2023

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10 pages, 319 KiB

Open AccessArticle

Moral Distress in Oncology: A Descriptive Study of Healthcare Professionals

by Lara Guariglia, Irene Terrenato, Laura Iacorossi, Giovanna D’Antonio, Sonia Ieraci, Stefania Torelli, Fabiola Nazzicone, Fabrizio Petrone and Anita Caruso

Int. J. Environ. Res. Public Health 2023, 20(8), 5560; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph20085560 - 18 Apr 2023

Cited by 2 | Viewed by 1311

Abstract

Background: The oncology setting is characterized by various complexities, and healthcare professionals may experience stressful conditions associated with ethical decisions during daily clinical practice. Moral distress (MD) is a condition of distress that is generated when an individual would like to take action [...] Read more.

Background: The oncology setting is characterized by various complexities, and healthcare professionals may experience stressful conditions associated with ethical decisions during daily clinical practice. Moral distress (MD) is a condition of distress that is generated when an individual would like to take action in line with their ethical beliefs but in conflict with the healthcare facility’s customs and/or organization. This study aims to describe the MD of oncology health professionals in different care settings. Methods: Descriptive quantitative study was conducted in the Operating Units of the Istituti Fisioterapici Ospitalieri in Rome between January and March 2022. The investigated sample consisted of the medical and nursing staff on duty at the facility, who were given a questionnaire through a web survey. Besides a brief sociodemographic form, the MD Scale-Revised questionnaire was used for data collection. Results: The sample consisted of nurses (51%) and physicians (49%), predominantly working in surgeries (48%), and having 20–30 years of service (30%). MD was higher among healthcare professionals, in medicine than that ing in corporate organizations, surgeries, or outpatient clinics (p = 0.007). It was not related to the profession (p = 0.163), gender (p = 0.103), or years of service (p = 0.610). Conclusions: This paper outlines the prevalence of MD in care settings and describes its relationship with profession, gender, and seniority. There is no patient care without the care of health professionals: knowing and fighting MD improves the safety of the treatments provided and the quality perceived by patients. Full article

2022

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11 pages, 499 KiB

Open AccessReview

Nursing Interventions That Promote Sleep in Preterm Newborns in the Neonatal Intensive Care Units: An Integrative Review

by Catarina Firmino, Marlene Rodrigues, Sofia Franco, Judicília Ferreira, Ana Rita Simões, Cidália Castro and Júlio Belo Fernandes

Int. J. Environ. Res. Public Health 2022, 19(17), 10953; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph191710953 - 02 Sep 2022

Cited by 1 | Viewed by 3385

Abstract

Sleep is a crucial factor for the psychological and physiological well-being of any human being. In Neonatal Intensive Care Units, preterm newborns’ sleep may be at risk due to medical and nursing care, environmental stimuli and manipulation. This review aims to identify the [...] Read more.

Sleep is a crucial factor for the psychological and physiological well-being of any human being. In Neonatal Intensive Care Units, preterm newborns’ sleep may be at risk due to medical and nursing care, environmental stimuli and manipulation. This review aims to identify the nurses’ interventions that promote sleep in preterm newborns in the Neonatal Intensive Care Units. An integrative review was conducted following Whittemore and Knafl’s methodology and the 2020 Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement. The research was carried out on the electronic databases PubMed, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and ScienceDirect, with a timeframe from 2010 to 2021. A total of 359 articles were initially identified. After selection and analysis, five studies were included in the sample. Interventions by nursing staff that promote sleep in preterm newborns in the Neonatal Intensive Care Units fall within three categories: environmental management, relaxation techniques and therapeutic positioning. Nurses play a vital role in implementing interventions that promote preterm newborns’ sleep. They can positively affect preterm newborns’ sleep by controlling environmental stimuli and applying relaxation techniques and therapeutic positioning to their care practices. Full article

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13 pages, 1035 KiB

Open AccessArticle

Pain Assessment with the BPS and CCPOT Behavioral Pain Scales in Mechanically Ventilated Patients Requiring Analgesia and Sedation

by Katarzyna Wojnar-Gruszka, Aurelia Sega, Lucyna Płaszewska-Żywko, Stanisław Wojtan, Marcelina Potocka and Maria Kózka

Int. J. Environ. Res. Public Health 2022, 19(17), 10894; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph191710894 - 01 Sep 2022

Cited by 1 | Viewed by 2723

Abstract

Background: Intensive Care Unit (ICU) patients often experience pain, especially during diagnostic, nursing, and therapeutic interventions. Pain assessment using the Behavioral Pain Scale (BPS) and Critical Care Pain Observation Tool (CCPOT) are recommended, but they are difficult to do in patients undergoing deep [...] Read more.

Background: Intensive Care Unit (ICU) patients often experience pain, especially during diagnostic, nursing, and therapeutic interventions. Pain assessment using the Behavioral Pain Scale (BPS) and Critical Care Pain Observation Tool (CCPOT) are recommended, but they are difficult to do in patients undergoing deep sedation. This study analyzed the usefulness of the BPS and CCPOT scales in assessing pain among patients with varying degrees of sedation. Methods: In 81 mechanically ventilated and sedated ICU patients, 1005 measurements were performed using the BPS and CCPOT scales. The study was conducted by 3 trained observers 3 times a day (each measurement at rest, during painful nursing interventions, and after the intervention). The Richmond Agitation-Sedation Scale (RASS), the Simplified Acute Physiology Score (SAPS II), and the Acute Physiology and Chronic Health Evaluation (APACHE II) were also analyzed from medical records as well as information on the length of hospitalization and treatment. Results: It was shown that signs of pain increased significantly (p < 0.001) during interventions in patients on both scales (BPS and CCPOT), and then returned to values close to the resting period. RASS results correlated significantly (p < 0.05) and positively with the results of the BPS and CCPOT. A strong correlation was found between the results of both scales at each stage of the study (R = 0.622–0.907). Conclusions: Nursing procedures are a source of pain in analgosedated patients. The BPS and CCPOT scales are useful tools for assessing the occurrence of pain in mechanically ventilated patients, including those in deep sedation. Full article

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12 pages, 726 KiB

Open AccessArticle

Social and Family Challenges of Having a Child Diagnosed with Phelan-McDermid Syndrome: A Qualitative Study of Parents’ Experiences

by Cristina García-Bravo, Domingo Palacios-Ceña, Sara García-Bravo, Jorge Pérez-Corrales, Marta Pérez-de-Heredia-Torres and Rosa Mª Martínez-Piédrola

Int. J. Environ. Res. Public Health 2022, 19(17), 10524; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph191710524 - 24 Aug 2022

Cited by 4 | Viewed by 1480

Abstract

(1) Background: Phelan-McDermid Syndrome (PMS) in children causes significant challenges affecting social and family relationships. The purpose of this study was to explore the experience of parents with children diagnosed with PMS regarding interactions with their social environment; (2) Methods: A qualitative descriptive [...] Read more.

(1) Background: Phelan-McDermid Syndrome (PMS) in children causes significant challenges affecting social and family relationships. The purpose of this study was to explore the experience of parents with children diagnosed with PMS regarding interactions with their social environment; (2) Methods: A qualitative descriptive study was conducted. Participants were recruited using non-probabilistic purposeful sampling. In total, 32 parents of children with PMS were included. In-depth interviews and researchers’ field notes were used to collect the data. An inductive thematic analysis was performed; (3) Results: Five themes were identified: (a) challenges in the relationship as a couple; (b) challenges within the family and close social relationships; (c) challenges in the educational-school environment; (d) challenges in the health environment and with health professionals, and (e) reconnection through the PMS association. It would be beneficial for parents to create training programs on PMS in the educational and healthcare settings, to promote the participation of professionals in the PMS association and to develop care programs focusing in their physical, psychological and social health. Full article

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12 pages, 366 KiB

Open AccessArticle

Participation of Nursing Students in Evidence-Based Practice Projects: Results of Two Focus Groups

by Cristina Lavareda Baixinho, Óscar Ramos Ferreira, Marcelo Medeiros and Ellen Synthia Fernandes de Oliveira

Int. J. Environ. Res. Public Health 2022, 19(11), 6784; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph19116784 - 01 Jun 2022

Cited by 2 | Viewed by 2101

Abstract

The development of true evidence-based practice requires that practitioners have the knowledge and skills to research, analyze, and use evidence. These skills must be acquired in pre-graduate training. The objective of the present study was to analyze the contributions of students’ participation in [...] Read more.

The development of true evidence-based practice requires that practitioners have the knowledge and skills to research, analyze, and use evidence. These skills must be acquired in pre-graduate training. The objective of the present study was to analyze the contributions of students’ participation in knowledge translation projects to clinical practice for evidence-based learning. This was a qualitative, descriptive, and exploratory study that used focus groups. Scripted interviews were administered. The design of the study included five phases and took place in the partnering institutions of the Safety Transition Project, involving fifteen participants. The study was authorized by the Research Ethics Committee. The data were analyzed following the steps encoding the categories, storage and recovery, and (3) interpretation and using computer software (WebQDA^®, Ludomédia, Aveiro, Portugal). Four categories were identified: learning evidence; communicating science; evidence-based practice; and developing skills. The successful implementation of evidence-based practice education resulted in students who understand its importance and use it competently. Further research should explore the skills developed by nurses involved in similar projects and their contribution to an EBP culture. Full article

23 pages, 6015 KiB

Open AccessArticle

Exposure to High Precariousness Prevalence Negatively Impacts Drug Prescriptions of General Practitioners to Precarious and Non-Precarious Populations: A Retrospective Pharmaco-Epidemiological Study

by François Birault, Lakshmipriva Le Bonheur, Nicolas Langbour, Sandivanie Clodion, Nematollah Jaafari, Marie-Christine Perault-Pochat and Bérangère Thirioux

Int. J. Environ. Res. Public Health 2022, 19(5), 2962; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph19052962 - 03 Mar 2022

Viewed by 1558

Abstract

(1) Background: Precarious patients are more difficult to care for due to low literacy rates and poor adherence to treatment and hospitalization. These difficulties have detrimental effects on general practitioners (GPs), deteriorating medical communication, advice, diagnoses, and drug prescriptions. To better understand how [...] Read more.

(1) Background: Precarious patients are more difficult to care for due to low literacy rates and poor adherence to treatment and hospitalization. These difficulties have detrimental effects on general practitioners (GPs), deteriorating medical communication, advice, diagnoses, and drug prescriptions. To better understand how precariousness affects primary care, we tested whether, among GPs, exposure to high precariousness prevalence more severely impacts drug prescriptions to precarious and non-precarious populations compared to low precariousness prevalence. Materials and methods: This pharmaco-epidemiological study, using linear regression analyses, compared the defined daily dose of 20 drugs prescribed by GPs to precarious and non-precarious patients in four French regions with low and high precariousness prevalence in 2015. (2) Findings: Exposure to high precariousness prevalence significantly impacted the prescriptions of nine medications to precarious patients and two medications to non-precarious patients, and distributed into three interaction patterns. (3) Interpretation: The selective over-prescription of drugs with easy intake modalities to precarious patients probably reflects GPs’ attempts to compensate for poor patient compliance. In contrast, the under-prescription of drugs targeting fungal infections in precarious populations and diabetes and cardiovascular diseases in non-precarious populations was seemingly due to a breakdown of empathy and professional exhaustion, causing medical neglect. Full article

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13 pages, 809 KiB

Open AccessArticle

Evolution of Legislation and Crimes Based on Sexual Identity or Orientation in Spain: A Retrospective Observational Study (2011–2021)

by Laura Ruiz-Azcona, Amada Pellico-López, Jimena B. Manjón-Rodríguez, Mar Sánchez Movellán, Purificación Ajo Bolado, José García-Vázquez, Ildefonso Hernández-Aguado, Joaquín Cayón-De las Cuevas and María Paz-Zulueta

Int. J. Environ. Res. Public Health 2022, 19(2), 859; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph19020859 - 13 Jan 2022

Viewed by 1820

Abstract

Respect for different sexual options and orientations prevents the occurrence of hate crimes against lesbian, gay, bisexual, trans and intersex (LGTBI) persons for this reason. Our aim was to review the legislation that protects the rights of LGTBI people and to quantify the [...] Read more.

Respect for different sexual options and orientations prevents the occurrence of hate crimes against lesbian, gay, bisexual, trans and intersex (LGTBI) persons for this reason. Our aim was to review the legislation that protects the rights of LGTBI people and to quantify the victimization rates of hate crimes based on sexual identity and orientation. A retrospective observational study was conducted across all regions of Spain from 2011–2021. The laws on LGTBI rights in each region were identified. Hate crime victimization data on sexual identity and orientation were collected in annual rates per 100,000 inhabitants, annual percentage change and average change during the study period to assess the trend. The regulatory development of laws against discrimination against LGTBI individuals is heterogeneous across regions. Overall, in Spain there is an upward trend in the number of hate crime victimizations motivated by sexual identity or orientation. The effectiveness of data collection, thanks to better training and awareness of police forces regarding hate crimes and the processes of data cleansing and consolidation contributes to a greater visibility of hate crimes against LGTBI people. Full article

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2021

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10 pages, 601 KiB

Open AccessArticle

Blood Transfusion Knowledge among Nurses in Malaysia: A University Hospital Experience

by Noor Haslina Mohd Noor, Noor Hafiza Saad, Mohammad Khan, Mohd Nazri Hassan, Marini Ramli, Rosnah Bahar, Shafini Mohamed Yusoff, Salfarina Iberahim, Wan Suriana Wan Ab Rahman, Zefarina Zulkafli and Md Asiful Islam

Int. J. Environ. Res. Public Health 2021, 18(21), 11194; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph182111194 - 25 Oct 2021

Cited by 9 | Viewed by 5126

Abstract

Blood transfusion is a fundamental and life-saving procedure where the consequence of errors can be fatal. Nurses’ knowledge plays an essential role in ensuring quality and safety in blood transfusion. The objective of this study was to assess blood transfusion-associated knowledge of tertiary [...] Read more.

Blood transfusion is a fundamental and life-saving procedure where the consequence of errors can be fatal. Nurses’ knowledge plays an essential role in ensuring quality and safety in blood transfusion. The objective of this study was to assess blood transfusion-associated knowledge of tertiary hospital nurses on the east coast of Malaysia. This was a cross-sectional study with 200 registered nurses involved in blood transfusion procedures at Hospital Universiti Sains Malaysia. The knowledge of the nurses was evaluated by using the routine blood transfusion knowledge questionnaire based on five parts, and <50%, 50–74%, or ≥75% of the knowledge was considered as poor, moderate, or high, respectively. Based on the scoring system, the overall knowledge of blood transfusion among Malaysian nurses (33.2 ± 8.4 years) was estimated to be 54.9 ± 7.6%. In individual items, the scoring was 81.0%, 45.4%, 49.2%, 63.0%, and 90.0% in knowledge prior to blood transfusion, on pre-transfusion, on post-transfusion, on complications, and on transfusion policy, respectively. The findings of this study indicated that most of the nurses’ overall knowledge of blood transfusion was at a moderate level; therefore, training courses and continuous medical education are warranted to improve knowledge and skills of the nurses to ensure good practices of blood transfusion. Full article

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11 pages, 321 KiB

Open AccessArticle

Knowledge and Perception of Registered Nurses Regarding the Scope of Practice of Speech-Language Pathologists

by Sami Alhamidi, Majid Alshahwan and Regie Tumala

Int. J. Environ. Res. Public Health 2021, 18(19), 10534; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph181910534 - 08 Oct 2021

Cited by 2 | Viewed by 2987

Abstract

Objective: To assess the knowledge and perception of registered nurses regarding the scope of practice of speech-language pathologists (SLP) in Saudi Arabia. Background: Interdisciplinary collaboration is vital between the SLP and nurses due to the complex care needed by patients with speech problems. [...] Read more.

Objective: To assess the knowledge and perception of registered nurses regarding the scope of practice of speech-language pathologists (SLP) in Saudi Arabia. Background: Interdisciplinary collaboration is vital between the SLP and nurses due to the complex care needed by patients with speech problems. Methods: A total of 294 registered nurses were surveyed utilizing the Knowledge and Perception of Speech-Language Pathologists questionnaire. Descriptive statistics and tests for differences and relationships were performed. Results: The findings revealed that nursing respondents had an overall good understanding of the value and scope of practice of the SLP. However, they frequently and wrongly responded to scenarios concerning patients who suffered from Alzheimer’s dementia, laryngeal cancer, traumatic brain injury, and stroke. Conclusions: It is vital for nurses to understand the value, role, and scope of practice of the SLP. Further educational nursing interventions and training are necessary for effective interprofessional collaboration and teamwork. Full article

13 pages, 2923 KiB

Open AccessArticle

Delayed Discharge for Non-Clinical Reasons in Hip Procedures: Differential Characteristics and Opportunity Cost

by Amada Pellico-López, Ana Fernández-Feito, David Cantarero, Manuel Herrero-Montes, Joaquín Cayón-De Las Cuevas, Paula Parás-Bravo and María Paz-Zulueta

Int. J. Environ. Res. Public Health 2021, 18(17), 9407; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18179407 - 06 Sep 2021

Cited by 3 | Viewed by 2336

Abstract

Delayed discharge for non-clinical reasons shares common characteristics with hip procedures. We sought to quantify the length of stay and related costs of hip procedures and compare these with other cases of delayed discharge. A cross-sectional study was conducted at a public hospital [...] Read more.

Delayed discharge for non-clinical reasons shares common characteristics with hip procedures. We sought to quantify the length of stay and related costs of hip procedures and compare these with other cases of delayed discharge. A cross-sectional study was conducted at a public hospital in Spain (2007–2015) including 306 patients with 6945 days of total stay and 2178 days of prolonged stay. The mean appropriate stay was 15.58 days, and the mean prolonged stay was 7.12 days. The cost of a prolonged stay was €641,002.09. The opportunity cost according to the value of the hospital complexity unit was €922,997.82. The mean diagnostic-related groups’ weight was 3.40. Up to 85.29% of patients resided in an urban area near the hospital (p = 0.001), and 83.33% were referred to a long-stay facility for functional recovery (p = 0.001). The proportion of patients with hip procedures and delayed discharge was lower than previous reports; however, their length of stay was longer. The cost of prolonged stay could account for 21.17% of the total. Compared with the remaining cases of delayed discharge, the appropriate stay was shorter in hip procedures, with a profile of older women living in an urban area close to the hospital and referred to a long-stay center for functional recovery. Full article

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11 pages, 327 KiB

Open AccessArticle

A Mixed-Methods Approach-Based Study of Anaphylaxis Awareness and Educational Needs among Nursing Students

by Yoongoo Noh and Insook Lee

Int. J. Environ. Res. Public Health 2021, 18(17), 9280; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18179280 - 02 Sep 2021

Viewed by 1978

Abstract

In this mixed-methods study, we identified anaphylaxis awareness among nursing students through a survey, and the needs for anaphylaxis education through focus group interviews (FGIs). Anaphylaxis awareness was surveyed from 10 June–30 July 2018 using a structured questionnaire with 221 junior or senior [...] Read more.

In this mixed-methods study, we identified anaphylaxis awareness among nursing students through a survey, and the needs for anaphylaxis education through focus group interviews (FGIs). Anaphylaxis awareness was surveyed from 10 June–30 July 2018 using a structured questionnaire with 221 junior or senior nursing students. To assess the needs for anaphylaxis education, 14 senior nursing students were interviewed using FGIs from 10–22 June 2018. Quantitative data were analyzed descriptively using SPSS, and qualitative data were assessed using thematic analysis. Nursing students’ awareness of anaphylaxis was identified by correct answers to items concerning symptoms (33.0%), causes (64.6%), and treatments (55.8%), with an overall average of 51.5%. The thematic analysis identified four themes reflecting students’ educational needs: the need for anaphylaxis education, various education methods, field training-based study of educational content, and repeated education. Nursing students’ anaphylaxis awareness is low. Their specific needs derived in this study for anaphylaxis education should draw special attention when planning nursing curriculum. Incorporating these findings in future education programs may promote students’ confidence in treating anaphylaxis. Full article

14 pages, 336 KiB

Open AccessArticle

Teaching the Holocaust in Nursing Schools: The Perspective of the Victims and Survivors

by Zvika Orr and Anat Romem

Int. J. Environ. Res. Public Health 2021, 18(17), 8969; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18178969 - 26 Aug 2021

Cited by 2 | Viewed by 2143

Abstract

In recent years, there has been increased recognition of the significance and relevance of Holocaust studies to nurses. However, these studies are rarely integrated in the nursing curriculum, and even when they are, the focus is usually on healthcare personnel who collaborated with [...] Read more.

In recent years, there has been increased recognition of the significance and relevance of Holocaust studies to nurses. However, these studies are rarely integrated in the nursing curriculum, and even when they are, the focus is usually on healthcare personnel who collaborated with the Nazi regime. This article aims to bridge this gap by analyzing a comprehensive requisite curriculum on the Holocaust for graduate nursing students. We emphasize the work of Jewish healthcare professionals during the Holocaust and the dilemmas they faced, as well as the trauma and resilience of Holocaust survivors, their treatment today, and implications for treating other patients. This article examines how studying these issues affected the graduate students. It analyzes the reflective accounts written by the students, using qualitative content analysis and Grounded Theory. The findings suggest that students received tools to act professionally and empathetically while demonstrating greater sensitivity to the patients’ identity, past experiences, trauma, and how the hospital as a “total institution” affects them. Many of the students developed conscious leadership. The program used a personalized pedagogical approach that contributed to experiential learning but was also emotionally challenging for the participants. We recommend including Holocaust studies as a requisite component in nursing programs worldwide. Full article

12 pages, 360 KiB

Open AccessArticle

Induction of SARS-CoV-2-Specific IgG and IgA in Serum and Milk with Different SARS-CoV-2 Vaccines in Breastfeeding Women: A Cross-Sectional Study in Northern Spain

by Carolina Lechosa-Muñiz, María Paz-Zulueta, Jose Manuel Mendez-Legaza, Juan Irure-Ventura, Rocío Cuesta González, Jorge Calvo Montes, Marcos López-Hoyos, Javier Llorca and María Jesús Cabero-Pérez

Int. J. Environ. Res. Public Health 2021, 18(16), 8831; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18168831 - 21 Aug 2021

Cited by 54 | Viewed by 4441

Abstract

Breastfeeding mothers were excluded from the clinical trials conducted for vaccines against SARS-CoV-2. Since the start of the vaccination, some doubts have arisen regarding its compatibility with breastfeeding. The aim of this study was to analyse the presence of anti-SARS-CoV-2 antibodies in breast [...] Read more.

Breastfeeding mothers were excluded from the clinical trials conducted for vaccines against SARS-CoV-2. Since the start of the vaccination, some doubts have arisen regarding its compatibility with breastfeeding. The aim of this study was to analyse the presence of anti-SARS-CoV-2 antibodies in breast milk and serum (IgG and IgA) of vaccinated breastfeeding women. The main variables of the observational study were: adverse related events after vaccination and determination of the presence of IgG and IgA isotypes antibodies in serum and in breast milk of vaccinated women against the SARS-CoV-2 antigens. Results: 110 breastfeeding mothers were included; 70 women (63.6%) were vaccinated with two doses of BNT162b2, 20 women (18.2%) with two doses of mRNA-1273, and 20 women (18.2%) with a single dose of ChAdOx1-S. Regarding adverse reactions and vaccine safety, 38 women had no adverse reactions; 20 (18.2%) had general malaise or adenopathies; 10 (9.1%) had a headache; and 7 (6.4%) had fever. When analysing IgG antibodies, significantly higher levels of antibodies were found in serum and breast milk from mothers vaccinated with BNT162b2 or mRNA-1273 vs. ChAdOx1-S (p < 0.001 and p = 0.001, respectively). Analysing IgA antibodies, significant differences were found when comparing mean values in serum from mothers vaccinated with BNT162b2 or mRNA-1273 vs. ChAdOx1-S (0.12, 0.16, and 0.02, respectively; p < 0.001) and breast milk of mothers vaccinated when comparing BNT16b2 vs. ChAdOx1-S. All vaccinated breastfeeding mothers had serum anti-S1 IgG antibodies in response to vaccination against SARS-CoV-2, regardless of the commercial vaccine administered. Conclusions: the anti-SARS-CoV-2 vaccines were well tolerated by the mothers and the breastfed infant. In addition, breastfeeding mothers offer their infants IgA and IgG isotype antibodies directed against SARS-CoV-2 protein S in breast milk. Full article

10 pages, 359 KiB

Open AccessArticle

Declared Reasons for Cessation of Breastfeeding during the First Year of Life: An Analysis Based on a Cohort Study in Northern Spain

by Carolina Lechosa-Muñiz, María Paz-Zulueta, Joaquín Cayón-De las Cuevas, Javier Llorca and María Jesús Cabero-Pérez

Int. J. Environ. Res. Public Health 2021, 18(16), 8414; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18168414 - 09 Aug 2021

Cited by 5 | Viewed by 2634

Abstract

Background: Breastfeeding is the gold standard of infant feeding due to the many advantages it offers to both the child and the mother. Objective: To identity the main reasons for cessation of breastfeeding reported by mothers during the first year of life. Design: [...] Read more.

Background: Breastfeeding is the gold standard of infant feeding due to the many advantages it offers to both the child and the mother. Objective: To identity the main reasons for cessation of breastfeeding reported by mothers during the first year of life. Design: A prospective cohort study was conducted, recruiting 970 infants from a university hospital in Spain. The main maternal variables studied were maternal age, parity, educational level, work occupation, smoking habit, weeks of gestation at birth, birth weight, feeding type, and duration of breastfeeding. All participants were followed for one year to determinate the duration of breastfeeding and to gather reasons for abandoning breastfeeding. Results: At six months, the percentage of breastfeeding experienced a decline of 50%, and only 24.5% of these mothers maintained breastfeeding. Up to 15.8% of the mothers decided to give up exclusive breastfeeding by their own choice, whereas 15.4% did so because they suspected low milk production. Work-related causes represent the third reason of abandonment. Conclusions: Our results highlight the need to improve the health policies for the promotion, protection, and support for the initiation and maintenance of breastfeeding. In particular, our results highlight the importance of researching women’s low milk production and work-related factors, with particular emphasis on improving conciliation measures. Full article

14 pages, 344 KiB

Open AccessArticle

“You Need to Get Over the Difficulties and Stand Up Again”—A Qualitative Inquiry into Young Nurses’ Coping with Lateral Violence from the Feminist Perspective

by Aimei Mao, Hon Lon Tam, Pak Leng Cheong and Iat Kio Van

Int. J. Environ. Res. Public Health 2021, 18(13), 7167; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18137167 - 04 Jul 2021

Cited by 8 | Viewed by 2924

Abstract

Previous studies have reported lateral violence (LV) styles among nurses and the adverse impacts of LV on nurses and nursing. Young nurses, including nursing students and novice nurses, are often victims of LV. A large qualitative research study that contained three sub-studies exploring [...] Read more.

Previous studies have reported lateral violence (LV) styles among nurses and the adverse impacts of LV on nurses and nursing. Young nurses, including nursing students and novice nurses, are often victims of LV. A large qualitative research study that contained three sub-studies exploring professional identity development in different professional stages was conducted by a research team in Macau, Special Administrative Region of China. Semi-structured interviews with nursing students and clinical nurses were carried out; among the 58 participants in the three sub-studies, 20 described some forms of LV and their ways of dealing with them. Framed by the feminist perspective, the researchers explored young nurses’ coping strategies in dealing with LV perpetrated by senior colleagues. Two themes were developed reflecting the coping strategies for LV: “making extra efforts” and “soothing emotional distress”. Three sub-themes were under the theme of “making extra efforts”: “catching up knowledge”, “making the most use of learning resources”, “adjusting communication manner”; another batch of sub-themes was under the theme of “soothing emotional distress”: “seeking support from schoolmates”, “living with family but crying alone”, and “adjusting lifestyle”. The study implied that young nurses exerted their agency in coping with LV in clinical practices. Nursing managers and educators should support young nurses’ efforts in overcoming power-based LV and incivility. Full article

12 pages, 1024 KiB

Open AccessArticle

Health Sciences Students’ Perceptions of the Role of the Supervisor in Clinical Placements

by Álvaro Borrallo-Riego, Eleonora Magni, Juan Antonio Jiménez-Álvarez, Vicente Fernández-Rodríguez and María Dolores Guerra-Martín

Int. J. Environ. Res. Public Health 2021, 18(9), 4427; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18094427 - 21 Apr 2021

Cited by 3 | Viewed by 2295

Abstract

The supervision of clinical placements is essential to achieving a positive learning experience in the clinical setting and which supports the professional training of those being supervised. The aim of this study was to explore health sciences students’ perceptions of the role of [...] Read more.

The supervision of clinical placements is essential to achieving a positive learning experience in the clinical setting and which supports the professional training of those being supervised. The aim of this study was to explore health sciences students’ perceptions of the role of the supervisor in the supervision of clinical placements. A quantitative methodology was used, administering a previously validated questionnaire, by means of an expert panel and a pre-test, to 134 students from the Faculty of Nursing, Physiotherapy and Podiatry at the University of Seville (Spain). The analysis of variables was carried out by means of a data matrix. The results revealed a statistically significant difference in the perception of placement supervision depending on the degree, with Nursing producing the highest degree of affirmation in the variables studied and the greatest satisfaction with placement supervision; in contrast, Physiotherapy produced the greatest dissatisfaction and the lowest degree of affirmation. The study and analysis of these perceptions facilitates the collection of relevant information in order to formulate actions that help to improve the supervision experience during placements. They also allow a greater understanding of what factors most influence the experience of supervision during clinical placements. Full article

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17 pages, 1340 KiB

Open AccessArticle

Knowledge, Attitudes, and Sources of Information on Vaccines in Spanish Nursing Students: A Cross-Sectional Study

by José Tuells, Cecilia M. Egoavil, Isabel Morales-Moreno, Elena Fortes-Montoya, Carlos Salazar-García and Noelia Rodríguez-Blanco

Int. J. Environ. Res. Public Health 2021, 18(7), 3356; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18073356 - 24 Mar 2021

Cited by 6 | Viewed by 2609

Abstract

Health professionals are the most influential and main sources of information about vaccines for the general population, as they are regarded as role models by patients and society. The objective of the present study was to determine the knowledge and attitudes of a [...] Read more.

Health professionals are the most influential and main sources of information about vaccines for the general population, as they are regarded as role models by patients and society. The objective of the present study was to determine the knowledge and attitudes of a group of university Nursing students about vaccines, as well as their sources of information and their education needs. A cross-sectional study was performed through a questionnaire (55 items) provided to Nursing students at two Spanish universities. A total of 1122 students participated in the study. The mean score obtained for knowledge about vaccines was 44.6 ± 4.3, and for attitudes towards vaccines, it was 37.2 ± 3.9. Hepatitis B (94.7%) and the Flu (89%) are the two main vaccines they should receive as health workers. The main source of information was the family environment (65.6%). Most of them considered that post-graduate education about vaccines should be provided by academic entities (universities, 62.7%). Among the health professionals, Nurses (85.5%) must be better educated and trained on the subject of vaccines. It is therefore necessary to delve into and complete the nurses’ training on vaccines, to educate them about the risks at the individual level, and their decisive role as promoters of the vaccination strategy for the general population. Universities must become the leaders in vaccine education and training. Full article

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12 pages, 593 KiB

Open AccessArticle

Are You Prepared to Save a Life? Nursing Students’ Experience in Advanced Life Support Practice

by Lorena Gutiérrez-Puertas, Verónica V. Márquez-Hernández, Vanesa Gutiérrez-Puertas, Mª Carmen Rodríguez-García, Alba García-Viola and Gabriel Aguilera-Manrique

Int. J. Environ. Res. Public Health 2021, 18(3), 1273; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18031273 - 31 Jan 2021

Cited by 3 | Viewed by 3013

Abstract

The objective of this study was to explore the experiences and perceptions of nursing students after applying advanced life support techniques on a hospitalised patient in cardiac arrest in a simulated setting. A qualitative descriptive phenomenological study was conducted. Fifty-four nursing students from [...] Read more.

The objective of this study was to explore the experiences and perceptions of nursing students after applying advanced life support techniques on a hospitalised patient in cardiac arrest in a simulated setting. A qualitative descriptive phenomenological study was conducted. Fifty-four nursing students from the University of Almería (Spain) participated. Three main themes and six subthemes were identified, which illustrate the experiences and perceptions of nursing students about performing advanced life support. The main themes were: (1) Analysing practice as part of the learning process, with the subthemes “working in an unknown environment” and “acquiring knowledge as the key to success”; (2) Facing reality: nursing students’ perceptions of an emergency situation, with the subthemes “facing stressful elements” and “emotional impact in emergency situations”; (3) Experience as a key element to integrating advanced life support into the healthcare setting, with the subthemes “discovering and facing the experience as a team” and “linking and transferring the situation to a real clinical setting”. The nursing students reported that the process of practising for an emergency situation through simulation was a fundamental part of their training, as it allowed them to acquire skills necessary for emergency situations and improve their clinical performance in advanced life support. In addition, they considered the experience a key element in integrating advanced life support into the healthcare setting. The results of this study highlight the need to develop and implement training programs focused on clinical and teamwork skills in nursing programs. Full article

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10 pages, 677 KiB

Open AccessReview

Effectiveness of Complementary Therapies in Cancer Patients: A Systematic Review

by María Dolores Guerra-Martín, María Sandra Tejedor-Bueno and Matías Correa-Casado

Int. J. Environ. Res. Public Health 2021, 18(3), 1017; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18031017 - 24 Jan 2021

Cited by 19 | Viewed by 6822

Abstract

According to the World Health Organization, cancer is the second leading cause of death in the world. In Spain, about a quarter of a million cases were diagnosed in 2017, and 81% of the Spanish population has used, at least once, some kind [...] Read more.

According to the World Health Organization, cancer is the second leading cause of death in the world. In Spain, about a quarter of a million cases were diagnosed in 2017, and 81% of the Spanish population has used, at least once, some kind of complementary therapy. Said therapies are increasingly being used by cancer patients. The purpose of the study is to analyse the effectiveness of complementary therapies among cancer patients. A systematic peer review was conducted following the PRISMA-ScR guide in four databases (PubMed, CINAHL, Scopus and WOS). The inclusion criteria were Randomised Clinical Trials, published between 2013 and 2018, with a value of 3 or more on the Jadad Scale. The protocol was registered in PROSPERO (CRD42019127593). The study sample amounted to 1845 patients (64.55% women), the most common being breast cancer patients (794), followed by lung cancer patients (341). Fifteen complementary therapies were identified. We found two studies for each of the following: electroacupuncture, phytotherapy, hypnotherapy, guided imagery and progressive muscle relaxation. From the remaining ones, we identified a study on each therapy. The findings reveal some effective complementary therapies: auriculotherapy and acupuncture, laser moxibustion, hypnosis, Ayurveda, electroacupuncture, progressive muscle relaxation and guided imagery, yoga, phytotherapy, music therapy and traditional Chinese medicine. On the other hand, electroacupuncture, laser moxibustion and traditional Chinese medicine presented adverse effects, and kinesiology did not show effectiveness. Full article

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11 pages, 353 KiB

Open AccessArticle

Nursing Students’ Satisfaction: A Comparison between Medium- and High-Fidelity Simulation Training

by Ana Rosa Alconero-Camarero, Carmen María Sarabia-Cobo, María José Catalán-Piris, Silvia González-Gómez and José Rafael González-López

Int. J. Environ. Res. Public Health 2021, 18(2), 804; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18020804 - 19 Jan 2021

Cited by 16 | Viewed by 5101

Abstract

Training based on clinical simulation is an effective method of teaching in nursing. Nevertheless, there is no clear evidence about if it is better to use high- or medium-fidelity simulation. The aim is to analyse if students are more satisfied when their clinical [...] Read more.

Training based on clinical simulation is an effective method of teaching in nursing. Nevertheless, there is no clear evidence about if it is better to use high- or medium-fidelity simulation. The aim is to analyse if students are more satisfied when their clinical simulation practices are based on high-fidelity simulation (HFS) or medium-fidelity simulation (MFS). Students´ satisfaction was assessed using the Satisfaction Scale Questionnaire with High-Fidelity Clinical Simulation. The sample is composed of 393 students from two Spanish Universities. Satisfaction with simulation in nursing students is significantly greater in MFS than HFS. Simulation is beneficial for learning in all its forms, but for the acquisition of basic skills, and at a lower cost, MFS proves to be effective. However, high-fidelity is not always better than medium-fidelity as this depends on the student’s level of knowledge and clinical experience. Full article

10 pages, 339 KiB

Open AccessArticle

Transcultural Adaptation and Theoretical Models of Validation of the Spanish Version of the Self-Care of Heart Failure Index Version 6.2 (SCHFI v.6.2)

by Raúl Juárez-Vela, Angela Durante, Rosa Antonio-Oriola, Vicente Gea-Caballero, Michał Czapla, Iván Santolalla-Arnedo, Regina Ruiz de Viñaspre-Hernández, Amaya Burgos-Esteban, José Vicente Benavet-Cervera, Jorge Rubio-Gracia and Ercole Vellone

Int. J. Environ. Res. Public Health 2021, 18(2), 569; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18020569 - 12 Jan 2021

Cited by 4 | Viewed by 2569

Abstract

Background: Heart failure (HF) is a major and growing public health problem worldwide. Across the world, heart failure is associated with high mortality, high hospitalization rates, and poor quality of life. Self-care is defined as a naturalistic decision-making process involving the choice of [...] Read more.

Background: Heart failure (HF) is a major and growing public health problem worldwide. Across the world, heart failure is associated with high mortality, high hospitalization rates, and poor quality of life. Self-care is defined as a naturalistic decision-making process involving the choice of behaviors that maintain physiologic stability, the response to symptoms when they occur, and the ability to follow the treatment regimen and control symptoms. One instrument used to measure self-care is the Self Care of Heart Failure Index. Aim: The purpose of this study was to test the psychometric properties of the Spanish version of the Self Care of Heart Failure Index v.6.2 (SCHFI v.6.2). Methodology: Before testing its psychometric properties, the SCHFI v.6.2 was translated and adapted from its original English version into Spanish. Subsequently, we tested the instrument’s psychometric properties on a sample of 203 participants with HF. Descriptive statistics were used to analyze the sociodemographic and clinical variables, and to describe item responses. We tested the factorial validity of the SCHFI v.6.2 using confirmatory and exploratory factor analysis. Results: Confirmatory factor analysis (CFA) was performed using the our pre-existing models which resulted with poor fit indices. Thus, we performed exploratory factor analysis (EFA) on each of the SCHFI v.6.2 scales. Conclusion: The Spanish version of the SCHFI v.6.2. has good characteristics of factorial validity and can be used in clinical practice and research to measure self-care in patients with HF. Full article

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12 pages, 374 KiB

Open AccessArticle

Living with Restrictions. The Perspective of Nursing Students with Primary Dysmenorrhea

by Elia Fernández-Martínez, Ana Abreu-Sánchez, Juan Francisco Velarde-García, María Teresa Iglesias-López, Jorge Pérez-Corrales and Domingo Palacios-Ceña

Int. J. Environ. Res. Public Health 2020, 17(22), 8527; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17228527 - 17 Nov 2020

Cited by 8 | Viewed by 2935

Abstract

Primary dysmenorrhea (PD) affects a large number of female university students, diminishing their quality of life and hindering academic performance, representing a significant cause of absenteeism. The purpose of our study was to determine how nursing students experienced restrictions as a result of [...] Read more.

Primary dysmenorrhea (PD) affects a large number of female university students, diminishing their quality of life and hindering academic performance, representing a significant cause of absenteeism. The purpose of our study was to determine how nursing students experienced restrictions as a result of primary dysmenorrhea. A qualitative exploratory study was conducted among 33 nursing students with primary dysmenorrhea. A purposeful sampling strategy was applied. Data were collected from five focus groups (two sessions each) and the field notes of 10 researchers. A video meeting platform was used to conduct the focus groups. A thematic inductive analysis was performed. Thirty-three female nursing students participated in the study with a mean age of 22.72 (SD 3.46) years. Three broad themes emerged: (a) restrictions on daily activities and sports; (b) academic restrictions, and (c) restrictions on social and sexual relationships. The students described restrictions in performing everyday activities, such as carrying weight, and shopping. Some students even gave up the practice of sports and were absent from classes at the university, and from clinical practices at the hospital. The pain affected their ability to maintain and create new social relationships. Primary dysmenorrhea caused restrictions in the personal, social and academic life of the nursing students. Full article

14 pages, 7535 KiB

Open AccessArticle

Occupational Safety and Health Training for Undergraduates Nursing Students: A Spanish Pilot

by Esther Vaquero-Álvarez, Antonio Cubero-Atienza, María Pilar Martínez-Jiménez, Manuel Vaquero-Abellán, María Dolores Redel-Macías and Pilar Aparicio-Martínez

Int. J. Environ. Res. Public Health 2020, 17(22), 8381; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17228381 - 12 Nov 2020

Cited by 4 | Viewed by 2208

Abstract

Most of blood borne and airborne pathogens are highly contagious, harmful and have prevalence among healthcare workers. In this group, healthcare students, especially nursing undergraduates, have even higher risk to be exposed and suffered a contagious accident. One of the main pillars to [...] Read more.

Most of blood borne and airborne pathogens are highly contagious, harmful and have prevalence among healthcare workers. In this group, healthcare students, especially nursing undergraduates, have even higher risk to be exposed and suffered a contagious accident. One of the main pillars to prevent exposure to such pathogens and decrease accidents seems to be through education. A prospective observational educational research focused on quantifying the students’ knowledge, and prevention culture was carried out. The educational approach based on the development of a technological tool, its integration in the students’ education, and posterior assessment. The Chi-square, ANOVA, Kruskal–Wallis, Man–Whitney U, and Spearman correlations were used to determine the effect of such educational methodology. The results, previous to the integration of the educational approach, showed differences between the elementary and proficient knowledge and correct procedure in each academic year (p < 0.05), being the best year the third academic year. The mean of elementary knowledge among second year students after the inclusion of the educational methodology improved for 2017/2018 with a mean of 7.5 (1.11) and in 2018/2019 with 7.87 (1.34). This study argued that the educational approach proposed could improve the prevention culture and knowledge among students and future healthcare professionals. Full article

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13 pages, 365 KiB

Open AccessArticle

Facilitators and Barriers in the Organ Donation Process: A Qualitative Study among Nurse Transplant Coordinators

by Víctor Fernández-Alonso, Domingo Palacios-Ceña, Celia Silva-Martín and Ana García-Pozo

Int. J. Environ. Res. Public Health 2020, 17(21), 7996; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17217996 - 30 Oct 2020

Cited by 8 | Viewed by 3622

Abstract

Background: Spain is the world leader in organ donation, with a rate of 49.0 donations per million population. Nurse transplant coordinators fulfill key roles for the success of the complex donation process. Our aims were: (a) to describe the experience of nurse transplant [...] Read more.

Background: Spain is the world leader in organ donation, with a rate of 49.0 donations per million population. Nurse transplant coordinators fulfill key roles for the success of the complex donation process. Our aims were: (a) to describe the experience of nurse transplant coordinators and (b) to identify barriers and facilitators during the process of organ donation. Methods: A qualitative phenomenological study was conducted within the National Transplant Organization. A purposive sampling method was used, and data collection methods included semistructured interviews, researcher field notes, and participants’ personal letters. A systematic text condensation analysis was performed. The study was approved by the Clinical Research Ethics Committee. Results: A total of 16 participants were recruited and four themes were identified: (a) a different job for nurses, (b) facilitators and barriers of the coordinator’s job, (c) not a job for a novice nurse, and (d) coordinators facing a paradigm shift. Coordinators described their job as being characterized with uncertainty and having to face emotional and institutional barriers. The facilitators identified were high educational level and training, and feelings of pride for being part of the National Transplant Organization. Conclusions: The organ donation process requires specialized training to avoid organizational barriers. Full article

10 pages, 366 KiB

Open AccessArticle

Factors Associated with In-Hospital Mortality in Acute Care Hospital Settings: A Prospective Observational Study

by Ana María Porcel-Gálvez, Sergio Barrientos-Trigo, Eugenia Gil-García, Olivia Aguilera-Castillo, Antonio Juan Pérez-Fernández and Elena Fernández-García

Int. J. Environ. Res. Public Health 2020, 17(21), 7951; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17217951 - 29 Oct 2020

Cited by 4 | Viewed by 2926

Abstract

Background: In-hospital mortality is a key indicator of the quality of care. Studies so far have demonstrated the influence of patient and hospital-related factors on in-hospital mortality. Currently, new variables, such as nursing workload or the level of dependency, are being incorporated. We [...] Read more.

Background: In-hospital mortality is a key indicator of the quality of care. Studies so far have demonstrated the influence of patient and hospital-related factors on in-hospital mortality. Currently, new variables, such as nursing workload or the level of dependency, are being incorporated. We aimed to identify which individual, clinical and hospital characteristics are related to hospital mortality. Methods: A multicentre prospective observational study design was used. Sampling was conducted between February 2015 and October 2017. Patients over 16 years, admitted to medical or surgical units at 11 public hospitals in Andalusia (Spain), with a foreseeable stay of at least 48 h were included. Multivariate regression analyses were performed to analyse the data. Results: The sample consisted of 3821 assessments conducted in 1004 patients. The mean profile was that of a male (52%), mean age of 64.5 years old, admitted to a medical unit (56.5%), with an informal caregiver (60%). In-hospital mortality was 4%. The INICIARE (Inventario del Nivel de Cuidados Mediante Indicadores de Clasificación de Resultados de Enfermería) scale yielded an adjusted odds ratio [AOR] of 0.987 (95% confidence interval [CI]: 0.97–0.99) and the nurse staffing level (NSL) yielded an AOR of 1.197 (95% CI: 1.02–1.4). Conclusion: Nursing care dependency measured by INICIARE and nurse staffing level was associated with in-hospital mortality. Full article

12 pages, 683 KiB

Open AccessBrief Report

Sleep Quality in Patients with Heart Failure in the Spanish Population: A Cross-Sectional Study

by Pablo Jorge-Samitier, Angela Durante, Vicente Gea-Caballero, Isabel Antón-Solanas, María Teresa Fernández-Rodrigo and Raúl Juárez-Vela

Int. J. Environ. Res. Public Health 2020, 17(21), 7772; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17217772 - 23 Oct 2020

Cited by 11 | Viewed by 2823

Abstract

Background: Heart failure is a major problem in western societies. Sleep Disorders maintain a bidirectional relationship with heart failure, as shown by studies conducted in other countries. This study aims to describe the quality of sleep in Spanish patients with heart failure. [...] Read more.

Background: Heart failure is a major problem in western societies. Sleep Disorders maintain a bidirectional relationship with heart failure, as shown by studies conducted in other countries. This study aims to describe the quality of sleep in Spanish patients with heart failure. Materials and methods: We carried out a cross-sectional study to analyze the quality of sleep in a sample of 203 patients with a diagnosis of heart failure admitted to an Internal Medicine Service. The Pittsburg Sleep Quality Index (PSQI) was used to evaluate sleep quality in our sample over a one-month period. Results: 75% of the sample presented sleep disorders. The most common problems included the interruption of sleep (73.5% nocturia and 30% breathing difficulties); 35% had poor sleep efficiency; 33% showed a decrease in daytime performance; 84% had used hypnotics at some point to induce sleep and 35% used them regularly. Conclusions: This is the first study to report on the perceived sleep quality of patients with heart failure in Spain. Self-perception of sleep quality differed from that estimated by the PSQI. The prevalence of the use of sleep-inducing medication was very high. The diurnal dysfunction generated by sleep disorders in a heart failure environment can contribute to the development of self-care and cognitive deterioration problems. Full article

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8 pages, 318 KiB

Open AccessBrief Report

Care Dependency in Patients with Heart Failure: A Cross-Sectional Study in Spain

by Raúl Juárez-Vela, Ángela Durante, Begoña Pellicer-García, Antonio Cardoso-Muñoz, José María Criado-Gutiérrez, Isabel Antón-Solanas and Vicente Gea-Caballero

Int. J. Environ. Res. Public Health 2020, 17(19), 7042; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17197042 - 26 Sep 2020

Cited by 3 | Viewed by 1909

Abstract

Background: Heart failure (HF) is a progressive and debilitating condition that represents an ever-growing problem for health systems worldwide. HF patients feel that they are a burden on their families, they feel socially isolated and have a low perception of their health. [...] Read more.

Background: Heart failure (HF) is a progressive and debilitating condition that represents an ever-growing problem for health systems worldwide. HF patients feel that they are a burden on their families, they feel socially isolated and have a low perception of their health. Accordingly, the objectives of this study were to: (1) to explore the profile of care dependency in a representative sample of Spanish HF patients through the Care Dependency Scale (CDS), and (2) to identify correlates of care dependency in this population. Material and Methods: We performed a cross-sectional study of 187 patients admitted for HF decompensation to the Hospital Clínico of Zaragoza (Spain). Results: Only 15% of our sample was highly or completely dependent on care from others. More specifically, our results indicate that HF patients felt a greater level of dependency on care from others when it comes to moving, getting dressed and undressed, maintaining good personal hygiene, participating in daily and recreational activities and being continent. Conclusions: We find association between the CDS categories that present a low score for care dependency in HF patients and the patients’ physical deterioration. Full article

15 pages, 393 KiB

Open AccessArticle

Living with Pain and Looking for a Safe Environment: A Qualitative Study among Nursing Students with Dysmenorrhea

by Elia Fernández-Martínez, Ana Abreu-Sánchez, Jorge Pérez-Corrales, Javier Ruiz-Castillo, Juan Francisco Velarde-García and Domingo Palacios-Ceña

Int. J. Environ. Res. Public Health 2020, 17(18), 6670; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17186670 - 13 Sep 2020

Cited by 12 | Viewed by 5098

Abstract

Dysmenorrhea refers to chronic pain associated with menstruation that is often accompanied by other symptoms. Primary dysmenorrhea (PD) occurs without any associated pelvic disease. Nonetheless, it may negatively affect women’s quality of life. Among university students, dysmenorrhea decreases academic performance and is a [...] Read more.

Dysmenorrhea refers to chronic pain associated with menstruation that is often accompanied by other symptoms. Primary dysmenorrhea (PD) occurs without any associated pelvic disease. Nonetheless, it may negatively affect women’s quality of life. Among university students, dysmenorrhea decreases academic performance and is a cause of absenteeism. The purposes of our study were to describe how nursing students experienced PD and the changes affecting their body and mood. A qualitative case study was performed among 33 nursing students with PD. Data were collected through five focus groups (with two sessions each) and 10 researchers’ field notes. We used a video meeting platform to conduct the focus groups. A thematic analysis was performed, and the Standards for Reporting Qualitative Research and the Consolidated Criteria for Reporting Qualitative Research guidelines were followed. Three main themes emerged from the data: (a) living with dysmenorrhea, with two subthemes: menstruation and pain; (b) body changes and mood swings; and (c) seeking a safe environment, with three subthemes: safe environment, unsafe environment, and key safety aspects. Students considered menstruation to be negative and limiting, causing physical and mood changes, making them feel less attractive, and conditioning their way of dressing and relating. Full article

13 pages, 502 KiB

Open AccessArticle

Impact of Nurses’ Intervention in the Prevention of Falls in Hospitalized Patients

by Raimunda Montejano-Lozoya, Isabel Miguel-Montoya, Vicente Gea-Caballero, María Isabel Mármol-López, Antonio Ruíz-Hontangas and Rafael Ortí-Lucas

Int. J. Environ. Res. Public Health 2020, 17(17), 6048; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17176048 - 20 Aug 2020

Cited by 8 | Viewed by 11488

Abstract

Background: Clinical safety is a crucial component of healthcare quality, focused on identifying and avoiding the risks to which patients are exposed. Among the adverse events that occur in a hospital environment, falls have a large impact (1.9–10% of annual income in acute [...] Read more.

Background: Clinical safety is a crucial component of healthcare quality, focused on identifying and avoiding the risks to which patients are exposed. Among the adverse events that occur in a hospital environment, falls have a large impact (1.9–10% of annual income in acute care hospitals); they can cause pain, damage, costs, and mistrust in the health system. Our objective was to assess the effect of an educational intervention aimed at hospital nurses (systematic assessment of the risk of falls) in reducing the incidence of falls. Methods: this was a quasi-experimental study based on a sample of 581 patients in a third level hospital (Comunitat Valenciana, Spain). An educational program was given to the intervention group (n = 303), and a control group was included for comparison (n = 278). In the intervention group, the nurses participated in a training activity on the systematized assessment of the risk of falls. Analysis was undertaken using the Bayesian logistic regression model. Results: a total of 581 patients were studied (50.6% male, 49.4% female), with an average age of 68.3 (DT = 9) years. The overall incidence of falls was 1.2% (0.3% in the intervention group and 2.2% in the control group). Most of the falls occurred in people ≥65 years old (85.7%). The intervention group had a lower probability of falling than the control group (OR: 0.127; IC95%: 0.013–0.821). Neither the length of hospital stay, nor the age of the participants, had any relevant effect. Conclusions: the systematic assessment of the risk of a patient falling during hospital processes is an effective intervention to reduce the incidence of falls. Full article

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13 pages, 2397 KiB

Open AccessArticle

Role of Global Self-Esteem in Predicting Life Satisfaction of Nursing Students in Poland, Spain and Slovakia

by Ewa Kupcewicz, Elżbieta Grochans, Marzena Mikla, Helena Kadučáková and Marcin Jóźwik

Int. J. Environ. Res. Public Health 2020, 17(15), 5392; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17155392 - 27 Jul 2020

Cited by 8 | Viewed by 2938

Abstract

Background: This study analyzed the role of global self-esteem and selected sociodemographic variables in predicting life satisfaction of nursing students in Poland, Spain and Slovakia. Methods: The study subjects were full-time nursing students from three European countries. A diagnostic survey was used [...] Read more.

Background: This study analyzed the role of global self-esteem and selected sociodemographic variables in predicting life satisfaction of nursing students in Poland, Spain and Slovakia. Methods: The study subjects were full-time nursing students from three European countries. A diagnostic survey was used as a research method, while the Rosenberg self-esteem scale (SES) and the satisfaction with life scale (SWLS) were used to collect data. Results: The research was performed on a group of 1002 students. The mean age of those surveyed was 21.6 (±3.4). The results showed significant differences both in the level of the global self-esteem index (F = 40.74; p < 0.0001) and in the level of general satisfaction with life (F = 12.71; p < 0.0001). A comparison of the structure of results demonstrated that there were significantly fewer students with high self-esteem in Spain (11.06%) than in Poland (48.27%) and in Slovakia (42.05%), while more students with a high sense of life satisfaction were recorded in Spain (64.90%) than in Poland (37.87%) or in Slovakia (47.44%). A positive, statistically significant correlation was found between global self-esteem and satisfaction with life in the group of Slovak students (r = 0.37; p < 0.0001), Polish students (r = 0.31; p < 0.0001) and Spanish students (r = 0.26; p < 0.0001). Furthermore, a regression analysis proved that three variables explaining a total of 12% output variation were the predictors of life satisfaction in Polish students. The regression factor was positive (ßeta = 0.31; R² = 0.12), which indicates a positive correlation and the largest share was attributed to global self-esteem (9%). In the group of Spanish students, global self-esteem explained 7% (ßeta = 0.27; R² = 0.07) of the output variation and 14% in the group of Slovak students (ßeta = 0.38; R² = 0.14). Conclusions: The global self-esteem demonstrates the predictive power of life satisfaction of nursing students, most clearly marked in the group of Slovak students. The measurement of the variables under consideration may facilitate the planning and implementation of programs aimed at increasing self-esteem among young people and promoting the well-being of nursing students. Full article

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15 pages, 624 KiB

Open AccessArticle

Nurses’ Self-Assessment of Caring Behaviors in Nurse–Patient Interactions: A Cross-Sectional Study

by Jasenka Vujanić, Nada Prlić and Robert Lovrić

Int. J. Environ. Res. Public Health 2020, 17(14), 5255; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17145255 - 21 Jul 2020

Cited by 29 | Viewed by 8480

Abstract

Nurse–patient interactions based on caring behaviors ensure better working conditions and better-quality healthcare. The aim of this quantitative study is to examine how nurses self-assess the frequency of applying caring behaviors in nurse–patient interactions and to identify the differences in the application frequency [...] Read more.

Nurse–patient interactions based on caring behaviors ensure better working conditions and better-quality healthcare. The aim of this quantitative study is to examine how nurses self-assess the frequency of applying caring behaviors in nurse–patient interactions and to identify the differences in the application frequency of caring behaviors in relation to work experience and education level. The respondents were Bachelor of Science (BSc) nurses and nurses with basic training (VET) employed in different clinical departments of the Clinical Hospital Center in Croatia. The survey used the “Caring Nurse–Patient Interactions Scale (Nurse Version)”. The respondents assessed the caring behaviors from the subscale “needs” as the most frequently applied (median (Me): 4.7; interquartile range (IQR): 4.4–4.9), while the least frequently applied were the procedures from the subscale “sensitivity” (Me: 3.8; IQR: 3.2–4.3). The VET nurses reported applying caring behaviors to the subscales “hope” (p < 0.001), “problem-solving” (p = 0.003), and “environment” (p = 0.021) more frequently than BSc nurses did. Compared with less experienced respondents, the respondents with more than 30 years of work experience applied the caring behaviors on the subscales “sensitivity” (p = 0.009), “expression of emotions” (p = 0.001), “problem-solving” (p = 0.008), and especially “humanism” and “spirituality” (p < 0.001) more frequently. The results indicate that respondents are more focused on applying skills or carrying out a task than on caring behaviors which is about demonstrating compassion, loving kindness, and relationships. Full article

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15 pages, 702 KiB

Open AccessArticle

Toward an Integrative Nursing Curriculum: Combining Team-Based and Problem-Based Learning with Emergency-Care Scenario Simulation

by Cheng-Yi Huang and Ya-huei Wang

Int. J. Environ. Res. Public Health 2020, 17(12), 4612; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17124612 - 26 Jun 2020

Cited by 12 | Viewed by 4357

Abstract

Objective: The study intended to combine team-oriented, problem-based learning (PBL) with emergency-care simulation to investigate whether an integrative intervention could positively impact the core nursing competencies and teacher performance of nursing students. Methods: The study belonged to the domain of action research, which [...] Read more.

Objective: The study intended to combine team-oriented, problem-based learning (PBL) with emergency-care simulation to investigate whether an integrative intervention could positively impact the core nursing competencies and teacher performance of nursing students. Methods: The study belonged to the domain of action research, which aimed to address the weaknesses of traditional teacher-led, lecture-based learning. An 18-week, single-case experimental design, in which 58 senior nursing students at a medical university in central Taiwan participated, was conducted to test the possible benefits of the intervention. The measures included the Scale of Core Nursing Competencies and the Teacher Performance Evaluation Scale. Results: The research results showed that nursing students who received integrative training that combined team-based PBL with emergency-care scenario simulation had stronger mastery over core nursing competencies. At the same time, they also evaluated both the “Emergency Care” course for which the curriculum was used and the teachers’ performance in that course more highly. Conclusions: The findings suggest that an integrative curriculum combining team-based PBL with scenario simulation is worth pursuing. Compared with traditional teacher-led, lecture-based teaching, this curriculum may be more effective in helping nursing students develop core competencies in their field. Full article

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11 pages, 1016 KiB

Open AccessArticle

Resilience Scale Psychometric Study. Adaptation to the Spanish Population in Nursing Students

by Ana M. Tur Porcar, Noemí Cuartero Monteagudo, Vicente Gea-Caballero and Raúl Juárez-Vela

Int. J. Environ. Res. Public Health 2020, 17(12), 4602; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17124602 - 26 Jun 2020

Cited by 7 | Viewed by 2877

Abstract

Nursing students and professionals are exposed to highly stressful clinical situations. However, when confronted with stress, which is exacerbated by academic and professional situations, there is a great disparity between those who do not know how to respond suitably to the demands from [...] Read more.

Nursing students and professionals are exposed to highly stressful clinical situations. However, when confronted with stress, which is exacerbated by academic and professional situations, there is a great disparity between those who do not know how to respond suitably to the demands from patients or teachers due to a lack of competence and personal resistance, and those who are more resilient and develop a greater range of strengths. This research aims to analyse the validity and psychometric characteristics of a questionnaire on resilience adapted to Spanish nursing bachelor’s degree students. The participants were 434 undergraduate nursing students from the province of Valencia (Spain) between 17 and 54 years of age (Mean, M = 21; Standard Deviation, SD = 0.320), 104 of whom were men (24%) and 330 women (76%). A cross-sectional group evaluation was carried out in the university itself, adhering to the ethical standards of the Declaration of Helsinki. Based on the descriptive, factorial, exploratory and confirmatory analyses, it was possible to confirm the suitability of the questionnaire and its adaptation to nursing students. The model is thus suitable for evaluating the population under study. Furthermore, there are statistically significant differences depending on age and gender. The results show that the questionnaire analysed is suited to evaluating resilience among Spanish nursing students, thereby justifying the adaptation of a scale of this nature to foster resilience among nursing students and nurses in professional life, who are exposed to critical situations with patients’ suffering, deterioration or death. Our study highlights important practical implications: Spanish nursing studies involve theory and practice, but students and nurses in professional life have to confront critical situations of patients’ suffering, deterioration, or death. These situations cause stress and feelings of impotence that may lead to chronic stress and even suicidal thoughts. Full article

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16 pages, 1943 KiB

Open AccessArticle

Analysis of the Relationship between Stress Intensity and Coping Strategy and the Quality of Life of Nursing Students in Poland, Spain and Slovakia

by Ewa Kupcewicz, Elżbieta Grochans, Helena Kadučáková, Marzena Mikla and Marcin Jóźwik

Int. J. Environ. Res. Public Health 2020, 17(12), 4536; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17124536 - 24 Jun 2020

Cited by 31 | Viewed by 5382

Abstract

Background: This study aimed to determine the relationship between stress intensity and coping strategies and the quality of life and health among nursing students in Poland, Spain and Slovakia. Methods: The study was performed on a group of 1002 nursing students from three [...] Read more.

Background: This study aimed to determine the relationship between stress intensity and coping strategies and the quality of life and health among nursing students in Poland, Spain and Slovakia. Methods: The study was performed on a group of 1002 nursing students from three European countries. A diagnostic survey was used as a research method and the data collection was based on the Perceived Stress Scale PSS-10, Mini-COPE Coping Inventory-and the WHOQoL-Bref questionnaire. Results: The average age of all the respondents was 21.6 years (±3.4). Most of the surveyed students rated their stress intensity over the last month as moderate or high. Comparison of the results of the stress levels in relation to the country of residence did not reveal statistically significant differences. In the group of Polish students, the most positive relationship between active coping strategies and the quality of life in the psychological (r = 0.43; p < 0.001) and physical health domain (r = 0.42; p < 0.001) were most strongly marked. Among Slovak students, significant correlations of low intensity were found between active coping strategies and the quality of life in the physical health (r = 0.15; p < 0.01), psychological (r = 0.21; p < 0.001), social relationships (r = 0.12; p < 0.05) and environment (r = 0.19; p < 0.001) domain. In overcoming stressful situations, Spanish students used the Sense of Humour strategy, which is considered less effective, although very useful in some cases. In this group, the strongest positive correlation was found for the psychological domain (r = 0.40; p < 0.001). Conclusions: There is a need to implement prevention and stress coping programmes at every stage of studies to ensure effective protection against the negative effects of stress and to improve the quality of life of nursing students. Full article

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16 pages, 353 KiB

Open AccessArticle

Challenges Affecting Access to Health and Social Care Resources and Time Management among Parents of Children with Rett Syndrome: A Qualitative Case Study

by Javier Güeita-Rodriguez, Pilar Famoso-Pérez, Jaime Salom-Moreno, Pilar Carrasco-Garrido, Jorge Pérez-Corrales and Domingo Palacios-Ceña

Int. J. Environ. Res. Public Health 2020, 17(12), 4466; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17124466 - 21 Jun 2020

Cited by 16 | Viewed by 3257

Abstract

Rare diseases face serious sustainability challenges regarding the distribution of resources geared at health and social needs. Our aim was to describe the barriers experienced by parents of children with Rett Syndrome for accessing care resources. A qualitative case study was conducted among [...] Read more.

Rare diseases face serious sustainability challenges regarding the distribution of resources geared at health and social needs. Our aim was to describe the barriers experienced by parents of children with Rett Syndrome for accessing care resources. A qualitative case study was conducted among 31 parents of children with Rett syndrome. Data were collected through in-depth interviews, focus groups, researchers’ field notes and parents’ personal documents. A thematic analysis was performed and the Standards for Reporting Qualitative Research (SRQR) guidelines were followed. Three main themes emerged from the data: (a) essential health resources; (b) bureaucracy and social care; and (c) time management constraints. Parents have difficulties accessing appropriate health services for their children. Administrative obstacles exist for accessing public health services, forcing parents to bear the financial cost of specialized care. Time is an essential factor, which conditions the organization of activities for the entire family. Qualitative research offers insight into how parents of children with Rett syndrome experience access to resources and may help improve understanding of how Rett syndrome impacts the lives of both the children and their parents. Full article

7 pages, 308 KiB

Open AccessBrief Report

Risk of Falling and Associated Factors in Older Adults with a Previous History of Falls

by Begoña Pellicer-García, Isabel Antón-Solanas, Enrique Ramón-Arbués, Loreto García-Moyano, Vicente Gea-Caballero and Raúl Juárez-Vela

Int. J. Environ. Res. Public Health 2020, 17(11), 4085; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17114085 - 08 Jun 2020

Cited by 13 | Viewed by 4037

Abstract

Falls in the elderly are one of the main geriatric syndromes and a clear indicator of fragility in the older adult population. This has serious consequences, leading to an increase in disability, institutionalization and death. The purpose of this cross-sectional study was to [...] Read more.

Falls in the elderly are one of the main geriatric syndromes and a clear indicator of fragility in the older adult population. This has serious consequences, leading to an increase in disability, institutionalization and death. The purpose of this cross-sectional study was to analyze the prevalence of risk of falling and associated factors in a population of 213 non-institutionalised, able older adults with a history of falling in the previous year. We used the following assessment tools: Questionnaire of the WHO for the study of falls in the elderly, Geriatric Depression Scale and Tinetti’s Gait and Balance Assessment Tool. Age, using ambulatory assistive devices, polymedication, hospital admission following a fall and depression were significantly associated with risk of falling. In order to prevent fall reoccurrence, community-based fall prevention programs should be implemented. Full article

9 pages, 302 KiB

Open AccessArticle

Transcultural Adaptation and Piloting of the “Regarding Blood-Sampling Practices at Primary Health Care Centres” Questionnaire

by Adolfo Romero-Arana, Blanca Prieto-Callejero, Javier Fagundo-Rivera, Juan Gómez-Salgado, Macarena Romero-Martín, Carlos Ruiz-Frutos and Adolfo Romero

Int. J. Environ. Res. Public Health 2020, 17(10), 3541; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17103541 - 19 May 2020

Cited by 1 | Viewed by 1742

Abstract

Preanalytical errors account for up to 70% of the total potentially detectable errors in the laboratory. The main problems detected are related with procedures associated with Primary Care nursing practices that are directly involved in the preanalytical phase. The objective of this study [...] Read more.

Preanalytical errors account for up to 70% of the total potentially detectable errors in the laboratory. The main problems detected are related with procedures associated with Primary Care nursing practices that are directly involved in the preanalytical phase. The objective of this study is to carry out a transcultural adaptation and piloting of the “Regarding Blood-Sampling Practices at Primary Health Care Centres” questionnaire as regards blood sampling in Primary Care. For this, a cross-sectional descriptive study has been developed within the Primary Care area of the Andalusian Public Health System. The venous blood sampling questionnaire was translated into and adapted to Spanish by qualified professionals and expert translators. The questionnaires were then delivered to all staff nurses from the health districts involved. The total sample consisted of 224 primary care nursing professionals. The factors that showed statistically significant relationships were identification and sample collection, management with information search, storage and labelling of samples, and reporting of errors. A lack of global relationship between factors makes it impossible to find a global quality factor in the sampling process. The process of translation, adaptation, and piloting of the questionnaire from its original version to the Spanish one has proven to be understandable by professionals in its entirety and to offer data similar to the original version. Full article

13 pages, 298 KiB

Open AccessArticle

Unmet Supportive Care Needs of Survival Patients with Nasopharyngeal Carcinoma

by Ya-Ling Lin, Chun-Yi Chuang, Vivian Chia-Rong Hsieh, Ming-Shou Tsai, Yen-Fang Liu, Xian-Xiu Chen and Shwn-Huey Shieh

Int. J. Environ. Res. Public Health 2020, 17(10), 3519; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17103519 - 18 May 2020

Cited by 3 | Viewed by 2457

Abstract

This study examined unmet supportive care needs for nasopharyngeal carcinoma (NPC) patients by cancer stage and treatment phase, as well as the factors associated with these unmet needs. At a cancer center in central Taiwan, information on consultations and services patients received at [...] Read more.

This study examined unmet supportive care needs for nasopharyngeal carcinoma (NPC) patients by cancer stage and treatment phase, as well as the factors associated with these unmet needs. At a cancer center in central Taiwan, information on consultations and services patients received at the resource center was described in the service chart. We extracted data available for NPC patients to evaluate their unmet supportive care needs (health information, patient care, treatment, nutritional, psychosocial, and economic) and their association with sex, age, cancer stage, and treatment phase. The 145 NPC patients were 68.3% male, 60.0% less than 50 years old, and 83.5% diagnosed at stages III and IV. The most prevalent unmet need was nutritional (40.7%), followed by psychosocial and patient care, with economic unmet needs the least (4.8%). Women were more likely than men to have patient care unmet needs (32.6% vs. 15.2%). Nutritional unmet need was higher in older patients than in younger ones (83.3% vs. 35.6%), with an adjusted odds ratio (aOR) of 9.39 (95% confidence interval (CI) = 2.17–40.70). Psychosocial unmet needs were higher in younger patients than old patients (34.5% vs. 0%) and in patients interviewed during follow-up period than those at newly diagnosed (55.2% vs. 23.1%). In conclusion, the most commonly reported concern was nutritional unmet needs for NPC patients. Their unmet needs may vary by demographic and disease factors, including patient sex and age, cancer stage, and treatment phase. Full article

14 pages, 684 KiB

Open AccessProtocol

Moving Evidence into Practice by Advanced Practice Nurses in Hospitalization Wards. Protocol for a Multicentre Quasi-Experimental Study in Three Hospitals in Spain

by Sandra Pol-Castañeda, Miguel Ángel Rodríguez-Calero, Concepción Zaforteza-Lallemand, Carlos Javier Villafáfila-Gomila, Ian Blanco-Mavillard, Francisco Ferrer-Cruz and Joan De Pedro-Gómez

Int. J. Environ. Res. Public Health 2020, 17(10), 3473; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17103473 - 16 May 2020

Cited by 3 | Viewed by 4122

Abstract

Evidence-based practice (EBP) combined with quality of care improves patient outcomes. However, there are still difficulties for its implementation in daily clinical practice. This project aims to evaluate the impact of the incorporation of the Advanced Practice Nurse (APN) role on the implementation [...] Read more.

Evidence-based practice (EBP) combined with quality of care improves patient outcomes. However, there are still difficulties for its implementation in daily clinical practice. This project aims to evaluate the impact of the incorporation of the Advanced Practice Nurse (APN) role on the implementation of EBP at three levels: context, nurses’ perceptions, and clinical outcomes. Mixed-methods study in two phases is proposed. Phase 1: a quasi-experimental design where five APNs are included in five hospitalization wards that are compared with another five similar wards without APNs. Variables from Practice-Environment-Scale-Nursing-Work-Index, Health-Science-Evidence-Based-Practice-Questionnaire, and Advanced-Practice-Nursing-Competency-Assessment-Instrument are used. Clinical outcomes are followed-up with monthly. A descriptive and exploratory analysis is performed. Phase 2: an exploratory qualitative design through focus groups at the intervention wards after one year of APNs implementation. Explicative data are gathered to explain the progression of change and how actors perceive and attribute triggers, barriers, and facilitators for change. An inductive thematic analysis is performed. The inclusion of APN in hospitalization context is insufficiently studied. It is hoped that these figures provide solutions to the multiple barriers in the development of EBP in these sceneries and contribute to resolve the gap between research results and healthcare practice. Full article

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9 pages, 301 KiB

Open AccessArticle

Quality of Care: Ecological Study for the Evaluation of Completeness and Accuracy in Nursing Assessment

by Angela Iula, Carola Ialungo, Chiara de Waure, Matteo Raponi, Matteo Burgazzoli, Maurizio Zega, Caterina Galletti and Gianfranco Damiani

Int. J. Environ. Res. Public Health 2020, 17(9), 3259; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17093259 - 07 May 2020

Cited by 10 | Viewed by 4124

Abstract

Nursing documentation is an important proxy of the quality of care, and quality indicators in nursing assessment can be used to assess and improve the quality of care in health care institutions. The study aims to evaluate the completeness and the accuracy of [...] Read more.

Nursing documentation is an important proxy of the quality of care, and quality indicators in nursing assessment can be used to assess and improve the quality of care in health care institutions. The study aims to evaluate the completeness and the accuracy of nursing assessment, analyzing the compilation of pain assessment and nutritional status (body mass index (BMI)) in computerized nursing records, and how it is influenced by four variables: nurse to patient ratio, diagnosis related group weight (DRG), seniority of charge nurse, and type of ward (medical, surgical or other). The observational ecological pilot study was conducted between September and October 2018 in an Italian Tertiary-Level Teaching Hospital. The nursing documentation analyzed for the ‘Assessment’ phase included 12,513 records, 50.4% concerning pain assessment, and 45% BMI. The nurse–patient ratio showed a significant direct association with the assessment of nutritional status (p = 0.032). The average weight DRG has a negative influence on pain and BMI assessment; the surgical units positively correlate with the compilation of nursing assessment (BMI and pain). The nursing process is an essential component for the continuous improvement in the quality of care. Nurses need to be accountable to improve their knowledge and skills in nursing documentation. Full article

13 pages, 327 KiB

Open AccessArticle

The Influence of Self-Concept on Clinical Decision-Making in Nurses and Nursing Students: A Cross-Sectional Study

by Nikolina Farčić, Ivana Barać, Robert Lovrić, Stana Pačarić, Zvjezdana Gvozdanović and Vesna Ilakovac

Int. J. Environ. Res. Public Health 2020, 17(9), 3059; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17093059 - 28 Apr 2020

Cited by 20 | Viewed by 6825

Abstract

The aim of this study is to examine the influence of nurses’ self-concept (NSC) on clinical decision-making (CDM) among nursing students and hospital nurses. A further aim is to examine whether there is a difference in CDM and NSC between hospital nurses with [...] Read more.

The aim of this study is to examine the influence of nurses’ self-concept (NSC) on clinical decision-making (CDM) among nursing students and hospital nurses. A further aim is to examine whether there is a difference in CDM and NSC between hospital nurses with various levels of experience and nursing students. A cross-sectional study was conducted during 2018 in the Faculty of Dental Medicine and Health and the University Hospital Center, in Osijek, Croatia, EU. The respondents consisted of 568 hospital nurses, and 129 BSc nursing students. Data were collected with the clinical decision-making in nursing scale (CDMNS) and the nurses’ self-concept questionnaire (NSCQ). There was no correlation between CDM and NSC in either students or hospital nurses. Hospital nurses generally had significantly higher scores in CDM than nursing students. On the other hand, students had a significantly higher total NSC level. The results of this study suggest that experience has a positive impact on nurses’ CDM skills. The high NSC estimated by students enables them to easily take up their clinical roles and approach the patient in a holistic manner, which is an attitude that gradually develops during studies and with clinical experience. Full article

12 pages, 695 KiB

Open AccessArticle

Cancer Patients and Anxiety: A Gender Perspective

by Paula Parás-Bravo, María Paz-Zulueta, Ester Boixadera-Planas, Víctor Fradejas-Sastre, Domingo Palacios-Ceña, César Fernández-de-las-Peñas and Cristina Alonso-Blanco

Int. J. Environ. Res. Public Health 2020, 17(4), 1302; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17041302 - 18 Feb 2020

Cited by 18 | Viewed by 2891

Abstract

The complexity of the diagnosis and treatment of cancer means that it is often associated with anxiety symptoms. The aim of our study was to further our understanding of the oncological process and the presence of anxiety symptoms, from a gender perspective. A [...] Read more.

The complexity of the diagnosis and treatment of cancer means that it is often associated with anxiety symptoms. The aim of our study was to further our understanding of the oncological process and the presence of anxiety symptoms, from a gender perspective. A cross-sectional study was performed, examining 402 medical records obtained by simple random sampling of oncology patients at a hospital in northern Spain from July 2012 to July 2014. Data collection took place between February and May 2015. Psychiatric and sociodemographic variables were gathered, as well as pain variables and information regarding the oncological process. The data analysis included a descriptive univariate analysis and a bivariate analysis, and a logistic regression model was performed. Our results suggest that women with cancer suffer more anxiety symptoms than men with cancer. Women with anxiety symptoms represented 76.5% of all patients with anxiety. The OR of suffering anxiety symptoms between women and men was 2.43 (95% CI 1.05–5.63) (p = 0.04). A greater incidence of anxiety symptoms was found in patients with cancer pain and oncological treatment with biological therapy. Our results suggest that the gender perspective is necessary in the management of mental health in patients with cancer. Nonetheless, further studies are necessary to confirm our findings. Full article

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14 pages, 560 KiB

Open AccessReview

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

by Tomás Arias-Colmenero, Mª Ángeles Pérez-Morente, Antonio Jesús Ramos-Morcillo, Concepción Capilla-Díaz, María Ruzafa-Martínez and César Hueso-Montoro

Int. J. Environ. Res. Public Health 2020, 17(2), 639; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17020639 - 19 Jan 2020

Cited by 22 | Viewed by 9098

Abstract

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, [...] Read more.

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. Full article

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13 pages, 1947 KiB

Open AccessArticle

Effectiveness of an Interdisciplinary Program Performed on Obese People Regarding Nutritional Habits and Metabolic Comorbidity: A Randomized Controlled Clinical Trial

by Virginia Esperanza Fernández-Ruiz, Antonio Jesús Ramos-Morcillo, María Solé-Agustí, José Antonio Paniagua-Urbano and David Armero-Barranco

Int. J. Environ. Res. Public Health 2020, 17(1), 336; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17010336 - 03 Jan 2020

Cited by 4 | Viewed by 3756

Abstract

Obesity is an important public health problem. The combined use of different therapies performed by an interdisciplinary group can improve the management of this health issue. The main goal of this research is to determine the effectiveness of a multidisciplinary program based on [...] Read more.

Obesity is an important public health problem. The combined use of different therapies performed by an interdisciplinary group can improve the management of this health issue. The main goal of this research is to determine the effectiveness of a multidisciplinary program based on healthy eating, exercise, cognitive-behavioral therapy, and health education in improving metabolic comorbidity, Body Mass Index (BMI), and nutritional habits among obese adults, at short (12 months) and long term (24 months). A randomized controlled clinical trial was conducted at a community care center between February 2014 and February 2016. A random sampling was done (299), total population (3262). A sample of 74 subjects diagnosed with obesity (experimental group, n = 37 and control group, n = 37) was conducted. Inclusion criteria: obese people (BMI: >30 kg/m²) with metabolic comorbidity and bad nutritional habits. Exclusion criteria: other comorbidities. A 12-month interdisciplinary program (with pre-test, 12 months and 24 months of follow-up) was applied. Intervention is based on healthy eating, exercise, and cognitive behavioral therapy. The intervention had a positive effect on nutritional habits (F2;144 = 115.305; p < 0.001). The experimental group increased fruit and vegetable intake (F2;144 = 39.604, p < 0.001), as well as fortified foods (F2;144 = 10,076, p < 0.001) and reduced fats, oils, and sweets F2;144 = 24,086, p < 0.001). In the experimental group, a BMI reduction of 2.6 to 24 months was observed. At follow-up, no participant had inadequate nutritional habits, compared to 35.1% of the control group (χ22 = 33,398; p < 0.001). There was also a positive response of metabolic comorbidities in the intervention group. The interdisciplinary program improved all participants’ metabolic parameters, BMI, and nutritional habits while maintaining the long-term effects (24 months). Full article

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2019

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10 pages, 461 KiB

Open AccessArticle

Should We Be Trained to Train? Nursing Students’ and Newly Qualified Nurses’ Perception on Good Lecturers and Good Clinical Preceptors

by José Manuel Martínez-Linares, Celia Parra-Sáez, Carlos Tello-Liébana and Olga María López-Entrambasaguas

Int. J. Environ. Res. Public Health 2019, 16(24), 4885; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph16244885 - 04 Dec 2019

Cited by 16 | Viewed by 5791

Abstract

Background: The reform of the Spanish higher education studies from the Bologna Declaration did not entail the necessary changes in the teaching methodologies used. The clinical preceptor emerged as the main guiding professional in the practical training of nursing students. The aim [...] Read more.

Background: The reform of the Spanish higher education studies from the Bologna Declaration did not entail the necessary changes in the teaching methodologies used. The clinical preceptor emerged as the main guiding professional in the practical training of nursing students. The aim of this qualitative study was to understand fourth-year nursing students’ and newly qualified nurses’ (NQNs) perception on their lecturers’ and clinical preceptors’ effectiveness. Methods: Exploratory, descriptive qualitative study was carried out at a Spanish University. By convenience sampling and according to defined inclusion and exclusion criteria, twelve newly qualified nurses and twelve fourth-year students of the Degree in Nursing were included in order to contrast the results. A thematic analysis of data was carried out, to later be coded by two researchers. Results: Two main themes were identified: the good lecturer and the good clinical preceptor, with several subthemes in each. These included the characteristics that both should have, both in teaching, nursing and interpersonal-relation skills. Conclusions: The need of preceptorship training programs has been highlighted in our context. Educators all over the world should be properly qualified in order to train and educate competent nurses for the future. Full article

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9 pages, 329 KiB

Open AccessArticle

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

by José Luis Díaz Agea, Antonio Jesús Ramos-Morcillo, Francisco José Amo Setien, María Ruzafa-Martínez, César Hueso-Montoro and César Leal-Costa

Int. J. Environ. Res. Public Health 2019, 16(23), 4646; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph16234646 - 22 Nov 2019

Cited by 12 | Viewed by 3076

Abstract

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 [...] Read more.

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. Full article

21 pages, 2017 KiB

Open AccessReview

Impact of Resistance Therapy on Motor Function in Children with Cerebral Palsy: A Systematic Review and Meta-Analysis

by Luisa Collado-Garrido, Paula Parás-Bravo, Pilar Calvo-Martín and Miguel Santibáñez-Margüello

Int. J. Environ. Res. Public Health 2019, 16(22), 4513; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph16224513 - 15 Nov 2019

Cited by 12 | Viewed by 4735

Abstract

Cerebral palsy is one of the main causes of disability in childhood. Resistance therapy shows benefits in increasing strength and gait in these patients, but its impact on motor function is not yet clear. The objective was to analyze the impact of resistance [...] Read more.

Cerebral palsy is one of the main causes of disability in childhood. Resistance therapy shows benefits in increasing strength and gait in these patients, but its impact on motor function is not yet clear. The objective was to analyze the impact of resistance therapy on the improvement in the motor function using a review and meta-analysis. A comprehensive literature research was conducted in Medline (PubMed), Institute for Scientific Information (ISI) Web of Knowledge, and Physiotherapy Evidence Database (PEDro) in relation to clinical trials in which resistance therapy was used and motor function was assessed. Twelve controlled clinical trials and three non-controlled clinical trials (only one intervention arm) studies were identified. In terms of pre–post difference, the overall intra-group effect was in favor of resistance therapy intervention: standardized mean difference (SMD) = 0.37, 95% confidence interval (CI) = 0.21 to 0.52, p < 0.001 (random-effects model), with moderate heterogeneity (I² = 59.82%). SMDs were also positive by restricting to each of the analyzed scales: SMD = 0.37, 1.33, 0.10, and 0.36 for Gross Motor Function Measure (GMFM), Lateral Step Up (LSU), Time Up and Go (TUG), and Mobility Questionnaire (MobQue) scales, respectively. Regarding the difference between groups, the results showed a high heterogeneity (I² < 99%), with the mean difference (MD) also favorable for the GMFM scale: MD = 1.73, 95% CI = 0.81 to 2.64, p < 0.001 (random-effects model). Our results support a positive impact of resistance therapy on motor function. Further studies should delve into the clinical relevance of these results. Full article

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14 pages, 331 KiB

Open AccessArticle

Knowledge, Attitudes, and Intentions towards Human Papillomavirus Vaccination among Nursing Students in Spain

by Sara Villanueva, Diego Gabriel Mosteiro-Miguéns, Eva María Domínguez-Martís, David López-Ares and Silvia Novío

Int. J. Environ. Res. Public Health 2019, 16(22), 4507; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph16224507 - 15 Nov 2019

Cited by 27 | Viewed by 4203

Abstract

Human papillomavirus (HPV), which is linked to specific types of cancer, can be prevented by vaccination. This study aimed to determine the knowledge and attitudes of nursing students about HPV and its vaccine as well as their intentions towards personal vaccination. A total [...] Read more.

Human papillomavirus (HPV), which is linked to specific types of cancer, can be prevented by vaccination. This study aimed to determine the knowledge and attitudes of nursing students about HPV and its vaccine as well as their intentions towards personal vaccination. A total of 536 Spanish nursing students were invited to complete the Spanish version of the questionnaire “Knowledge, attitudes and intentions towards HPV”. Overall, 367 surveys were completed (68.4% response rate). Data analysis included the calculation of three scores: the knowledge score, categorized into low (<33%), moderate (33%–66%), and good knowledge (>66%); the attitude score, sorted into positive (<2.5), neutral (2.5–3.5), and negative attitude (>3.5); and the intention score, categorized into not favorable (<4), neutral (4–7), and favorable intention (>7). Knowledge about HPV and its vaccine was moderate (54.34 ± 0.9%), and the attitude towards vaccination was positive (2.34 ± 0.03). The intention towards personal vaccination increased significantly after completing the questionnaire (before: 4.14 ± 0.27, after: 6.02 ± 0.28; p < 0.001). The present study highlights the need of training future nurses about HPV and its vaccine, considering the important role it plays in the prevention of sexually transmitted diseases. Full article

12 pages, 367 KiB

Open AccessArticle

The Impact of Health Human Resources Policies in Primary Care Nursing: A Qualitative Study

by María Madrazo-Pérez, Paula Parás-Bravo, Esperanza Rayón-Valpuesta, Cristina Blanco-Fraile and Domingo Palacios-Ceña

Int. J. Environ. Res. Public Health 2019, 16(19), 3653; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph16193653 - 28 Sep 2019

Cited by 5 | Viewed by 3129

Abstract

Background: Organizational culture plays a key role regarding organizational outcomes and determining strategies, goals, and modes of operating which is associated with higher rates of worker morale, turnover and lower adverse events related to patient quality of care issues. Aim: to describe the [...] Read more.

Background: Organizational culture plays a key role regarding organizational outcomes and determining strategies, goals, and modes of operating which is associated with higher rates of worker morale, turnover and lower adverse events related to patient quality of care issues. Aim: to describe the impact of the relocation of nurses from hospitals and other contexts to primary care from the perspective of primary care nurses. Methods: A qualitative, focused ethnographic study. Site: Cantabro Health Service, Cantabria, Spain. Purposeful sampling methods were used to include nurses who were working in primary care during the study, and who had previous experience of at least one year in primary care. Observation (385 hours, 7 months) and in-depth interviews (17) were used to collect data. A thematic analysis was applied. Results: Four themes emerged from the data: (a) staff policies applied, (b) beliefs regarding the newly incorporated nursing staff, (c) reasons for relocation to primary care, and (d) concern for the future. Conclusions: In primary care, the relocation of non-qualified nursing professionals who are at the end of their career may have a negative impact on the organizational culture. It is necessary to research the most appropriate measures for guaranteeing a satisfactory work environment based on nurses who are qualified in primary health care settings. Full article

11 pages, 471 KiB

Open AccessArticle

A Model of Phlebitis Associated with Peripheral Intravenous Catheters in Orthopedic Inpatients

by Sookhee Lee, Kyunghee Kim and Ji-Su Kim

Int. J. Environ. Res. Public Health 2019, 16(18), 3412; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph16183412 - 14 Sep 2019

Cited by 10 | Viewed by 4713

Abstract

Phlebitis leads to increased discomfort for patients, longer hospital stays, and higher healthcare costs. This study aimed to identify predictive factors of peripheral phlebitis related to intravenous injection among orthopedic inpatients, develop a prediction model, and evaluate the goodness-of-fit of the prediction model. [...] Read more.

Phlebitis leads to increased discomfort for patients, longer hospital stays, and higher healthcare costs. This study aimed to identify predictive factors of peripheral phlebitis related to intravenous injection among orthopedic inpatients, develop a prediction model, and evaluate the goodness-of-fit of the prediction model. This study included 270 orthopedic patients who were hospitalized in the orthopedic ward of a general hospital. A peripheral intravenous injection-related questionnaire based on previous studies and the modified Infusion Nurses Society scale were used to collect data. Phlebitis risk factors were identified, and a prediction model was developed using the Bayesian regression model. Vein quality, contrast medium use, hygiene duration, and period of nursing clinical experience were significant based on their 95% confidence intervals. The prediction model exhibited good discrimination. The prediction model developed in this study can be used for screening high-risk patients for peripheral intravenous catheter-related phlebitis and for providing basic data for developing interventions for the prevention and management of peripheral intravenous catheter-related phlebitis. Full article

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