences of healthcare professionals (midwives, registered nurses, gynaecologists and paediatricians) and nursing students. Methods: A constructivist grounded theory study was conducted at Jaume I University in Spain between May and July 2021, including concurrent data collection and interpretation through constant comparison analysis. An inductive analysis was carried out using the ATLAS.ti 9.0 software to organise and analyse the data. Results: Twenty in-depth interviews were conducted, which revealed that healthcare professionals and students considered obstetric violence a violation of human rights and a serious public health issue. The interviews allowed them to describe certain characteristics and propose preventive strategies. Three main categories were identified from the data analysis: (i) characteristics of obstetric violence in the daily routine, (ii) defining the problem of obstetric violence and (iii) strategies for addressing obstetric violence. Participants identified obstetric violence as structural gender-based violence and emphasised the importance of understanding its characteristics. Our results indicate how participants’ experiences influence their process of connecting new information to prior knowledge, and they provide a connection to specific micro- and macro-level strategic plans. Discussion: Despite the lack of consensus, this study resonates with the established principles of women and childbirth care, but also generates a new theoretical model for healthcare students and professionals to identify and manage obstetric violence based on contextual factors. The term ‘obstetric violence’ offers a distinct contribution to the growing awareness of violence against women, helps to regulate it through national policy and legislation, and involves both structural and interpersonal gender-based abuse, rather than assigning blame only to care providers. Conclusions: Obstetric violence is the most accurate term to describe disrespect and mistreatment as forms of interpersonal and structural violence that contribute to gender and social inequality, and the definition of this term contributes to the ongoing awareness of violence against women, which may help to regulate it through national policy and legislation