Nurses' freedom of expression: Rights, obligations and responsibilities.

AIM: This commentary aims to spark debate on the ethical, legal, professional and institutional challenges faced by nurses' use and interactions when using traditional, mass and social media. BACKGROUND: Freedom of expression is a core value of democratic systems. However, it appears to be a complex right when exercised by nurses in traditional media and/or during online interactions. Active use of these types of media can help promote healthcare incentives and reach larger audiences, or even influence public policy. Nevertheless, with the increase in social media use, some nurses have been found to have engaged in unprofessional practices, which, in some serious cases, have led to their dismissal. EVALUATION: We identified specific instances of conflicts-most commonly related to breach of privacy, inappropriate interactions on social media or a simple lack of knowledge or guidance regarding its use-and formal complaints concerning nurses' freedom of expression. KEY ISSUES: While nursing codes do exist, professional guidelines concerning the use of mass and social media are still much needed. With the advent of social media, there may be ambiguity regarding how nurses engage with and make use of these platforms. In order to ensure that nurses interact professionally with any form of media, clear ethical, legal and professional frameworks of use are needed. Specific codes exist, such as the new ICN code of ethics or the NMC code, among other initiatives, but more comprehensive guidance is needed in order to support nurses in using better judgement regarding their media interactions. While the existence of such frameworks may not fix the problem of incorrect use, it can help those nurses looking for clear guidance when interacting with mass media or using social media. Also, it is important that more professionals are aware that such guidance exists, since understanding the limits and dangers of certain interactions would ultimately protect nurses' and patients' rights. CONCLUSION: The increasing use of media platforms by nurses calls for further professional guidance regarding its professional utilization. To date, limited guidance exists to support media interactions. In an interconnected world that favours media interaction in both professional and private spheres, the development and widespread dissemination of clear guidance for professionals must also detail two essential points: how professionals can better interact with media platforms and also how they can avoid having unethical media interactions in the first place. IMPLICATIONS FOR NURSING MANAGEMENT: The existence of a solid, comprehensive framework for generalized media use should ensure that nurses can exercise their right to freedom of expression. Clearer limitations should support nurses' professional presence and interactions in the media.

COVID-19 and the global need for knowledge on nurses' health.

AIM: To emphasize that nurses need to be fully protected to carry out their vital role, particularly during pandemics, yet the lack of a standardized and systematic collection of high-quality disaggregated data on nurses health inhibits our ability to assess this within and across countries. BACKGROUND: Nurses are the largest workforce group in the health sector, yet only 59 countries worldwide report on nurse COVID-19 infections and related deaths, and the standardized, systematic collection of disaggregated health data is not yet in place. SOURCES OF EVIDENCE: Medline, International Council of Nurses, World Health Organization, Centers of Disease Control and Prevention and the experiences of the authors. DISCUSSION: Inconsistent recording and definitions of nurses, precarious and informal employment conditions, limited transparent and reliable data, lack of mass testing and long-standing structural issues and biases have affected nursing for too long. CONCLUSIONS: These issues are reflected in the limited capacity of many national public health information systems to collect, monitor and report on the health of the largest group of health workers. Political will, accountability and public data transparency at different levels are essential to adequately protect nurses at work. IMPLICATIONS FOR NURSING PRACTICE, AND NURSING AND HEALTH POLICY: Building on current momentum in the nursing field, immediate political action is required to strengthen existing nursing and midwifery policies, standards and regulatory capacity, as well as existing public health services and information and surveillance systems. The generation of up-to-date, context-specific knowledge is needed to inform and monitor political decisions related to the protection of nurses, and the improvement of their employment conditions, as well as to strengthen accountability for these areas at various levels.

Blogged nursing: analysis of the phenomenon and contextualization in the Spanish setting.

Blogging within the health profession has grown in the recent past. This article aims to perform an analysis of the theoretical aspects of blogging, the use by professional nurses and students, benefits for patients, and, finally, an approach to the activities of Spanish nursing blogs. Blogs have great advantages as social communication tools. Immediacy in content update, closeness to information consumers, and compatibility with other Web 2.0 tools are points to be highlighted. Nurses use blogs for education and communication with other health professionals, students, and patients. For patients, therapeutic effects have been demonstrated in using blogging to share their health problems and express their experiential viewpoints. There are about 80 blogs written by Spanish nurses; most of them originated in the period between 2010 and 2012. These blogs are targeted to professionals (59%), patients (20%), or mixed (13%). There is a great heterogeneity in content: informative style (20%), opinion (28%), narrative (9%), experiential (2%), or humorous (2%). Nursing language is present in 15%, research and evidence-based practice in 13%, and protocols, guidelines, and procedures in 11% of them. We propose the need to plan institutional strategies for effective use of Web 2.0 resources as well as the need to unify criteria to provide quality content.

[Impact of diffusion of the methodology of evidence-based nursing through Facebook]. / Impacto a través de Facebook. Blog enfermería basada en la evidencia.

AIMS: Evaluate the impact of diffusion of the contents of the blog "Evidence-Based Nursing" through Facebook. METHOD: Cross-sectional study carried out via a web link to the online survey (previously tested) to a population of 2132 Facebook profiles that had a "friendship" with the profile studied. The survey had 8 items and a descriptive study of variables was conducted using SPSS 19. RESULTS: 75.9% of the sample has a Facebook profile of a personal character and 94.1% of cases are interested in evidence-based practices. 55.6% of the sample knows the blog, plus 46.5% answered that they read it occasionally, compared with 17.1% who does regularly and 35.7% who say they do not read it. Of all readers, 75.75% say they have improved their knowledge in terms of evidence-based practice after reading it. 88% said they did not follow the blog by other means or social network and in the case that they did, the most used are Google Reader, and Twitter Networked Blogs. CONCLUSIONS: Reading the contents of this blog improve the knowledge about evidence-based practices of the "friends" of the social profile, as they themselves relate. The adequacy of the social profile as a dissemination tool is successful as it is necessary to investigate in depth the functioning of social networks.

[SCRUTATIOm: how to detect retracted literature included in systematics reviews and metaanalysis using SCOPUS© and ZOTERO©]. / SCRUTATIOm: cómo detectar literatura retractada incluida en revisiones sistemáticas y metaanálisis usando SCOPUS© y ZOTERO©.

A good and accurate literature review is a key element of systematic reviews and meta-analyses and always needs to be based on high quality original studies and logically never retracted. The aim of this methodological note is to provide a fast, reproducible and reliable system for detecting retracted literature included in systematic reviews and meta-analyses, allowing the consistency of the results of these to be verified and enabling the possibility of being able to communicate the potential presence of errors to the journals involved by means of a post-publication or post-peer review process. The SCRUTATIOm method, apply routinely, allows us to know if a certain study has been published in our field of study, which may not provide consistent evidence to the body of knowledge.

Necessary political competences for nurses from the perception of the student body: Cross-sectional study in Spain.

BACKGROUND: Nursing should have a fundamental role in the development of health policies. The current state of the educational system regarding leadership-related skills and political competence in nursing students is a field to explore. OBJECTIVES: To explore Spanish nursing students' perceptions about their political competence. DESIGN: Cross-sectional study that was carried out between December 2019 and June 2020. SETTINGS AND PARTICIPANTS: Students of the Degree in Nursing at the Universitat Jaume I (Spain). METHODS: An ad hoc scale composed of 33 items was designed. Sociodemographic variables of interest for the study were collected, such as participation in organizations. A descriptive analysis of the sample and the scale and a bivariate analysis were carried out. RESULTS: 91.8% (n = 90) of items were answered by women. The 2nd (40.8%, n = 40) and 4th (29.6%, n = 29) courses were the most represented. 29.6% (n = 29) belonged to some association or organization, with sports (31.1%, n = 9), NGOs (17.2%, n = 5), cultural (17.2%, n = 5) and student organizations (13.8%, n = 4) being the most represented. Within these associations, 48.3% (n = 14) of participants claimed to have an active role. Statistically significant differences were observed by course in the Political Knowledge category (p = 0.030). The variables "belonging to an organization" and "having an active role" in it seemed to have more influence on the scale than the rest of the sociodemographic variables. CONCLUSIONS: Learning strategies must benefit from skills and prior experiences of students to strengthen new learning. It also seems to be important to emphasize that the theoretical basis is important, but that promoting civic participation among students can be very relevant for the acquisition of political competence.

Bots' Activity on COVID-19 Pro and Anti-Vaccination Networks: Analysis of Spanish-Written Messages on Twitter.

This study aims to analyze the role of bots in the dissemination of health information, both in favor of and opposing vaccination against COVID-19. Study design: An observational, retrospective, time-limited study was proposed, in which activity on the social network Twitter was analyzed. Methods: Data related to pro-vaccination and anti-vaccination networks were compiled from 24 December 2020 to 30 April 2021 and analyzed using the software NodeXL and Botometer. The analyzed tweets were written in Spanish, including keywords that allow identifying the message and focusing on bots' activity and their influence on both networks. Results: In the pro-vaccination network, 404 bots were found (14.31% of the total number of users), located mainly in Chile (37.87%) and Spain (14.36%). The anti-vaccination network bots represented 16.19% of the total users and were mainly located in Spain (8.09%) and Argentina (6.25%). The pro-vaccination bots generated greater impact than bots in the anti-vaccination network (p < 0.000). With respect to the bots' influence, the pro-vaccination network did have a significant influence compared to the activity of human users (p < 0.000). Conclusions: This study provides information on bots' activity in pro- and anti-vaccination networks in Spanish, within the context of the COVID-19 pandemic on Twitter. It is found that bots in the pro-vaccination network influence the dissemination of the pro-vaccination message, as opposed to those in the anti-vaccination network. We consider that this information could provide guidance on how to enhance the dissemination of public health campaigns, but also to combat the spread of health misinformation on social media.

Effectiveness of Early Warning Scores for Early Severity Assessment in Outpatient Emergency Care: A Systematic Review.

Background and Objectives: Patient assessment and possible deterioration prediction are a healthcare priority. Increasing demand for outpatient emergency care services requires the implementation of simple, quick, and effective systems of patient evaluation and stratification. The purpose of this review is to identify the most effective Early Warning Score (EWS) for the early detection of the risk of complications when screening emergency outpatients for a potentially serious condition. Materials and Methods: Systematic review of the bibliography made in 2022. Scientific articles in Spanish and English were collected from the databases and search engines of Pubmed, Cochrane, and Dialnet, which were published between 2017 and 2021 about EWSs and their capacity to predict complications. Results: For analysis eleven articles were selected. Eight dealt with the application of different early warning scores in outpatient situations, concluding that all the scoring systems they studied were applicable. Three evaluated the predictive ability of various scoring systems and found no significant differences in their results. The eight articles evaluated the suitability of NEWS/NEWS2 to outpatient conditions and concluded it was the most suitable in pre-hospital emergency settings. Conclusions: The early warning scores that were studied can be applied at the pre-hospital level, as they can predict patient mortality in the short term (24 or 48 h) and support clinical patient evaluation and medical decision making. Among them, NEWS2 is the most suitable for screening potentially deteriorating medical emergency outpatients.

Health Literacy and Critical Lecture as Key Elements to Detect and Reply to Nutrition Misinformation on Social Media: Analysis between Spanish Healthcare Professionals.

Health misinformation about nutrition and other health aspects on social media is a current public health concern. Healthcare professionals play an essential role in efforts to detect and correct it. The present study focuses on analyzing the use of competencies associated with training in methodology, health literacy, and critical lecture in order to detect sources of health misinformation that use scientific articles to support their false information. A qualitative study was conducted between 15 and 30 January 2022, wherein the participants were recruited from active users from a nutrition conversation on Twitter, diets, and cancer and defined themselves as healthcare professionals. This study demonstrates that health literacy and critical lecture competencies allow for the detection of more misinformation messages and are associated with a high rate of responses to users that spread the misinformation messages. Finally, this study proposes the necessity of developing actions to improve health literacy and critical lecture competencies between healthcare professionals. However, in order to achieve this, health authorities must develop strategies to psychologically support those healthcare professionals faced with bullying as a result of their activity on social media debunking health hoaxes.

Quotation Accuracy of Systematic Review and Meta-Analysis Protocols on Acupuncture.

Currently, published systematic review protocols (SR protocols) have increasingly become a new trend in fields such as acupuncture and are therefore a new source of quotations in these fields. Systematic reviews are considered the pinnacle of the evidence pyramid as they embody comprehensive literature searching. Quotations are key elements to achieve this goal as they can support the assertions of the original authors, but the 'misquotation' exists, too, and they can be misleading to the reader. The aim of this study was to examine the quotation accuracy of SR protocols in a meta-analysis on acupuncture research. We searched SCOPUS through 31 December, 2020, and each protocol and its citations were analyzed and classified as correct or incorrect. We used descriptive statistics to report the quotation errors and characteristics of the included protocols. The results showed 248 SR protocols, where 124 protocols received quotations and 38 quotations (31.4%) were erroneous. Only 11 (4.4%) of the published SRs and SR protocols had been published previously. Furthermore, the scientific journal in which the most SR protocols were published was Medicine (193; 77.8%), followed by BMJ Open (39; 15.7%). Authors from China (86.5%) were the most productive in publishing SRs and SR protocols. Finally, we concluded that the number of SR protocols and meta-analyses published in scientific journals and indexed by databases exceeds the publication capacity of the SRs associated with them, generating scientific literature that does not make any novel contribution to knowledge.

[#CienciaenelParlamento: the need for a parliamentary office of science and technology advice]. / #CienciaenelParlamento: la necesidad de una oficina parlamentaria de asesoramiento científico y tecnológico.

One of the aims of the citizen's initiative #CienciaenelParlamento is helping to establishing a parliamentary office of scientific and technological advice in the Spanish parliament. Said office would be in charge of fostering networking spaces between scientific knowledge and public policies and of triggering public debate between policy-makers, experts and the general public. In this article, we first review the main parliamentary mechanisms of scientific advice, with special attention to one in particular: parliamentary offices of scientific and technological advice. These offices exist in 22 parliaments worldwide, but there are none in Spain. Second, we describe the activity undertaken by #CienciaenelParlamento in its collaboration with the Congress of Deputies during the 12th Spanish Legislature. This collaboration reached its peak with a two-day networking event in November 2018 with over 200 scientists and almost 100 deputies, who all debated twelve topics of social interest and the most up-to-date scientific knowledge. Thanks to this collaboration, the Congress has taken the first steps towards officially establishing a parliamentary science advice office. Lastly, we enumerate some examples about how these parliamentary offices in other countries have contributed with other stakeholders to better public debate and processing of public policies in public health and other areas. To conclude, we at #CienciaenelParlamento believe that a parliamentary science advice office would help to enhance the science-policy ecosystem in Spain.

Design of the EBE-ST Questionnaire among Nursing Students: Multicenter Study from Eight Universities in Spain.

BACKGROUND: Twenty years after the degree in nursing was introduced in Spain, the subject of evidence-based nursing is still unstructured and unestablished in most faculties. Moreover, there are hardly any rigorous studies at a national level that evaluate the current state of this competence in our faculties. Understanding the starting point is essential for the curricular design to ensure that evidence-based practice is implemented among future professionals. AIM: To design and validate an evidence-based nursing competency questionnaire for fourth-year nursing students. METHODS: A specific questionnaire was developed and validated (EBE-ST). A cross-sectional survey design with psychometric validation of an instrument. Participants were 304 senior year nursing students from eight universities in Spain (2020). RESULTS: The EBE-ST questionnaire is composed of 33 items that determine eight factors. It presents adequate reliability and validity (alpha = 0.882), measuring knowledge, attitudes and the practical application of evidence-based practice. CONCLUSIONS: We have created an instrument with good psychometric properties to measure evidence-based practice competence among senior nursing students. The heterogeneity of knowledge regarding evidence-based nursing in our country suggests that further reflection is warranted on the incorporation of this topic during undergraduate training. We have designed and validated an evidence-based nursing competency questionnaire specific to nursing students.

Coping Strategies as a Mental Health Protection Factor of Spanish Nurses during COVID-19.

BACKGROUND: Due to the healthcare crisis caused by COVID-19, nurses have been exposed to stressful, uncertain situations. In such situations, emotional coping strategies are especially important due to their repercussion on health. The purpose of this study is analyze the relationships between nurses' coping strategies and health, with attention to factors related to perceived threat and/or someone close to them is COVID-19 positive. METHODS: This descriptive cross-sectional study was done with a sample of 351 nurses in Spain. In addition to the questionnaire on perception of threat from COVID-19, the Cognitive Emotion Regulation Questionnaire and the General Health Questionnaire, an ad hoc question asked them whether someone close to them was COVID-19 positive. RESULTS: Perceived threat and use of negative coping strategies were related, and these strategies were related to a greater presence of somatic symptoms, anxiety, social dysfunction, and depression. CONCLUSIONS: Given the work and personal influence of coping on nurses, interventions must be designed to promote adaptive strategies.

Adaptation to Change Questionnaire for Nurses: Validation and New Needs in the Context of COVID-19.

BACKGROUND: The worldwide pandemic caused by the SARS-CoV-2 coronavirus has challenged healthcare systems and the professionals who work in them. This challenge involves strong changes to which nurses have had to quickly adapt. Emotional and cognitive-behavioral factors influence the capacity for adaptation to change. Based on this model, the objective of this study was to validate the Adaptation to Change Questionnaire (ADAPTA-10) for identifying professionals in a population of nurses who have problems adapting to adverse situations such as those caused by COVID-19. METHODS: This study was performed with a sample of 351 nurses. (3) Results: The ADAPTA-10 questionnaire was found to have good psychometric properties, and to be an effective, useful tool for nurses in research and clinical practice. The two-dimensional structure proposed in the original model was confirmed. Scales are also provided by sex for evaluation of adaptation to change; the highest scores on the emotional component were among nurses who had not personally encountered the virus. CONCLUSIONS: This instrument will be able to detect of the needs for adaptation to the new reality associated with COVID-19, as well as other situations in which nurses are immersed that demand adaptation strategies.

[Ethical considerations during health crisis: about SARS-CoV-2 coronavirus pandemic.] / Consideraciones éticas durante las crisis sanitarias: a propósito de la pandemia por el coronavirus SARS-CoV-2.

In 2009, the H1N1 pandemic raised a series of ethical considerations that influenced the approach to the crisis. In the framework of the SARS-CoV-2 coronavirus pandemic, these issues have been repeated, and the analysis of what happened in 2009 can be seen as a warning. The principles of justice, solidarity, equity, transparency and reciprocity should be included in future pandemic response plans, including lessons learned.

En 2009 se vivió la pandemia del H1N1 con una serie de implicaciones éticas que influyeron en el abordaje de la crisis. En el marco de la pandemia por el coronavirus SARS-CoV-2 se han repetido estas cuestiones, y el análisis de lo sucedido en 2009 ha resultado premonitorio. Los principios de justicia, solidaridad, equidad, transparencia y reciprocidad deben ser incluidos en los futuros planes de respuesta ante pandemias, incluyendo las lecciones aprendidas.

The Evidence-Based Practice Silent Enemy: Retracted Articles and Their Use in Systematic Reviews.

Today, evidence-based nursing practice strives to improve health care, ensure adherence to treatment, improve health outcomes, and guarantee patient safety. The main scientific documents that nurses should consult, to obtain the best possible evidence, are systematic reviews and meta-analyses. However, this type of scientific document has a major issue if it uses retracted articles that could directly affect the consistency of the results shown in the reviews. The aim of this commentary is to present the current issue represented by the use of retracted articles in meta-analyses of systematic reviews and how researchers could detect them, through the use of different instruments, avoiding them, and providing a reliable SR or meta-analysis that could be useful for day-to-day clinical and research activities.

Increase in Video Consultations During the COVID-19 Pandemic: Healthcare Professionals' Perceptions about Their Implementation and Adequate Management.

In response to the COVID-19 pandemic, health care modalities such as video consultations have been rapidly developed to provide safe health care and to minimize the risk of spread. The purpose of our study is to explore Spanish healthcare professionals' perceptions about the implementation of video consultations. Based on the testimonies of 53 professionals, different categories emerged related to the four identified themes: benefits of video consultations (for professionals, patients, and the health system, and compared to phone calls), negative aspects (inherent to new technologies and the risk of a perceived distancing from the professional), difficulties associated with the implementation of video consultations (technological difficulties, lack of technical skills and refusal to use video consultation among professionals and patients), and the need for training (technological, nontechnical, and social-emotional skills, and adaptation of technical skills). Additionally, the interviewees indicated that this new modality of health care may be extended to a broader variety of patients and clinical settings. Therefore, since video consultations are becoming more widespread, it would be advisable for health policies and systems to support this modality of health care, promoting their implementation and guaranteeing their operability, equal access and quality.

Nurse Training in Gender-Based Violence Using Simulated Nursing Video Consultations during the COVID-19 Pandemic: A Qualitative Study.

Gender-based violence (GBV) is a serious global public health problem that becomes aggravated during public health emergencies that involve quarantine measures. It is important to train nursing students on GBV, especially in vulnerable situations, such as the current COVID-19 pandemic. The purpose of our study is to explore the perceptions of third-year nursing students about simulated nursing video consultations for providing assistance to potential cases of GBV victims using a high-fidelity clinical simulation methodology. After all of the simulated scenarios were completed, 48 scripted interviews were carried out following a guide composed of four open-ended questions to facilitate in-depth discussion. A descriptive qualitative study based on the interpretative paradigm was conducted. The nursing students indicated that they improved their knowledge on GBV victim management (mainly their awareness of the problem, recognition of the role of nursing professionals, and performance of non-technical skills), although they also mentioned the need for continuous training (particularly in socio-emotional skills, interview techniques, a holistic nursing care approach, and not presupposing). This innovative high-fidelity simulation methodology allows nursing students to improve their awareness of the GBV problem, acquire a realistic view about their role in addressing GBV, and build their non-technical skills (such as active listening, communication skills, empathy, and generating confidence) required to adequately care for victims of GBV.