Stress, mental health, and protective factors in nursing students: An observational study.

BACKGROUND: Nursing students suffer high levels of stress, especially in the first year. OBJECTIVES: to compare academic stress at the beginning and end of nursing studies; to analyse the relationships between academic stress, mental health, and protective factors; and to examine whether resilience mitigates the effect of academic stress on psychological well-being. DESIGN: A cross-sectional study. SETTING AND PARTICIPANTS: Sample was 370 first- and fourth-year nursing students from Spain (University of Castilla-La Mancha, University of Cantabria, and University of Sevilla). VARIABLES AND DATA COLLECTION: We assessed academic and clinical stress, coping skills, anxiety, depression, psychological well-being, and resilience were measured. DATA ANALYSIS: We performed a descriptive analysis of the study sample, as well as correlation and hierarchical regression models. Additionally, mediation models were estimated. RESULTS: First-year students presented higher academic stress than fourth-year students. Clinical stress, anxiety, depression, and emotional coping predicted academic stress, while academic stress, depression, and coping skills predicted psychological well-being. Mediation models showed a significant path between academic stress, resilience, depression, and psychological well-being. CONCLUSION: Academic stress has a detrimental effect on the mental health. Coping strategies and resilience may be protective factors that should be encouraged in interventions designed to improve psychological well-being.

Adaptation and Validation of the MapMe Body Image Scales in Spanish Parents of Schoolchildren.

Childhood overweight and obesity is a worldwide problem and to treat it parents' detection has to be improved. The MapMe Body Image Scales (BIS) are a visual tool developed to improve parental perception of child weight in the United Kingdon (UK) based on British growth reference criteria. The aim of this study was to make a transcultural adaptation and validation of the MapMe BIS in Spain based on International Obesity Task Force (IOTF) cut offs A descriptive cross-sectional study was done. First, a translation and cultural adaptation was carried out. A total of 155 10-11-year-old children and their parents participated in this study. Children were measured to calculate their weight status, Body Mass Index (BMI), Body Fat Percentage (BFP) and Waist Circumference (WC), and their parents completed a purpose designed questionnaire about their perception and satisfaction of child's body weight status using the adapted BIS. Test-retest reliability, criterion validity and concurrent validity of the adapted BIS were analyzed. This study shows that the adapted MapMe BIS has good psychometric properties and is a suitable visual scale to assess parental perception of weight status in 10 and 11-year-old children in Spain.

Parents' Perceptions of Children's and Adolescents' Use of Electronic Devices to Promote Physical Activity: Systematic Review of Qualitative Evidence.

BACKGROUND: The use of physical activity (PA) electronic devices offers a unique opportunity to engage children and adolescents in PA. For this age group (2-17 years), parents play a key role in promoting healthy lifestyles and regulating the use of electronic devices. Therefore, parents' perceptions of the use of electronic devices for PA in children and adolescents are critical for efficient intervention. OBJECTIVE: The aim of this qualitative systematic review was to improve the understanding of parents' perceptions of the use of electronic devices for PA in children and adolescents. METHODS: A systematic search of electronic databases (Medline/PubMed, SPORTDiscus, Web of Science, Scopus, OpenGrey, and Deep Blue) was conducted. Studies from inception (2010) to May 2022 were identified. Qualitative studies on the perceptions of healthy children's and adolescents' (aged 2-17 years) parents regarding PA interventions performed on electronic devices were included according to the Cochrane Qualitative and Implementation Methods Group Guidance Series and the Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ) statement. The Joanna Briggs Institute Qualitative Assessment and Review Instrument was used for methodological validity. RESULTS: In total, 18 studies with 410 parents, mostly mothers, were included. Parents' perceptions were grouped into 4 categories: usefulness, advantages, general perceptions (electronic devices for health promotion, preferences for real-life PA, and concerns), and acceptability (barriers and facilitators) of electronic devices for PA. Parents perceived electronic devices as useful for increasing PA, learning new skills, and increasing motivation for PA and valued those devices that promoted socialization and family and peer bonding. In terms of general perceptions, parents had positive attitudes toward PA electronic devices; however, they preferred outdoor and real-life PA, especially for preschoolers and children. Concerns, such as physical and psychological harm, addiction, conflicts, and compliance difficulties, were found. Facilitators were identified as ease of use, appropriate feedback, promotion of socialization, and motivational strategies, such as rewards, challenges, and attractiveness. Barriers, such as discomfort, price, and difficulties in using or understanding electronic devices, were also identified. For older children and adolescents, parents were more concerned about high levels of screen time and setting limits on electronic devices and therefore preferred PA electronic devices rather than traditional ones. CONCLUSIONS: Overall, the participants had positive attitudes toward electronic devices for PA and perceived them as an effective way to promote PA in children and adolescents. They also perceived several benefits of using electronic devices, such as health promotion, increased awareness and motivation, and socialization, as well as barriers, facilitators, and age differences. The results of this study could provide researchers with insights into designing more effective, age-appropriate PA electronic devices for children and adolescents and improving adherence to their use. TRIAL REGISTRATION: PROSPERO CRD42021292340; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=292340.

Perceptions of Mothers about Support and Self-Efficacy in Breastfeeding: A Qualitative Study.

Breastfeeding is a complex process influenced by different personal and social factors which will determine both the initiation and the resilience for its maintenance. The aim is to identify the beliefs and expectations of mothers concerning breastfeeding to determine the perception of their self-efficacy and the influence on the management of their babies' feeding. A qualitative study through semi-structured interviews was carried out. The sample size was defined by the saturation criteria. Twenty-two women participated, eleven were from an urban environment and eleven were from a rural environment. Mothers' knowledge of breastfeeding, their expectations of that process, their experience, and their strategies for overcoming problems associated with initiating, establishing, and continuing breastfeeding were influenced by the role of nurses and midwives in supporting their perception of self-efficacy. Likewise, maternity policies are important for the continuance of exclusive breastfeeding. This study shows the complexity of the initiation and establishment of breastfeeding and the existence of several social factors surrounding these moments. Furthermore, it demonstrates the importance and reference of nurses and midwives and the role of State maternity policies.

Parental Perception of Weight and Feeding Practices in SchoolChildren: A Cross-Sectional Study.

Childhood obesity has become a public health problem. Parents play an important role in the transmission of feeding habits and the detection of their child's weight status. The aim was to analyse the prevalence of overweight/obesity and to determine the relationship between children's weight status, different feeding practices and weight misperception. A cross-sectional study was conducted in randomly selected schools. The children's weight status was measured, and a questionnaire was used to identify the feeding practices applied by parents and their perception of their children's weight. The sample comprised 127 children aged 4 and 5 years and 189 aged 10 and 11. Differences were observed between parental feeding practices and weight status, monitoring being the most used practice. Parents use less pressure to eat and more restriction if their children have overweight or obesity. Misperception of weight was 39.6%, being higher in overweight children, who were perceived as normal weight in 53.19%. Children classified as obese were perceived as overweight in 88.23%. The use of inappropriate eating practices shows a need for health education in parents according to weight status. In addition, the parents' perception should be improved to increase early detection of overweight and start actions or seek professional help.

Barriers and Facilitators to Leisure Physical Activity in Children: A Qualitative Approach Using the Socio-Ecological Model.

Despite the benefits of engaging in physical activity during their leisure time, children do not meet the recommendations on physical activity. Following the socio-ecological model as a theoretical framework, the aim of this study was to determine the barriers and facilitators that influence physical activity participation in children's leisure time. Data collection was conducted through focus groups and individual drawings in a sample of 98 eight- to eleven-year-olds from six schools in Cuenca (Spain). Following the socio-ecological model, individual characteristics (age and sex), as well as the microsystem (parents and friends), mesosystem (timing and out-of-school schedule) and exosystem (safety and weather) influence physical activity participation. The relationships between these levels of the socio-ecological model reveal that opportunities for leisure physical activity are determined by children's schedules. This schedule is negotiated by the family and is influenced by parents' worries and necessities. This is the main barrier to physical activity participation due to the creation of more restrictive, sedentary schedules, especially for girls. Our results show the elements required to develop successful strategies to increase physical activity opportunities, namely, focusing on giving children the opportunity to choose activities, raising parents' awareness of the importance of physical activity and improving the perceived safety of parks, taking into consideration the gender perspective.

"Football is a boys' game": children's perceptions about barriers for physical activity during recess time.

The aim of the study was to know the factors that influence boys and girls' perceptions for performing physical activity during playground recess from their own perspective. Ninety-eight schoolchildren aged 8-11 years from five schools from Cuenca (Spain) participated in 22 focus groups and carried out 98 drawings following the socioecological model as a theoretical framework. A content analysis of the transcripts from the focus groups and drawings was carried out by three researchers. Results showed that, in spite of boys and girls identified same barriers, there were gender differences in their perceptions. Gender socialization was the key as central category and helped to understand these differences. Boys preferred play football and this sport had a monopoly on the recess space. Weather was a barrier for boys. Girls and boys, who did not play football, were relegated to peripheral areas and lack of materials was a barrier for them. Teachers were a barrier for all children who did not play football. Thus, in order to promote recess physical activity, researchers, teachers and educational policy makers should take into account gender socialization and promote inclusive non-curricular physical activity in schools.

Resilience as a mediator between cardiorespiratory fitness and mental health-related quality of life: A cross-sectional study.

In this cross-sectional study, we analyzed the relationship between resilience, cardiorespiratory fitness, and mental health-related quality of life, and examined whether resilience acts as a mediator between the latter two. The study included 770 university students, aged 18-30 years, from Cuenca, Spain. Anthropometric, sociodemographic, cardiorespiratory fitness (20 m shuttle run test), biochemical parameters, resilience, and mental health-related quality of life measurements were analyzed. The results showed that mental health-related quality-of-life values were significantly higher in students who had good cardiorespiratory fitness and a high level of resilience. Moreover, resilience acted as a partial mediator between cardiorespiratory fitness and mental health-related quality of life at 33.79%. Therefore, in young adults, resilience mediates the relationship between cardiorespiratory fitness and mental health-related quality of life. These findings should be taken into account by nurses and other public health professionals, because in addition to the development of physical activity interventions to improve mental health-related quality of life, it is necessary to implement measures that increase resilience to achieve mental wellness.

[Validity of the Connor-Davidson resilience scale (10 items) in a population of elderly]. / Validez de la escala de resiliencia de Connor-Davidson(10 ítems) en una población de mayores no institucionalizados.

AIMS: To examine the psychometric properties of the Spanish version of the CD-RISC 10-items in a sample of the elderly population of Cuenca, Spain; and to assess if the Spanish version preserves the same factorial structure as the original one. METHODS: A cross sectional study was conducted in five health centres in the province of Cuenca. The study included a random sample of 500 people aged 60-75 years who lived within the community. MEASUREMENTS: The sociodemographic variables, CD-RISC-10 (resilience), PSS (perceived stress), SF-12v2, Pfeiffer Short Portable Mental Status questionnaire, GDS (geriatric depression), and MOS (social support), were all used to gather data. The number of factors underlying the CD-RISC 10 items was analysed using exploratory factor analysis. Furthermore, this factor structure was tested by confirmatory factor analysis. RESULTS: A single underlying factor was found in the CD-RISC 10 items. The factor structure was tested using confirmatory factor analysis and it was found that a single factor model showed acceptable goodness of fit values for both men and women. Convergent validity was performed to test whether the mean scores of the variables were significantly associated with resilience. The Cronbach's α coefficient for the CD-RISC 10 items scale was 0.81. The overall scores of the Spanish version of the CD-RISC-10 items correlated directly with MOS and the physical and mental components of SF-12, and inversely with the PSS and GDS. CONCLUSIONS: The Spanish version of the CD-RISC-10 showed good psychometric properties. Thus, it can be used as a valid and reliable instrument to measure resilience in the non-institutionalized older population.

[Factors associated with health-related quality of life in the institutionalised elderly: differences between men and women]. / Factores asociados con calidad de vida relacionada con la salud en mayores institucionalizados: diferencias entre hombres y mujeres.

AIM: To examine the relationship between co-morbidity, functional capacity, mood and perception of social support, and the physical and mental dimensions of the Health-Related Quality of Life and assess the differences between institutionalised elderly men and women without severe cognitive impairment in Cuenca, Spain. METHODS: A cross sectional, descriptive and multicentre study was conducted in 16 nursing homes. A representative sample of 281 elderly patients was randomly selected. MEASURES: demographic, clinic variables and standardised tools: SF12 health questionnaire, Mini-Mental State Examination, Barthel Index, Geriatric Depression Scale and Medical Outcomes Study Social Support Survey. Data analysis was performed using multiple lineal regression models for physical and mental dimension of SF12, differentiated for gender. RESULTS: The sample included 55% elderly women with an mean age of 82.6 years, and 45% men with a mean age of 81.2 years. Comorbidity was higher in women (1.96), but in the linear regression this was not associated with the physical dimension of HRQOL. We found an association with disability (ß=313), depressive symptoms (ß=-.164) and perceived social support (ß=158). The worst HRQOL in women was found in the mental dimension associated with depressive symptoms (ß= -.422) and in the low perceived social support (ß=154). CONCLUSIONS: Biological and functional factors were only associated with the physical dimension, while depression was associated with both dimensions (physical and psychological). The differential factor that could explain the lower HRQOL in institutionalised women could be explained by a more negative experience of the disability and loss of social support.

Reliability and validity of the Spanish version of the 10-item Connor-Davidson Resilience Scale (10-item CD-RISC) in young adults.

BACKGROUND: The 10-item Connor-Davidson Resilience Scale (10-item CD-RISC) is an instrument for measuring resilience that has shown good psychometric properties in its original version in English. The aim of this study was to evaluate the validity and reliability of the Spanish version of the 10-item CD-RISC in young adults and to verify whether it is structured in a single dimension as in the original English version. FINDINGS: Cross-sectional observational study including 681 university students ranging in age from 18 to 30 years. The number of latent factors in the 10 items of the scale was analyzed by exploratory factor analysis. Confirmatory factor analysis was used to verify whether a single factor underlies the 10 items of the scale as in the original version in English. The convergent validity was analyzed by testing whether the mean of the scores of the mental component of SF-12 (MCS) and the quality of sleep as measured with the Pittsburgh Sleep Index (PSQI) were higher in subjects with better levels of resilience. The internal consistency of the 10-item CD-RISC was estimated using the Cronbach α test and test-retest reliability was estimated with the intraclass correlation coefficient.The Cronbach α coefficient was 0.85 and the test-retest intraclass correlation coefficient was 0.71. The mean MCS score and the level of quality of sleep in both men and women were significantly worse in subjects with lower resilience scores. CONCLUSIONS: The Spanish version of the 10-item CD-RISC showed good psychometric properties in young adults and thus can be used as a reliable and valid instrument for measuring resilience. Our study confirmed that a single factor underlies the resilience construct, as was the case of the original scale in English.