Validation of the attitudes towards people living with HIV/AIDS scale in nursing students.

BACKGROUND: One of the environments where people living with HIV/AIDS should feel safer is in the health care setting; however, scientific evidence has identified discriminatory behaviour on the part of health care professionals towards these people. The reduction or abolition of discriminatory practices requires, first of all, to know the attitudes of nursing students towards AIDS with tools appropriate to the socio-cultural context of the disease. The objectives of this study are to update the AIDS Attitudes Scale for Nursing Students (EASE) by adapting it to the sociocultural landscape and to analyse the reliability and structural validity of the new scale. METHODS: The results of the questionnaires answered by 213 undergraduate nursing students from the Faculty of Health Sciences of Ceuta (University of Granada) were analysed. Reliability (test-retest, n = 33) and validity (n = 180) tests were carried out. RESULTS: An exploratory and confirmatory factor analysis indicated that a four-factor model was the most parsimonious solution. Items were examined for their underlying relationships and labelled: professional practice, social integration, partner and family, and benevolent stigma. The new scale yielded a McDonald's Omega coefficient (ω) of 0.893. Convergent validity was established for average variance extracted per factor greater than 0.5 and divergent validity when the variance retained by each factor is greater than the variance shared between them (average variance extracted per factor > ϕ2). CONCLUSIONS: The new scale is a psychometrically sound instrument for assessing attitudes towards people living with HIV/AIDS in nursing students.

Levels and predictors of postpartum depression and anxiety during the first year of the COVID-19 pandemic in a confined cross-border city.

Pregnancy and/or the puerperium involve social, physiological and psychological changes that make women more vulnerable to mental disorders such as anxiety and depression, even more so if these develop in stressful contexts such as the pandemic. The aim of this study is to identify factors associated with the risk of postpartum anxiety and depression during the COVID-19 pandemic. A cross-sectional study was conducted among postpartum women (n = 69) who gave birth between March 2020 and March 2021 in Melilla, a Spanish cross-border city with Morocco whose borders were closed, making it a confined city. The scales used were the State-Trait Anxiety Inventory and the Edinburgh Postnatal Depression Scale. Results reported an elevated risk of depression (85.5%) and anxiety (63.8%), with severe anxiety reaching 40.6% of cases. Predictors of postpartum depression comprised a personal history of mood disorders (ß = 8.421; CI95% = 4.863/11.978) and having been diagnosed with COVID-19 during pregnancy or postpartum (ß = 4.488; CI95% = 1.331/7.646). As regards anxiety, it is predicted on the basis of mood antecedents (ß = 14.175; CI95% = 7.870/20.479), the fact of having been diagnosed with COVID-19 during pregnancy or postpartum (ß = 8.781; CI95% = 2.970/14.592) and the fact of being a multipara (ß = 5.513; CI95% = 0.706/10.321). In conclusion, special attention should be paid to women with a history of mood disorders and a positive diagnosis of COVID-19 during pregnancy or postpartum, even more so in the case of multiparous women, because of its impact on mental health during the postpartum period. Supplementary Information: The online version contains supplementary material available at 10.1007/s12144-023-04719-6.

Impact of Work-Life Balance on the Quality of Life of Spanish Nurses during the Sixth Wave of the COVID-19 Pandemic: A Cross-Sectional Study.

This study addresses the health-related quality of life (HRQoL) of Spanish nurses during the sixth wave of the COVID-19 pandemic, assessed through the EQ-5D and EQ-VAS indices. METHODS: This cross-sectional 334 study used online surveys, recruiting 305 Spanish nurses. RESULTS: Nurses generally perceived a good HRQoL. "Negative work-family interaction" is adversely associated with the EQ-VAS (ß = -0.337, 95% CI [-1.733, -0.723]) and EQ-5D (ß = -0.399, 95% CI [-0.021, -0.01]) indices, while "positive work-family interaction" shows a positive relationship with the EQ-VAS (ß = 0.218, 95% CI [0.381, 1.759]). The presence of a "paid supportive caregiver" is positively associated with the EQ-VAS (ß = 0.18, 95% CI [1.47, 12.3]) and EQ-5D (ß = 0.149, 95% CI [0.004, 0.117]) indices, but a higher "number of children" is negatively linked with the EQ-5D index (ß = -0.146, 95% CI [-0.061, -0.002]). In addition, living with a partner (EQ-VAS ß = 0.16, 95% CI [1.094, 14.67] and EQ-5D index ß = 0.174, 95% CI [0.018, 0.163]) and working a "rotating shift" (EQ-5D index ß = 0.158, 95% CI [0.005, 0.098]) are positively associated. CONCLUSIONS: These findings highlight the need to comprehensively address nurses' well-being, considering both their working conditions and their home environment, especially in crisis contexts such as the current pandemic.

Humanization of nursing care: a systematic review.

Advances in healthcare in recent years have resulted in the automation and standardization of healthcare. Consequently, care has become dehumanized. There is a lack of trust from patients toward the health care system, as well as feelings of stress, exhaustion, and fatigue among professionals. The aim of this article is to describe the humanization actions in nursing care, as well as the barriers and facilitating strategies to carry them out. A systematic review of the scientific literature has been carried out following the recommendations of the PRISMA declaration. The search was carried out in the WOS, SCOPUS, CINAHL Complete, MEDLINE (via PubMed), EMBASE and Cochrane Library databases. The keywords used were "humanization of assistance," "nursing care," and "nurse-patient relations," restricting to original studies in English or Spanish, from 2018 to 2022. One author performed the search, selection, and screening of records. Two authors were involved in data extraction, and a third author decided in case of conflict. The systematic review was guided by ethical conduct that respects authorship and reference sources. Of the 744 articles initially identified, 27 were included in this review. Methodological quality was assessed following the STROBE statement or the CASPe and MMAT tools. The main barriers were found to be the lack of training of nurses and their working conditions, as well as the unwillingness of the institutions. Facilitating strategies consisted of solving implementation problems, promoting communication to strengthen nurse-patient relationships and accompaniment by family members. The main interventions are related to the physical environment and have been studied in obstetrics and pediatrics services. Barriers related to training, work situation and lack of institutional involvement are complemented with facilitating strategies that aim to implement the humanized model at a general level.

Attitudes towards people living with HIV/AIDS through the EAPVVS-E: A descriptive analysis in nursing students.

BACKGROUND: Despite advances in antiretroviral treatment, stigma towards people with HIV/AIDS continues to exist. Nursing students, as future key players in health care, must advocate for the elimination of stigma through education, empathy and the creation of a supportive environment. This holistic approach is crucial to improving their quality of life and moving towards the eradication of HIV/AIDS. AIM: To identify nursing students' attitudes towards people living with HIV or AIDS and their relationship with sociodemographic and academic-cultural variables of the participants. DESIGN: A cross-sectional study was performed. SETTINGS: The research was carried out in the Nursing Degree of the Faculty of Health Sciences of the Ceuta Campus of the University of Granada. PARTICIPANTS: Convenience sampling was used to recruit 284 students of the degree in Nursing. METHODS: Data were collected voluntarily and on an anonymous basis, using the "Attitudes Towards People Living with HIV/AIDS Scale in Nursing Students". Bivariate and multivariate analyses were performed. RESULTS: Factors 1 (Professional Practice), 2 (Social Integration) and 3 (Partner and Family) exhibited mean scores considered to be favourable attitudes (>4 points). In contrast, Factor 4, called Benevolent Stigma, had a mean score of 3.68 ± 0.97. Religious beliefs, academic year, sexual orientation, academic practices and age are considered influential variables in the different factors. CONCLUSIONS: Nursing students present attitudes with favourable scores. However, these results highlight the importance of influencing the different factors, especially in the second year of the Bachelor's Degree in Nursing in our sample. Thus, an educational intervention in this area would be necessary to reinforce the values of humanised care.

Epidemiological Profile of Patients with Vulvovaginal Candidiasis from a Sexually Transmitted Infection Clinic in Southern Spain.

Epidemiological data on women suffering from vulvovaginal candidiasis and its recurrence are outdated and vague. The aim of this study was to identify the prevalence of women diagnosed with vulvovaginal candidiasis, as well as the epidemiological profile and associated risk factors in the province of Granada (Spain). Data from the Centre for Sexually Transmitted Infections of the Granada province between 2000 and 2018 (N = 438) were used in this study. Associations between sociodemographic and sexual behaviour variables with vulvovaginal candidiasis were analysed using the Chi-square test and bivariate logistic regression. The prevalence of candidiasis was 14.6%. The sociodemographic profile corresponded to a woman aged 25.14 ± 4.8 years on average, who is of Spanish nationality (60.9%), a student (55.7%), in non-active employment (59.7%), with a higher education (56.7%), single (93.5%), and under 30 years of age (79.7%). Variables associated with this diagnosis were the absence of oro-genital contact (OR = 1.99; 95% CI = 0.25-0.74), having a regular partner (OR = 1.99; 95% CI = 1.05-3.75), and age of sexual debut, with the probability increasing by 12% (95% CI = 1.00-1.24) with each year. In this context, vulvovaginal candidiasis infection is common, and its epidemiological profile is contradictory, so our results do not suggest a relevant role of sexual risk behaviours in the diagnosis. Further research is needed to improve the estimates and factors associated with this infection.

Good practices in perinatal bereavement care in public maternity hospitals in Southern Spain.

OBJECTIVE: To assess the attitudes and care practices of midwives and nurses in the province of Granada in relation to death care and perinatal bereavement, to determine their degree of adaptation to international standards and to identify possible differences in personal factors among those who best adapt to international recommendations. DESIGN: A local survey of 117 nurses and midwives from the five maternity hospitals in the province was conducted using the Lucina questionnaire developed to explore professionals' emotions, opinions, and knowledge during perinatal bereavement care. Adaptation of practices to international recommendations was assessed using the CiaoLapo Stillbirth Support (CLASS) checklist. Socio-demographic data were collected to establish their association with increased compliance with recommendations. FINDINGS: The response rate was 75.4%, the majority were women (88.9%), with a mean age of 40.9 (SD=1.4) and 17.4 (SD= 10.58) years of work experience. Midwives were the most represented (67.5%) and reported having attended more cases of perinatal death (p = 0.010) and having more specific training (p<0.001.) Of these, 57.3% would recommend immediate delivery, 26.5% would recommend the use of pharmacological sedation during delivery and 47% would take the baby immediately if the parents expressed their wish not to watch them. On the other hand, only 58% would be in favour of taking photos for the creation of memories, 47% would bathe and dress the baby in all cases, and 33.3% would allow the company of other family members. The percentage that matched each recommendation on memory-making was 58%, 41.9% matched the recommendations on respect for the baby and parents, and 23% and 10.3% matched the appropriate delivery and follow-up options, respectively. The factors associated with 100% of the recommendations, according to the care sector, were being a woman, a midwife, having specific training and having personally experienced the situation. KEY CONCLUSIONS: Although the levels of adaptation observed are more favourable than in other nearby contexts, serious deficiencies are identified in the province of Granada with respect to internationally agreed recommendations on perinatal bereavement care. More training and awareness-raising of midwives and nurses is needed, which also considers factors related to better compliance. IMPLICATION FOR PRACTICE: This is the first study to quantify the degree of adaptation to international recommendations in Spain reported by midwives and nurses, as well as the individual factors associated with a higher level of compliance. Areas for improvement and explanatory variables of adaptation are identified, which allow support for possible training and awareness-raising programmes aimed at improving the quality of care provided to bereaved families.

Posters as a Tool to Improve Hand Hygiene among Health Science Students: Case-Control Study.

(1) Background: Numerous educational interventions have been conducted to improve hand hygiene (HH) compliance and effectiveness among nursing students, with mixed results. The aim is to evaluate the effectiveness of posters as a teaching tool and factors associated with HH quality. (2) Methods: A pre-post experimental intervention study was conducted with a total of 293 nursing students randomly assigned to two groups (experimental and control) who, before and after HH, took cell culture samples from their non-dominant hands. Only the experimental group was exposed to the poster. (3) Results: In the experimental group, significant differences were observed among students older than 22 years (p = 0.017; V = 0.188), with a higher percentage of failures (15.7% vs. 3.6%). Poster displaying was associated with passing, other variables being equal, although without statistical significance (ORa = 2.07; 95% CI = 0.81-5.26). Pre-practice hand contamination was weakly associated with lower HH quality (ORa = 0.99, 95% CI = 0.99-0.99). (4) Conclusions: The use of posters as a teaching method shows indications of efficacy. Prior hand contamination slightly affects the quality of HH. Further evaluation of teaching methods is needed to ensure good technical performance of HH to prevent the spread of infectious diseases during the COVID-19 pandemic.

Sexist Myths Emergency Healthcare Professionals and Factors Associated with the Detection of Intimate Partner Violence in Women.

This study analysed the capacity of emergency physicians and nurses working in the city of Granada (Spain) to respond to intimate partner violence (IPV) against women, and the mediating role of certain factors and opinions towards certain sexist myths in the detection of cases. This is a cross-sectional study employing the physician readiness to manage intimate partner violence survey (PREMIS) between October 2020 and January 2021, with 164 surveys analysed. Descriptive and analytical statistics were applied, designing three multivariate regression models by considering opinions about different sexist myths. Odds ratios and 95% confidence intervals (CIs) were considered for the detection of cases. In the past six months, 34.8% of professionals reported that they had identified some cases of IPV, particularly physicians (OR = 2.47, 95% CI = 1.14-5.16; OR = 2.65, 95% CI = 1.26-5.56). Those who did not express opinions towards sexist myths related to the understanding of the victim or the consideration of alcohol/drug abuse as the main causes of violence and showed a greater probability of detecting a case (NS) (OR = 1.26 and OR = 1.65, respectively). In order to confirm the indicia found, further research is required, although there tends to be a common opinion towards the certain sexual myth of emergency department professionals not having an influence on IPV against women.

Dating Violence: Idealization of Love and Romantic Myths in Spanish Adolescents.

Dating violence is a significant problem among adolescents. It encompasses a variety of violent behavior, from verbal abuse to physical and sexual abuse, from threats to rape and murder. Among young people, idealization of love and romantic myths are very common as a consequence of our culture and society, which lead them to develop dysfunctional relationships that somehow favor and facilitate partner violence and sexist ideas in daily life. Education is the basic tool to eradicate discrimination and violence against women. The objective of this study is to explore the false myths of romantic love in adolescents and their related factors. A cross-sectional study was conducted with 16-19-year-old teenagers (n = 180), through questionnaires and by employing the romantic love myths scale, the ambivalent sexism inventory, and the love attitudes scale. Adolescents accepted to a greater degree the love myths associated with idealization than those related to abuse with scale values of Med = 2.72, SD = 0.55, and Med = 1.34, SD = 0.68, respectively. Designed models predict love idealization on the basis of benevolent sexism (ß = 0.03; CI 95% = 0.021-0.039), religion (ß = 0.198; CI 95% = 0.047-0.349), passionate love (ß = 0.038; CI 95% = 0.015-0.061), practical love (ß = 0.024; CI 95% = 0.001-0.047), and friendly love (ß = 0.036; CI 95% = 0.014-0.058). Hostile sexism and undergraduate studies were associated with the myths that relate love and abuse (ß = 0.19; CI 95% = 0.007-0.031, ß = 0.208; CI 95% = 0.001-0.414, respectively).

Spanish Nursing Students' Attitudes toward People Living with HIV/AIDS: A Cross-Sectional Survey.

Human immunodeficiency virus (HIV) infection is still a public health issue. Human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) creates, in society, stigmatizing attitudes, fear, and discrimination against infected people; even health professionals do not feel trained enough to adequately take care of these patients, which affects the quality of care provided to such patients. The purpose of this study was to explore nursing students' attitudes and other related factors toward people with HIV/AIDS, as well as their evolution in subsequent academic years. A cross-sectional study was performed with students in four academic years from four Spanish health sciences institutions (n = 384). Data were collected voluntarily and on an anonymous basis, utilizing the "Nursing students' attitudes toward AIDS" (EASE) validated scale. The students' attitudes toward people with HIV/AIDS were relatively positive, with a total mean EASE value of 85.25 ± 9.80. Statistically significant differences were observed according to the academic year (p = 0.041), in 4 out of 21 items of the scale and among students with no religious beliefs. By adjusting every variable, only the weak association with religion was maintained (p = 0.045).

Sexually Transmitted Infections and Associated Factors in Southeast Spain: A Retrospective Study from 2000 to 2014.

The World Health Organization estimates that more than one million people acquire a Sexually Transmitted Infection (STI) every day, compromising quality of life, sexual and reproductive health, and the health of newborns and children. It is an objective of this study to identify the factors related to a Sexually Transmitted Infection diagnosis in the province of Granada (Spain), as well as those better predicting the risk of acquiring such infections. In this study, 678 cases were analyzed on a retrospective basis, which were treated at the Centre for Sexually Transmitted Diseases and Sexual Orientation in Granada, between 2000-2014. Descriptive statistics were applied, and by means of binary logistic regression, employing the forward stepwise-likelihood ratio, a predictive model was estimated for the risk of acquiring an STI. Sex, age, occupation, economic crisis period, drug use, number of days in which no condoms were used, number of sexual partners in the last month and in the last year, and number of subsequent visits and new subsequent episodes were associated with an STI diagnosis (p < 0.05). The risk of being diagnosed with an STI increased during the economic crisis period (OR: 1.88; 95%-CI: 1.28-2.76); during the economic crisis and if they were women (OR:2.35, 95%- CI: 1.24-4.44); and if they were women and immigrants (OR: 2.09; 95%- CI:1.22-3.57), while it decreased with age (OR: 0.97, 95%-CI: 0.95-0.98). Identification of the group comprised of immigrant women as an especially vulnerable group regarding the acquisition of an STI in our province reflects the need to incorporate the gender perspective into preventive strategies and STI primary health care.

Validation of the Women's Views of Birth Labor Satisfaction Questionnaire (WOMBLSQ4) in the Spanish Population.

The satisfaction of women with the birth experience has implications for the health and wellness of the women themselves and also of their newborn baby. The objectives of this study were to determine the factor structure of the Women's Views of Birth Labor Satisfaction Questionnaire (WOMBLSQ4) questionnaire on satisfaction with the attention received during birth delivery in Spanish women and to compare the level of satisfaction of pregnant women during the birth process with that in other studies that validated this instrument. A cross-sectional study using a self-completed questionnaire of 385 Spanish-speaking puerperal women who gave birth in the Public University Hospitals of Granada (Spain) was conducted. An exploratory factor analysis of the WOMBLSQ4 questionnaire was performed to identify the best fit model. Those items that showed commonalities higher than 0.50 were kept in the questionnaire. Using the principal components method, nine factors with eigenvalues greater than one were extracted after merging pain-related factors into a single item. These factors explain 90% of the global variance, indicating the high internal consistency of the full scale. In the model resulting from the WOMBLSQ4 questionnaire, its nine dimensions measure the levels of satisfaction of puerperal women with childbirth care. Average scores somewhat higher than those of the original questionnaire and close to those achieved in the study carried out in Madrid (Spain) were obtained. In clinical practice, this scale may be relevant for measuring the levels of satisfaction during childbirth of Spanish-speaking women.

Economic Crisis and Sexually Transmitted Infections: A Comparison Between Native and Immigrant Populations in a Specialised Centre in Granada, Spain.

This study aimed to analyse the influence of the economic crisis on the prevalence of sexually transmitted infections (STIs) in the immigrant population compared to the native population. A cross-sectional study was conducted by reviewing 441 clinical records (329 Spanish nationals and 112 non-Spanish nationals) of individuals who, between 2000 and 2014, visited an STI clinic in Granada and tested positive for an infection. Descriptive statistical analyses were performed, and infection rates, odds ratios, and 95% confidence intervals (CIs) were calculated. The mean age was 28.06 years (SD = 8.30; range = 16-70). During the period 2000-2014, the risk of being diagnosed with an STI was higher among non-Spanish nationals than among Spanish nationals (odds ratio (OR) = 5.33; 95% CI = 4.78-6.60). Differences between both populations were less marked during the crisis period (2008-2014: OR = 2.73; 95% CI = 2.32-3.73) than during the non-crisis period (2000-2007: OR = 12.02; 95% CI = 10.33-16.17). This may be due to underreporting of diagnoses in the immigrant population. Immigrants visiting the STI clinic in Granada are especially vulnerable to positive STI diagnoses compared to the native population.

Differences in Sexually Transmitted Infections between the Precrisis Period (2000⁻2007) and the Crisis Period (2008⁻2014) in Granada, Spain.

OBJECTIVE: To analyze the difference in the prevalence of sexually transmitted infections (STIs) between two time periods (2000⁻2007 and 2008⁻2014, with the latter period characterized by the economic crisis), as well as determine differences in sociodemographic factors, clinical care, and risk indicators. METHODS: This was a retrospective, observational, and analytical study, reviewing 1437 medical records of subjects attending a specialized center in the province of Granada (Spain) for consultation associated with the presence or suspicion of an STI between 2000⁻2014. Data were collected on variables relating to the research objective. A descriptive and bivariate statistical analysis was performed by multiple logistic regression. RESULTS: In the analysis comparing the presence of STIs between the crisis and non-crisis periods, the percentage of positive diagnoses reached 56.6% compared to 43.4% negative diagnoses during the non-crisis period, while the percentages were 75.2% and 24.8%, respectively, during the crisis period. This difference was statistically significant (p < 0.001) with an odds ratio (OR) of 2.21 after adjusting for age, sex, days since last unprotected sexual intercourse, and partners in the last year. CONCLUSIONS: There are significant differences in the prevalence of STIs between the study periods, which is consistent with the reports of some authors regarding the effect of the financial crisis on these conditions; however, it is worth considering other aspects that might explain the differences.

Sexually Transmitted Infections and Associated Factors in Homosexuals and Bisexuals in Granada (Spain) During the Period 2000-2015.

Sexually transmitted infections (STIs) are a major public health issue. Previous research shows the vulnerability of the homosexual and bisexual population, as well as the influence of economic, political, and cultural determinants. The aim of this study was to describe the socio-demographic healthcare profile and the main risk factors associated with STIs in homosexuals and bisexuals seen at the STI clinic in Granada (Spain) during the years 2000-2015. Infection prevalences were compared between the economic crisis period (2008-2014) and the rest of the years analysed. A cross-sectional observational and analytical study was conducted by reviewing 261 clinical records of individuals with suspected or present infection. Univariate, bivariate, and multivariate analyses were performed. 91.2% of the individuals were men, and 8.8% were women, with the mean age being 28.61 (SD = 9.35, Range = 17-74) years old. The prevailing sexual orientation identity was homosexual. 94.2% were single. The main reason for consultation was HIV. Differences in prevalence were found between crisis and non-crisis years (OR = 3.91; 95% CI = 1.73-9.19). In conclusion, their profile was that of a young, single man suspecting possible HIV infection. STI prevalence was significantly higher in the years of economic recession in comparison to the rest of the years.

Mitos sobre violencia de género en una población de jóvenes andaluces y factores asociados / Myths about gender violence in a population of young Andalusians and associated factors

Objetivo principal: Analizar el grado de acuerdo en relación con una serie de mitos sobre violencia de género en personas jóvenes, y explorar factores asociados. Metodología: Estudio transversal mediante cuestionario voluntario y anónimo a jóvenes < 25 años residentes en Andalucía detectados por el alumnado de enfermería de la Universidad de Granada durante los años 2016 y 2018. Resultados principales: Participaron un total de 3291 jóvenes. Los mitos con mayor grado de acuerdo fueron: “Los maltratadores son violentos por naturaleza” (37%) y “Los maltratadores están locos” (36,3%). En 2018, respecto a 2016, se duplica el riesgo de estar de acuerdo con pensar que los maltratadores tienen problemas con el alcohol o drogas (OR=2,46; IC95%=2,02-3,00), la violencia de género ocurre en familias de bajo nivel económico o académico (OR=2,17; IC95%=1.54-3,04), o que son casos aislados (OR=2,02; IC95%=1.44-2.83). Conclusión principal: Persisten ciertos mitos entre la población juvenil andaluza, y además en los últimos años, algunos se han visto reforzados. (Au)

Objective: Analyze the degree of agreement in relation to a series of myths about gender violence in young people, and explore associated factors. Methods: Cross-sectional study using a voluntary and anonymous questionnaire to young people <25 years of age living in Andalusia detected by the Nursing students of the University of Granada during the years 2016 and 2018. Results: A total of 3,291 young people participated. The myths with the highest degree of agreement were: “Batterers are violent by nature” (37%) and “Batterers are crazy” (36.3%). In 2018, compared to 2016, the risk of agreeing with thinking that abusers have problems with alcohol or drugs is doubled (OR = 2.46; 95% CI = 2.02-3.00), gender violence occurs in families of low economic or academic level (OR = 2.17; 95% CI = 1.54-3.04), or that are isolated cases (OR = 2.02; 95% CI = 1.44-2.83). Conclusions: Certain myths persist among the Andalusian youth population, and also in recent years, some have been reinforced. (AU)

Inadequate prenatal care and maternal country of birth: a retrospective study of southeast Spain.

OBJECTIVE: To quantify the association between the maternal country of birth and inadequacy in the use of prenatal care, and to identify factors that might explain this association. STUDY DESIGN: A retrospective case series was carried out in a public hospital in southern Spain, including 6873 women who delivered between 2005 and 2007. The maternal country of birth was categorised into four regional groups: Spain, Maghreb (north-west Africa), Eastern Europe and Others (non-Spain), while the use of prenatal care was quantified according to a modified Kotelchuck index: APNCU-1M and APNCU 2M. The effect of country of birth on inadequate prenatal care was analysed using a multiple logistic regression model designed to accommodate factors such as age, parity, previous miscarriages, and pre-gestational and gestational risks. Likelihood ratio tests were performed to assess any interactions. RESULTS: A significant association was found between maternal country of birth and inadequate prenatal care regardless of the index used. Under APNCU 1-M the strength of association was strongest for Eastern European origin (odds ratio (OR) 6.17, 95% confidence interval (CI) 5.2-7.32), followed by the Maghreb (OR: 5.58, 95% CI: 4.69-6.64). These associations remained virtually unchanged after adjusting for potential confounders. Interactions were observed between age and parity, with the highest risk of inadequacy seen among the Eastern European childbearing women over 34 years of age having 1-2 previous children (OR: 7.63, 95% CI: 3.65-15.92). CONCLUSION: Prenatal health care initiatives would benefit from the study of a larger number of variables to address the differences between different groups of women. We recommend the widespread use of standardised indices for the study of prenatal care utilisation.

Eficacia de la postura materna manos-rodillas para corregir la posición fetal occipitoposterior en el parto / Efficacy of hands and knees maternal posture to correct the occipitoposterior fetal position during labor

Objetivo principal: Valorar la rotación fetal de posición occipitoposterior (OP) a occipitoanterior (OA) durante el parto con la postura "manos-rodillas" (MR) frente a la postura "decúbito lateral (DL) hacia la espalda fetal". Metodología: Ensayo clínico multicéntrico. Mediante asignación aleatoria, 65 gestantes con posición fetal OP adoptaron la postura MR (grupo MR) y 70 gestantes la postura DL hacia la espalda fetal (grupo DL) durante 30 minutos. Resultados principales: Similar rotación fetal a OA durante la intervención del grupo MR frente al grupo DL (55,4% vs. 54,3%; Odds Ratio de 1,04 para un intervalo de confianza al 95%:0,53-2,06). Tampoco hubo diferencias estadísticamente significativas para los resultados de duración y tipo de terminación del parto entre los grupos. Conclusión principal: Para mejorar los resultados de los partos con posición fetal occipitoposterior recomendamos la adopción de las posturas MR y DL hacia la espalda fetal durante el parto, pues ambas tienen similar eficacia de rotación fetal a occipitoanterior

Objective: To evaluate the efficacy of hands and knees (HK) maternal posture during labor thus promoting fetal rotation from occipitoposterior to occipitoanterior and to compare the results with the lateral toward the fetal back posture. Methods: Multicenter clinical trial. By simple randomization and for at least 30 minutes, 65 women with a single fetus in occipitoposterior position took the HK posture (HK group) and 70 women took the "lateral toward the fetal back" posture (lateral group). Results: HK group and lateral group have similar fetal rotation to occipitoanterior during the intervention (55.4% vs. 54.3%, odds ratio of 1.04 for a confidence level of 95%: 0.53-2.06). There were no statistically significant differences for the results of duration and type of birth between groups. Conclusions: To improve birth outcomes, We recommend that pregnant women with occipitoposterior fetal position adopt HK posture and lateral toward the fetal back posture during labor, because both postures have similar efficacy of fetal rotation to occipitoanterior

Evolución y futuro de las competencias de las enfermeras especialistas obstétrico-ginecológicas (Matronas) / Evolution and future of Obstetrics and Gynaecology Nurses specialists (Midwives)

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