Development of a scale to gain insight into the experience of living with chronic heart failure: The UNAV-Experience of Living with Chronic Heart Failure Scale.

BACKGROUND: To date, there are no tools for the nursing staff to gain systematic insight on the experience lived by patients with chronic heart failure. The objective of this study was to develop a scale for this purpose. METHODS: The study was conducted between January 2018 and December 2020 in three Spanish hospitals. The process described by DeVellis was used for the development of the scale. The items were built based on a phenomenological study and a systematic review of the literature. Next, feedback from a panel of experts was obtained, the scale was administered to a sample of patients with chronic heart failure, and a cognitive interview and an observational study were conducted to create the final version of the scale. RESULTS: The first version of the scale had in seven domains and 76 items. After its evaluation by a panel of experts, it was reduced to a second version with six domains and 55 items. Following the administration of Version 2 to 17 patients (58.8% male, mean age 59.53, 70.6% classified as NYHA functional class II), five items were modified and two eliminated. Thus, the third version of the UNAV-CHF Experience Scale was composed of six domains and 53 items. CONCLUSIONS: This study presents the development of the UNAV-experience of living with chronic heart failure scale. It is an original and novel instrument that allows systematically explore this experience. A larger-scale study is necessary to confirm the validity of our scale.

[IMPACT OF ADVANCED NURSING PRACTICE ON STAFF DEVELOPMENT AND EVIDENCE-BASED PRACTICE]. / Impacto de la práctica avanzada en enfermería. EN EL DESARROLLO DEL PERSONAL Y LA PRÁCTICA BASADA EN LA EVIDENCIA.

INTRODUCTION: At international level, there is abundant evidence of the positive impact that the Advanced Practice Nurse (APN) has on patients, health care organizations and nursing professionals. At national level, such evidence is incipient and should be developed in order to justify investments in the introduction of APN roles. The present study provides evidence on the impact of the APN in the professional development of nurses in one outpatient clinic of a hospital in Northern Spain. MATERIAL AND METHODS: The advanced practice nursing student (APNS) developed a change project aimed at improving knowledge of evidence based practice (EBP) among nurses in the cited outpatient clinic. To that end, the APNS followed the steps of the PEPPA (participatory, evidence-based, patient-focused process, for guiding the development, implementation, and evaluation of advanced practice nursing) framework and conducted unstructured observations, literature reviews, personal interviews and group discussions with 8 patients, 2 nurses and 4 cardiologists. The evaluation of the change project included personal interviews with nurses in the outpatient clinic before and after the intervention. RESULTS: Nurses notably increased their knowledge on formulating clinical questions, developing and executing bibliographic searches, synthesizing and criticizing evidence, and applying and evaluating research results. DISCUSSION AND CONCLUSIONS: The results suggest that the positive impact of the integration of APNs into the Spanish clinical setting is not restricted to just patients and the hospital setting, but extends to the professional development of nurses and the outpatient clinic setting.