Compassionate Care: A Qualitative Exploration of Nurses' Inner Resources in the Face of Burnout.

There is a universal shortage of nurses, with a current needs-based shortage of 5.9 million. This is not solely a recruitment issue but one of retention, triggered by high levels of work-induced stress, burnout, and reports of low job satisfaction resulting in poor care delivery. Some of the health repercussions on nurses include anxiety, insomnia, depression, migraines, irritability, absenteeism, and sometimes alcoholism and drug abuse. To tackle some of these costly issues, a qualitative exploration into how inner resources is used by nurses to cope with stress at different points of their careers is proposed. Through the lens of grounded theory, semi-structured interviews will be carried out with two distinct sets of participants: (1) Student nurses registered at the University of the Illes Baleares between 2022-2025. (2) Experienced nurses on the Balearic nursing register. Interviews will be coded and then analysed using Atlas.ti. Expected results will inform curriculum improvements that will benefit the well-being of (student) nurses, from the outset of their training, pre-empting potential psycho-social risks before they arise in the workplace. This is vital as it addresses nurses' mental health as well as chronic issues of retention and absenteeism.

Validation of the Spanish version of the five-item General Self-Efficacy (GSE) scale in a sample of nursing students: Evidence of validity, reliability, longitudinal invariance and changes in general self-efficacy and resilience in a two-wave cross-lagged panel model.

AIM: The aim of this study is to validate the Spanish version of the five-item General Self-Efficacy scale in a sample of nursing students, by: 1) offering evidence of validity and reliability; 2) studying the longitudinal measurement invariance of the scale; 3) providing evidence on the changes in the levels of self-efficacy that occur after one year of nursing education; and 4) offering longitudinal evidence on the relationship between nursing students' self-efficacy and resilience levels. BACKGROUND: Nurses' general self-efficacy has been related to both personal and organizational outcomes. In Spain, some competencies the students must acquire during the Degree in Nursing implicitly refer to self-efficacy. For the measurement of general self-efficacy, the General Self-Efficacy Scale is one of the most widely used in Europe. DESIGN: A longitudinal design was used. Research took place at the University of Valencia and the University of the Balearic Islands (Spain). Participants were 324 nursing students, in the first year of the Nursing Degree. METHODS: The five-item General Self-Efficacy scale and the Brief Resilience Coping Scale were used. Analyses included descriptive statistics, reliability estimates, confirmatory factor analysis, a longitudinal measurement invariance routine and several competing cross-lagged models. RESULTS: Evidence of reliability shown by the scale was adequate and a one-factor solution for the structure was found. Additionally, the five-item GSE showed evidence of invariance over time. A causal effect of self-efficacy on nursing students' levels of resilience was found. CONCLUSIONS: The Spanish version of the five-item General Self-Efficacy scale is a brief instrument that can contribute to the assessment of some of the basic competencies of the Degree in Nursing, which improve during their education and how these changes are related to other skills important for the nursing profession, such as resilience.

Food addiction and its relationship with other eating behaviours among Spanish university students.

BACKGROUND: Food addiction (FA) is characterised by symptoms such as loss of control over food consumption, inability to reduce consumption despite the desire to do so, and continued consumption despite negative consequences. The modified Yale Food Addiction Scale 2.0 (mYFAS 2.0) is a widely used instrument to assess FA. OBJECTIVES: To validate the Spanish mYFAS 2.0; to analyse the relationships between FA with other eating behaviours, sociodemographic variables, and Body Mass Index (BMI); and to test the eating-related variables that account for the variance in FA. METHODS: The sample consisted of 400 university students (Mage = 24.16, SDage = 6.12; 51% female), who completed the mYFAS 2.0 and measures of eating-related constructs. RESULTS: A confirmatory factor analysis (CFA) supported the one-factor structure of the mYFAS 2.0. The scale showed good internal consistency (α = .78), and good convergent validity with the mYFAS. FA was related to eating styles, binge eating, and bulimia. No differences in FA were observed between males and females, and there was no association between FA and BMI. In addition, younger participants scored higher on FA than older participants. The eating-related variables explain 54.7% of the variance in FA. CONCLUSIONS: The mYFAS 2.0 is a valid and reliable scale to assess FA in the Spanish population. The positive and significant relationship of variables related to eating (eating styles, binge eating and bulimia) with FA was demonstrated. These variables were indicated by those at high risk of FA.

Psychometric validation of the MIND Youth Questionnaire (MY-Q) to assess quality of life in Spanish patients with type 1 diabetes between 12 and 25 years old.

AIM: Validate in Spanish the Monitoring Individual Needs in Diabetes Youth Questionnaire (MY-Q), a multi-dimensional self-report HRQoL questionnaire designed for paediatric diabetes care. DESIGN AND METHODS: After translation, 209 patients diagnosed with type 1 diabetes, between 12 and 25 years old were assessed. The patients belonged to 12 hospitals in Spain. RESULTS: Exploratory factor analysis including one-factor up to seven-factor solutions were tested. The three-factor solution (Negative Impact of Diabetes, Empowerment and Control of Diabetes and Worries) was the most parsimonious model with adequate fit: χ2(723)=568.856 (p<0.001), CFI=0.913, RMSEA=0.072 [0.064, 0.080], SRMR=0.075. The three-factor solution and the grouping of the items followed a clear rationale. Cronbach's alpha was 0.816 for Negative Impact, 0.700 for Empowerment and Control and 0.795 for Worries. The study of the relationship between the MY-Q dimensions and socio-demographics variables show a relationship between age and the MY-Q: F(6,410)=10.873 (p<0.001), η2=0.137. Participants younger than 14 years old showed greater scores on Empowerment and Control when compared to participants between 14 and 17 years old (p=0.021); statistically significant differences were found for the participants 18 years old or older, who showed lower levels of Worries than the younger patients. Concurrent validity found that the dimension of Negative Impact of Diabetes was positively related to WHO-5, and the PedsQL Diabetes Module. CONCLUSION: The Spanish version of the MY-Q to measure HRQoL in patients with type 1 diabetes between the ages of 12 and 25, has adequate psychometric properties and conceptual and semantic equivalence with the original version in Dutch.

Cross-Sectional Study of the Professional Quality of Life of Palliative Care Professionals during the COVID-19 Pandemic.

BACKGROUND: The display of compassionate care by palliative care professionals is of the utmost importance to the patients, their families, and even to their own professional well-being. Lately and, especially due to the emergence of the COVID-19 pandemic, palliative care professionals have been subjected to greater pressures stemming from their work environment, organizational standpoint, and emotional sense of view. Not only have these factors made it harder for professionals to deliver compassionate care to their patients, but they have also decreased their overall well-being. The aim is to study how sociodemographics, workplace characteristics, internal resources, and the COVID-19 pandemic-derived pressures have affected the professionals' capacity to perform compassionate care and their well-being while at the same time exploring the relationship between compassionate care and well-being. METHODS: This study used a cross-sectional design with data gathered from Spanish palliative care professionals. The final sample was formed by 241 participants. They were surveyed about compassion, professional quality of life, well-being, sociodemographic data, working conditions, self-care, and coping with death competence, and the impact of the COVID-19 pandemic. The analyses used were descriptive statistics, bivariate tests, and the construction of a structural equation model. RESULTS: Compassion was predicted by the ability to control their workload and the ability to cope with death. Burnout was predicted by age, workload, workload control, self-care, material resources, and changes in teamwork. Moreover, compassion, age, workload control, and changes in teamwork and self-care were shown to significantly predict compassion satisfaction. When it comes to compassion fatigue, different variables were shown to predict it, those being compassion, control over the workload, social self-care, and the ability to cope with death. CONCLUSIONS: Having a healthy lifestyle and an adequate social support system is key to maintaining professional well-being in the case of palliative care professionals. Inner resources such as the ability to perform self-care and the capacity to cope with death are of vital importance to taking care of these professionals. Thus, it would be beneficial to establish training programs focused on these aspects in the myriad of sanitary centers that perform these tasks, as these abilities are necessary to withstand the work-related pressures and, at the same time, be able to provide compassionate care for patients.

Using latent profile analysis to understand palliative care professionals' quality of life during the COVID-19 pandemic.

Healthcare workers' professional quality of life has been increasingly under the spotlight, even more so during the COVID-19 pandemic, which has posed a genuine challenge for them. This study aims to describe the professional quality of life profiles of a sample of Spanish palliative care professionals during the COVID-19 pandemic, encompassing aspects such as work satisfaction, burnout, compassion fatigue, and compassion satisfaction; while studying the relationships between these profiles and sociodemographic variables, clinical situations experienced during the pandemic, protectors of professional quality of life, the quality of care delivered, and the professionals' wellbeing. Data from a survey of Spanish palliative care professionals were used. The variables measured were professional quality of life, sociodemographic characteristics, COVID-19-related experiences, protectors of professional quality of life, wellbeing, and quality of care. Our research included latent profile analyses, along with chi-squared and t-tests. The results suggested two profiles of professional quality of life, namely low (32.78%) and high (67.22%). The following profile displayed a higher likelihood of having a low professional quality of life: younger professionals, registered nurses, with a decrease in their teamwork, without specific training in palliative care, in coping with death and stress or emotional training and with lower levels of self-care and self-compassion, whose patients were unable to die a dignified death. Similarly, a low professional quality of life profile was associated with reduced wellbeing and poorer quality of care offered. In conclusion, providing professionals with education and training to improve their ability to handle end-of-life care and stress, maintaining cohesive teams and promoting self-care and self-compassion are pivotal to maintaining the quality of life and wellbeing of palliative care professionals and the quality of care that they provide.

Wellbeing Training Based on Contemplative Practices in a Sample of Intensive Care and Homecare Professionals: A Pilot and Feasibility Non-Randomized Clinical Trial.

BACKGROUND: Intensive care unit (ICU) and homecare unit professionals are susceptible to higher levels of stress and burnout than other healthcare professionals, which has an impact on their well-being, and in turn on their patients. In terms of data, there is not much research about the effects of psychological interventions on ICU and homecare professionals. The aim of this study was to investigate the effectiveness of Wellbeing Training based on Contemplative Practices (WTCP) for the increase of psychological functioning in a sample of ICU and homecare professionals. METHODS: A pilot and feasibility non-randomized clinical trial was conducted. Participants in the WTCP group (n = 19) attended an at-work 8-session/2 h group WTCP program aimed at directly training four basic skills: (a) sustained positive emotions, (b) recovery from negative emotions, (c) pro-social behavior and generosity, and (d) mind wandering, mindfulness, and "affective stickiness". Nineteen professionals were allocated in the control group. RESULTS: Results indicated that WTCP had a positive impact on self-compassion, personal accomplishment (burnout), and frequency of negative emotions. Moreover, a thematic analysis of participant interviews (n = 14) was conducted. CONCLUSIONS: These preliminary results are promising, though future research is needed to evaluate the effectiveness of WTCP using randomized controlled trial methodologies.

The Spanish Version of the State Self-Compassion Scale-Long Form (SSCS-L): A Study of Its Validity and Reliability in a Sample of Nursing Students.

BACKGROUND: In nurses, self-compassion mitigates the effects of stress, burnout and compassion fatigue, and enhances empathy, compassion and well-being and quality of life. The Self-Compassion Scale is the most-used instrument. The aim of this study is to validate the Spanish version of the new developed State Self-Compassion Scale-Long (SSCS-L). METHODS: Students of the first year of the Nursing Degree were surveyed online. Together with the SSCS-L, their levels of positive and negative affect was reported. Analyses included descriptive statistics, competitive confirmatory factor analysis, evidence on criterion-related validity and estimates of reliability. RESULTS: The best fitting model for the SSCS-L was the one hypothesizing six-correlated factors of self-compassion: self-kindness, common humanity, mindfulness, self-judgement, isolation, and over-identification. Positive relations between the positive dimensions of self-compassion and positive affect were found, whereas there were negative relations between the positive poles of self-compassion and negative affect. Estimates of reliability were adequate, except for the dimension of over-identification. CONCLUSIONS: Self-compassion has become a key competency for nurses. The SSCS-L is an appropriate tool to allow an adequate assessment of self-compassion in experimental contexts.

Learning Strategies and Entrepreneurial Attitudes: A Predictive Model of Entrepreneurship Intention in Peruvian Undergraduate Students / Estrategias de aprendizaje y actitudes emprendedoras: un modelo predictivo de la intención emprendedora en estudiantes universitarios peruanos / Estratégias de aprendizagem e atitudes empreendedoras: um modelo preditivo de intenção empreendedora em estudantes universitários peruanos

This study aims to empirically test how learning strategies would fit into an undergraduate entrepreneur's profile.The design is cross-sectional with a sample of 527 The tested structural model adequately fits the data. It provided helpful information on learning strategies and entrepreneurial attitudes accounting for up to 20 % of variance of entrepreneurship intention. The learning strategies most related to entrepreneurial attitudes are those related to creativity, transference, and assess-ment of one's own performance. This paper provides for the first time evidence about the predictive power of several learning strategies on the entrepreneurial attitudes in connection with entrepreneurship intention (willingness and likelihood). This work increases our understanding of entrepreneurs' learning strategies, so that we can improve the design and implementation of educational resources to promote entrepreneurs' careers in emerging markets.Peruvian undergraduate students. A structural equation model was specified, estimated, and tested in Mplus 8.4. The model hypothesized direct effects of the different learning strategies on a factor of entrepreneurial attitudes (considering proactivity, pro-fessional ethics, empathy, innovation, autonomy, and risktaking dimensions) which, in turn, explained two indicators of entrepreneurship intention as outcomes.

Este estudio busca comprobar empíricamente cómo las estrategias de aprendizaje encajarían en el perfil de un emprendedor de pregrado. El diseño es transversal, con una muestra de 527 estudiantes peruanos de pregrado. Se especificó, estimó y probó un modelo de ecuaciones estructurales en M plus 8.4. El modelo hipotetizó efectos directos de las diferentes estrategias de aprendizaje sobre un factor de actitudes emprendedoras (considerando las dimensiones de proactividad, ética profesional, empatía, innovación, autonomía y asunción de riesgos) que, a su vez, explicaban dos indicadores de intención emprendedora como resultados. El modelo estructural probado se ajusta adecuadamente a los datos. Proporcionó información útil sobre las estrategias de aprendizaje y las actitudes emprendedoras que explican hasta el 20 % de la varianza de la intención emprende-dora. Las estrategias de aprendizaje más relacionadas con las actitudes emprendedoras son las relaciona-das con la creatividad, la transferencia y la evaluación del propio rendimiento. Esta investigación proporciona la primera evidencia acerca del poder predictivo de varias estrategias de aprendizaje sobre las actitudes emprendedoras, en relación con la intención emprendedora (voluntad y probabilidad). Asimismo, aumenta nuestra comprensión de las estrategias de aprendizaje de los emprendedores, de modo que podamos mejorar el diseño y la implementación de recursos educativos para promover las carreras de los emprendedores en los mercados emergentes.

Este estudo teve como objetivo verificar empiricamente como as estratégias de aprendizagem se encaixariam no perfil de um empreendedor de graduação. O desenho é transversal com uma amostra de 527 estudantes de graduação peruanos. Um modelo de equação estrutural foi especificado, estimado e testado no Mplus 8.4. O modelo hipotetizou efeitos diretos das diferentes estratégias de aprendizagem sobre um fator de atitudes empreendedoras (considerando as dimensões de proatividade, ética profissional, empatia, inovação, autonomia e assunção de riscos) que, por sua vez, explicaram como resultados dois indicadores de intenção empreendedora. O modelo estrutural testado ajustase adequadamente aos dados. Forneceu informações úteis sobre estratégias de aprendizagem e atitudes empreendedoras que explicam até 20 % da variância da intenção empreendedora. As estratégias de aprendizagem mais relacionadas com as atitudes em-preendedoras são as relacionadas com a criatividade, a transferência e a avaliação do próprio desempenho. Este trabalho fornece a primeira evidência analisando o poder preditivo de várias estratégias de aprendizagem sobre as atitudes empreendedoras em relação à intenção empreendedora (vontade e probabilidade). Este trabalho aumenta nossa compreensão das estratégias de aprendizagem dos empreendedores para que possamos melhorar o desenho e a implementação de recursos educacionais para fomentar a carreira dos empreendedores em mercados emergentes.

The measurement of compassionate leadership: Adaptation and Spanish validation of the compassionate leadership self-reported scale.

BACKGROUND: A culture of shared leadership is widespread among palliative care teams based on a commitment to valuing and including all people equally. As compassion is a core value for end-of-life care work, compassionate leadership may be the best way to lead in palliative care. AIMS: The aims of this study were twofold: (1) to adapt and validate the Compassionate Leadership Self-reported Scale in a sample of palliative care professionals; and (2) to study the relation between compassionate leadership and associated concepts of self-compassion, awareness and self-care. METHODS: A cross-sectional survey of 296 Spanish end-of-life care professionals was conducted. Analyses included descriptive statistics, a confirmatory factor analysis (CFA) with four-correlated factors, reliability estimates and a structural model. RESULTS: Results suggested there were medium to high levels of compassionate leadership in the sample. The CFA showed an adequate overall fit: χ2 (98) = 277.595 (p < 0.001); CFI = 0.986; SRMR = 0.047; RMSEA = 0.088 [0.076, 0.100]. Reliability estimates for four subscales of compassionate leadership (attending, understanding, empathising and helping) were also adequate, ranging from 0.72 to 0.96. Finally, the structural model predicting compassionate leadership suggested that the dimensions of attending and understanding were most highly related to positive self-compassion and awareness; empathising, to self-care and awareness; and helping, to positive self-compassion and self-care. CONCLUSION: The Compassionate Leadership Scale has adequate psychometric properties when used to assess compassionate leadership in the context of end-of-life care. Our results indicate that self-compassion, awareness and self-care are important correlates of such compassionate leadership.

Psychometric Properties of the Self-Compassion Scale-Short Form: Study of Its Role as a Protector of Spanish Nurses Professional Quality of Life and Well-Being during the COVID-19 Pandemic.

Self-compassion is a multifaceted construct that represents compassion turned inward and involves approaching one's failure and inadequacy with kindness. To measure these self-compassionate behaviors, the Self-Compassion Scale-Short Form (SCS-SF) is one of the most widely used and has been recurrently employed in the healthcare arena. Specifically, self-compassion has been pointed out as essential for providing compassionate care and maintaining healthcare workers balance. AIM: The aim of this study is twofold: (1) to provide evidence of the psychometric properties of the SCS-SF in a sample of Spanish nurses and (2) to study of its role as a protector of Spanish nurses professional quality of life and well-being during the COVID-19 pandemic. METHODS: A sample of 115 Spanish nurses was studied. Mean age was 43.79 years old (SD = 10.99); 84.3% were women. The factorial structure of the SCS-SF was studied with competitive confirmatory factor analysis (CFA). Finally, a full structural equation model was tested, in which positive and negative self-compassion predicted professional quality of life, and professional quality of life, in turn, predicted well-being. RESULTS: Three a priori structures were compared: one-factor, two-factor, and six-factor model. The two-factor solution, positive and negative self-compassion, was retained as the best structure to represent the data. Regarding the predictive model, the two poles of self-compassion predicted professional quality of life prediction, and professional quality of life positively predicted well-being, showing a strong relationship. CONCLUSION: Self-compassion can be an important resource for nurses' balance, promoting adequate professional quality of life and their well-being.

The Impact of the COVID-19 Pandemic on Burnout, Compassion Fatigue, and Compassion Satisfaction in Healthcare Personnel: A Systematic Review of the Literature Published during the First Year of the Pandemic.

This literature review aimed to determine the level of burnout, compassion fatigue, and compassion satisfaction, as well as their associated risks and protective factors, in healthcare professionals during the first year of the COVID-19 pandemic. We reviewed 2858 records obtained from the CINAHL, Cochrane Library, Embase, PsycINFO, PubMed, and Web of Science databases, and finally included 76 in this review. The main results we found showed an increase in the rate of burnout, dimensions of emotional exhaustion, depersonalization, and compassion fatigue; a reduction in personal accomplishment; and levels of compassion satisfaction similar to those before the pandemic. The main risk factors associated with burnout were anxiety, depression, and insomnia, along with some sociodemographic variables such as being a woman or a nurse or working directly with COVID-19 patients. Comparable results were found for compassion fatigue, but information regarding compassion satisfaction was lacking. The main protective factors were resilience and social support.

Palliative Care Professionals' Inner Life: Exploring the Mediating Role of Self-Compassion in the Prediction of Compassion Satisfaction, Compassion Fatigue, Burnout and Wellbeing.

CONTEXT: Palliative care professionals are exposed to suffering on a daily basis. Working in such an environment frequently raises existential issues, psychological challenges, and emotional distress, that can detract from compassionate care. Identifying factors that help professionals cope with frequent exposure to issues related to mortality, such as compassion, could enhance palliative care providers' and patients' quality of life and wellbeing. OBJECTIVES: To improve our understanding of the factors associated with professionals' inner life studying the role of self-compassion as a mediating variable between self-care and awareness and professionals' quality of life, and quantifying the impact of compassionate care. METHODS: A cross-sectional online survey of palliative care professionals was conducted through the Spanish Society of Palliative Care. 296 professionals answered the survey. RESULTS: The model tested showed an adequate fit (χ2(212) = 476.688 (P < .001), CFI = .907, RMSEA = .066 [.058,.073], and SRMR = .068), and the hypotheses were supported. Self-care and awareness predicted coping with death and self-compassion, which in turn predicted professional quality of life. Self-compassion had the greatest predictive power. Professional quality of life showed a statistically significant and positive effect on personal wellbeing, explaining more than 50% of its variance (R2 = .574; P < .001). CONCLUSION: For palliative care professionals, the cultivation of self-compassion is equally needed as compassion for others. Professional quality of life and compassionate care are related to professionals' wellbeing: when professionals take care of themselves, this will lead in a more compassionate care, but also in healthier, happier professionals.

Development and Validation of the Brief Nursing Stress Scale (BNSS) in a Sample of End-of-Life Care Nurses.

Nursing has been identified as a very stressful profession. Specifically in end-of-life care, nurses frequently experience stressful situations related to death and dying. This study aims to develop and validate a short scale of stress in nurses, the Brief Nursing Stress Scale. A cross-sectional survey of Spanish end-of-life care professionals was conducted; 129 nurses participated. Analyses included a confirmatory factor analysis of the Brief Nursing Stress Scale, estimation of reliability, relation with sex, age and working place, and the estimation of a structural equation model in which BNSS predicted burnout and work satisfaction The confirmatory factor analysis showed an adequate fit: χ2(9) = 20.241 (p = 0.017); CFI = 0.924; SRMR = 0.062; RMSEA = 0.098 [0.040,0.156]. Reliability was 0.712. Women and men showed no differences in stress. Younger nurses and those working in hospital compared to homecare showed higher levels of stress. A structural equation model showed nursing stress positively predicted burnout, which in turn negatively predicted work satisfaction. Nursing stress also had an indirect, negative effect on work satisfaction. The Brief Nursing Stress Scale showed adequate estimates of validity, reliability, and predictive power in a sample of end-of-life care nurses. This is a short, easy-to-use measure that could be employed in major batteries assessing quality of healthcare institutions.

Development and Psychometric Validation of the Brief Nurses' Practice Environment Scale and Its Relation to Burnout Syndrome and Job Satisfaction: A Study in Spanish Nurses.

Introduction: Nursing environment is a vast concept that traditionally has included a wide range of job characteristics and has been related to burnout and job satisfaction. For its measurement, the Practice Environment Scale of the Nursing Work Index (PESNWI) stands out. However, shorter instruments are needed. The purpose of the study is to develop and test the Brief Nurses' Practice Environment (BNPE) Scale. Methods: The BNPE Scale was developed and tested in a sample of 210 Spanish nurses (data collection 2018). Results: Cronbach's alpha was 0.702. The confirmatory factor analysis (CFA), with an excellent fit, offered evidence of internal validity. Regarding validity, the BNPE Scale predicted both burnout and job satisfaction. Finally, evidence pointed out a cutoff score of <12 for low levels of practice environment and a cutoff score of >15 for higher levels in practice environment. Conclusions: The BNPE Scale is a short, easy-to-use measure that could be employed in major batteries assessing the quality of healthcare institutions.

The Impact of the COVID-19 Pandemic on ICU Healthcare Professionals: A Mixed Methods Study.

The large numbers of patients admitted to intensive care units due to COVID-19 has had a major impact on healthcare professionals. The incidence of mental health disorders among these professionals has increased considerably and their professional quality of life has suffered during the pandemic. This study aims to explore the impact of the provision of COVID-19 patient care on ICU healthcare professionals. A mixed methods study with an exploratory concurrent design was conducted between June and November 2020 in the Balearic Islands, Spain. Data were collected using a self-report online survey (n = 122) based on three validated questionnaires, and individual semi-structured in-depth online interviews (n = 11). Respondents scored 2.5 out of 5 on the moral distress scale, moderate/high on the compassion satisfaction scale, and moderate on the burnout and compassion fatigue subscales. Age was significantly and negatively related to professional quality of life but was positively related to workload and unavailability of protective equipment. Three main groups of themes relating to the impact of the pandemic emerged from the in-depth interviews: (a) clinical, (b) professional, and (c) personal and family impacts in the two waves. ICU healthcare professionals should be viewed as second victims of the COVID-19 pandemic as they have suffered significant psychological, professional, and moral harm.

Development and Validation of the OSA-CPAP Perceived Competence Evaluation Interview.

INTRODUCTION: Continuous positive airway pressure (CPAP) is one of the most common therapies for Obstructive Sleep Apnea (OSA). We present a brief, patient-reported outcome measure used to assess patients' levels of adherence with CPAP treatment. METHODS: A questionnaire was developed based on academic literature. We qualitatively tested a pool of 18 items. It was tested in a sample of 174 patients from the Hospital La Princesa. Next, 1021 patients from Catalonia were evaluated. RESULTS: 5 items were removed. Nominal groups referred to three areas: general knowledge about OSA and its risks; CPAP treatment information and expectations; CPAP use, monitoring, and confidence with its use. The 13 retained items maintained the same meaning as the original questionnaire (r=.986; p<.001) and the three proposed dimensions detected a significant increase in general knowledge of OSA (t[173]=8.097, p<.001); CPAP treatment information (t[173]=15.170, p<.001); and CPAP use (t[173]=14.642, p<.001). The final 12-item version was reliable (CRI=.793) and its internal structure was adequate (χ2[51]=72.073; p=.027, CFI=.967, RMSEA=.020 [.000, .030]). Women had a better general knowledge of OSA (t[1,018]=2.190, p=.029), CPAP treatment information (t[1,018]=2.920, p=.004), and higher overall OSA-CPAP scores (t[1,018]=3.093, p=.002). Scores were positively related to quality of life and motivation, adherence was positively related to CPAP use and monitoring, and the total score was negatively related to daytime sleepiness. CONCLUSIONS: The interview could help clinicians prevent some dropouts by targeting patients with lower adherence. It's a tool for assessing patient adherence to CPAP and to promote strategies through education and external motivational stimuli.

The impact of strict and forced confinement due to the COVID-19 pandemic on positive functioning variables, emotional distress, and posttraumatic growth in a Spanish sample.

Background: The adverse consequences of the COVID-19 pandemic on mental health have been widely studied in recent months. However, few studies have examined the protective psychological factors that may explain how individuals are coping with the COVID-19 pandemic and its forced confinements. Objective: This study analyzes the impact of confinement due to the COVID-19 pandemic on positive functioning variables (resilience, meaning of life, gratitude, compassion, life satisfaction), emotional distress (depression, anxiety, perceived stress, affect), and posttraumatic growth (PTG). The impact was measured during and after the first month of strict and obligatory confinement in Spain. Methods: The sample was composed of 438 Spanish residents (78.3% women) between the ages of 18 and 68 (M = 35.68; SD = 13.19) during the first stage (first two weeks) of confinement. The sample was reduced to 197 participants during the second stage (fifth week) of confinement. Several online self-reported questionnaires were administered to assess positive functioning variables, emotional distress, and PTG. Results: Women, youths, individuals without a partner, with lower monetary incomes, or diagnosed with a mental disorder or chronic illness experienced lower scores in positive functioning variables and greater emotional distress during the first stage of confinement. Linear mixed models showed that scores on positive functioning variables, emotional distress, and PTG worsened in the second stage of confinement. Nevertheless, a structural equations model showed that increases in positive functioning variables in the second stage were associated with increases in life satisfaction (R2 = .450) and related to decreases in emotional distress (R2 = .186), leading in turn to increases in PTG (R2 = .061). Conclusions: Individuals could experience PTG during strict and mandatory confinement. The increase in PTG during this adverse event was indirectly associated with increases in positive functioning variables (i.e. gratitude, presence of meaning, resilience), through improvements in life satisfaction and emotional distress.

Antecedentes: Las consecuencias adversas de la pandemia de COVID-19 en la salud mental han sido ampliamente estudiadas en los últimos meses. Sin embargo, pocos estudios han examinado los factores psicológicos protectores que pueden explicar cómo los individuos están haciendo frente a la pandemia de COVID-19 y sus confinamientos forzados.Objetivos: Este estudio analiza el impacto del confinamiento debido a la pandemia COVID-19 sobre las variables de funcionamiento positivo (resiliencia, sentido en la vida, gratitud, compasión, satisfacción con la vida), el malestar emocional (depresión, ansiedad, estrés percibido, afecto) y el crecimiento postraumático (CPT). El impacto se midió durante y después del primer mes de un confinamiento estricto y obligatorio en España.Métodos: La muestra estuvo compuesta por 438 residentes españoles (78.3% mujeres), con edades comprendidas entre 18 y 68 años (M= 35.68; DT= 13.19) en la primera medición (las dos primeras semanas de confinamiento). La muestra se redujo a 197 participantes en la segunda medición (la quinta semana de confinamiento). Se administraron varios cuestionarios auto-informados online dirigidos a evaluar las variables de funcionamiento positivo, el malestar emocional y el CPT.Resultados: Los participantes que eran mujeres, más jóvenes, sin pareja, con ingresos económicos más bajos, o diagnosticados con un trastorno mental o enfermedad crónica, experimentaron menores puntuaciones en variables de funcionamiento positivo y mayor malestar emocional en las primeras semanas del confinamiento. Los modelos lineales mixtos mostraron que las puntuaciones en las variables de funcionamiento positivo, el malestar emocional y el CPT empeoraron en la segunda etapa del confinamiento. Sin embargo, un modelo de ecuaciones estructural mostró que los aumentos en la segunda etapa en las variables positivas de funcionamiento se asociaban con aumentos en la satisfacción de la vida (R2 = .450), y se relacionaban con disminuciones en el malestar (R2 = .186), lo que a su vez conducía a aumentos en el CPT (R2 = .061).Conclusiones: Las personas pueden experimentar CPT durante el confinamiento estricto y obligatorio. El aumento de la CPT durante dicho evento adverso se asoció indirectamente con el aumento de las variables de funcionamiento positivo (i.e. gratitud, sentido en la vida, resiliencia), a través de las mejoras en la satisfacción de la vida y el malestar emocional.

The Personal Wellbeing Index in Spanish Palliative Care Professionals: A Cross-Sectional Study of Wellbeing.

Health professionals are especially exposed to stress, with consequences on professionals' health and wellbeing. However, palliative care professionals' wellbeing has been the subject of very little research. The aim of this work is to study the Personal Wellbeing Index (PWI) in a sample of Spanish palliative care professionals, as well as to study their levels of wellbeing and the relationships of wellbeing with variables such as gender, age, marital status, profession, and professional quality of life. A cross-sectional survey of Spanish palliative care professionals was conducted. The Spanish version of the PWI and the Short version of the Professional Quality of Life Scale were used. Here, 296 palliative care professionals attending patients at the end of life participated in the study. They showed medium to high levels of wellbeing. The PWI showed an adequate internal structure [χ 2 (20) = 116.130 (p < 0.001)]; Comparative Fit Index (CFI) = 0.970; standardized root mean square residual (SRMR) = 0.041; root mean square error of approximation (RMSEA) = 0.140 (0.116, 0.166)] and excellent estimates of reliability [α = 0.879 and Composite Reliability Index (CRI) = 0.923]. Wellbeing was higher for married compared to single and showed no relation with age, gender, and profession. Additionally, a structural equation model was estimated, in which a positive relation was found between wellbeing and compassion satisfaction and a negative one with burnout. The PWI is adequate to measure personal wellbeing in Spanish palliative care professionals.