[Systematic review of the primary care quality assessment instruments used in the last 10 years]. / Revisión sistemática de los instrumentos de evaluación de la calidad de Atención Primaria utilizados en los últimos 10 años.

OBJECTIVE: There are numerous instruments in the scientific literature for the evaluation of the quality of Primary Care (PC) and to know which of them are the most used and in which countries provides more information to make a well-founded decision. The aim is to determine which, between 2013 and 2023, have been the instruments used to assess the international quality of PC, its evolution and geographical distribution. DESIGN: Systematic review. DATA SOURCES: PubMed and Embase. From March to December 2023. INCLUSION CRITERIA: 1) Validation studies of specific assessment instruments to measure the quality of PC and/or the satisfaction of patients, providers or managers. 2) carried out in the field of PC and 3) published between 1/01/2013 and 01/02/2023. 83 full-text articles were included. DATA EXTRACTION: From each publication, an instrument used to evaluate the quality of the PC, attributes of the PC it evaluates, recipient of the evaluation, user, provider or manager, year, and country. RESULTS: Fifteen PC assessment instruments were found. The most widely used is the Primary Care Assessing Tool (PCAT), with wide geographical distribution, versions in several languages, is more limited in Europe, except in Spain, and is mostly used in the Primary Care Assessing Tool (PCAT). CONCLUSIONS: The PCAT, due to its cultural adaptability, availability in several languages, its ability to evaluate the fundamental principles of PC enunciated by the World Health Organization and to contemplate the perspectives of all health agents, is a complete, versatile, and consistent questionnaire for the evaluation of the quality of PC.

Parental Assessment of Infantile Hemangioma Cosmetic Clinical Outcomes: Results of the Spanish Hemangioma Nationwide Prospective Cohort.

BACKGROUND: Functional impairment is the main consideration when it comes to choosing therapy for infantile hemangiomas (IH). However, since most hemangiomas are treated for cosmetic reasons, it is important to know the cosmetic outcome assessed by the parents. OBJECTIVE: To evaluate the aesthetic outcomes of IH, considering the characteristics of the lesions and the treatments used. PATIENTS AND METHODS: The Spanish Infantile Hemangioma Nationwide Prospective Cohort (2016-2022) recruited all consecutive patients diagnosed with IH in 12 Spanish hospitals. The children included had two photos of the IH lesion (at both baseline and at the end of the study). A panel of parents blindly assessed all available photos using a scale from 0 (worst cosmetic outcomes) to 10 (best cosmetic outcomes). The different scores - both before and after treatment - as well as the outcomes percent considered excellent (>9) were described and compared. We analyzed the effect of receiving different therapies and performed causal model analyses estimating the mean treatment effect of parents' assessments. RESULTS: The median follow-up was 3.1 years. A total of 824 photos were evaluated. Baseline aesthetic impact was higher in the propranolol group vs the topical timolol and observation treatment groups (1.85 vs 3.14 vs 3.66 respectively; p<0.001). After treatment, the aesthetic impact was similar between both treatment groups (7.59 vs 7.93 vs 7.90; p>0.2). The causal model could only be applied to the comparison between topical timolol and observation, revealing no differences whatsoever. CONCLUSION: This is the first prospective cohort to analyze the aesthetic outcome of IH. The final aesthetic results of the three therapies were similar, with nearly 40% of patients achieving excellent aesthetic outcomes.

[Correlations between dietary salt intake and 24-h urine sodium excretion in a sample of the urban population of Cáceres]. / Correlaciones entre la ingesta de sal en la dieta y la eliminación de sodio en la orina de 24 h en una muestra de población urbana de Cáceres.

OBJECTIVE: Excessive salt intake is associated with higher levels of AHT and prevalence of cardiovascular diseases. WHO recommends consuming less than 5 g/day of salt (equivalent to 2 g Na+/day). Identifying foods and behaviours with greater contribution to excess intake would facilitate preventive dietary advice. DESIGN: Observational study. SITE: Urban Health Center in Cáceres. MAIN MEASUREMENTS: We estimated salt consumption using two food consumption frequency (FFQ) questionnaires, one generic and one with high Na+ content, and a 24 h follow-up survey. We use the Evalfinut program for nutritional evaluation of the diet. We analyzed correlations between estimated salt intake and 24-h urine sodium elimination (gold standard). RESULTS: 92% of the population had consumption higher than the recommendations with intakes equivalent to 9.5 g/day of salt (3.7 g/d of Na+). When sodium intake is determined by the Na+/K+ ratio, 79.54% have high intakes. Sodium elimination follows a slightly increasing trend with BMI. The perception of salt consumption is low, 56.3% consider it "adequate". 32.4% add salt to food once served. FFQ underestimate Na+ intake and targeted surveys provide higher values. The correlation between FFQ and Na+ urinary elimination is weak. CONCLUSION: We must reduce salt intake by increasing the perception of consumption, improving knowledge about the salt content in food and identifying target patients of the health council.

Validation and psychometric properties of the 8-item Morisky Medication Adherence Scale (MMAS-8) in type 2 diabetes patients in Spain.

AIMS: To validate a translated and culturally adapted version of the Morisky Medication Adherence Scale for use in Spanish population, and to examine the psychometric properties of this scale in patients with type 2 diabetes mellitus in Spain. DESIGN: This cross-sectional study was conducted in a single university hospital in Spain. Patients diagnosed with type 2 diabetes mellitus at least 1 year before inclusion, being treated with anti-diabetic medication were included. INTERVENTION: We used the Spanish version of the scale to measure treatment adherence. PRINCIPAL MEASUREMENTS: three level categorical scale is broken down into low adherence (score of <6), medium adherence (score of 6 to <8) and high adherence (score of 8). To validate the questionnaire, we measured internal consistency through Cronbach's α, confirmed construct validity through an exploratory principal component analysis and assessed test-retest reliability. RESULTS: 232 patients met the inclusion criteria. The Cronbach's α coefficient was 0.40 (95% CI 0.28-0.52). The exploratory principal component analysis showed three components. The intraclass correlation coefficient was 0.718 (95% CI 0.564-0.823). CONCLUSIONS: the Spanish version of the Morisky Medication Adherence scale showed low internal consistency, the exploratory factor analysis identified three dimensions, and the test-retest reliability was acceptable, therefore, psychometric properties of MMAS-8 are not suitable for measuring medication adherence in type 2 diabetes mellitus patients from Spain.

[Translation and cross-cultural adaptation into Spanish, Catalan and Galician of the Hopkins Symptom Checklist-25 to identify depression in Primary Care]. / Traducción y adaptación transcultural al español, catalán y gallego de la escala Hopkins Symptom Checklist-25 para la detección de depresión en Atención Primaria.

AIM: To describe the translation and cross-cultural adaptation process of the Hopkins Symptom Checklist-25 (HSCL-25) scale into Spanish, Catalan and Galician. DESIGN: Translation, cross-cultural adaption and comprehensibility analysis through cognitive debriefing. LOCATION: Research Units of Primary Care in Barcelona and Vigo. PARTICIPANTS: Family doctors and Primary Care patients. MAIN MEASUREMENTS: Following the guidelines of the International Society for Pharmacoeconomics and Outcomes Research (ISPOR): 1) Direct translation. 2) Pilot study based on Delphi methodology with family doctors. 3) Back-translation. 4) Equivalence analysis. 5) Comprehension analysis of versions obtained in Spanish, Catalan and Galician through cognitive debriefing in a sample of patients. 6) Transcultural harmonization. RESULTS: 73 family doctors participated in the Delphi study. The consensus was established in the first round for the Spanish and Catalan translations, and in the second round for the Galician. The back-translations were similar in all 3languages. All versions were equivalent between them and compared to the original English version. In the cognitive interview, 10 patients participated for each language, without modifying the writing of the items. CONCLUSIONS: The translations of the HSCL-25 scale in Spanish, Catalan and Galician are semantically and conceptually equivalent to the original version. Translations are understandable and well accepted by patients.

[ECoLaE: Validation of a questionnaire on breastfeeding knowledge and skills for Nursing]. / ECoLaE: validación de un cuestionario sobre conocimientos y habilidades en lactancia materna para enfermería.

OBJECTIVE: To validate the "Questionnaire on breastfeeding knowledge and skills" in Nurses (EcoLa). DESIGN: A validation study, with prior linguistic adaptation, according to the skills and training of the nurses. LOCATION: Cantabria. PARTICIPANTS: General nurses, paediatrics specialists, and midwives from the Cantabrian Health Service, with responsibility for mother-child care. MAIN MEASUREMENTS: The psychometric properties of the nursing version of ECoLa were evaluated. Internal consistency was measured using α-Cronbach for multiple choice and overall answer questions, and Kuder-Richardson's formula (KR20) for dichotomous response questions. Inter-observer concordance was measured using the kappa coefficient in items 18 and 21, and the test-retest reliability with 11 subjects using the intraclass correlation coefficient. RESULTS: The mean score in the questionnaire was 21.15±4.67 points. There were no statistically significant differences as regards the gender or number of children. There was an association between the score obtained in the questionnaire and previous experience in lactation, and with the professional profile (midwife 24.23 points, paediatric nurse 21.20 points, and general nurse 20 points; P<.01). The internal consistency showed a KR20 of 0.802, and the α-Cronbach for multiple-choice questions was 0.719, and 0.866 for overall. Interobserver concordance for Item 18 had a kappa=0.6, for item 30 kappa=0.825), and for total score the kappa=0.856). The test-retest reliability overall score (CCI=0.856, 95% CI 0.55-0.96), and for question 30 (CCI=0.93, 95% CI 0.75-0.98). CONCLUSIONS: The questionnaire scale has psychometric properties that make its use valid and reliable in the evaluation of the training of nursing professionals.

[Adapting and validating a questionnaire to measure the self-care practices in healthy child population residing in Spain]. / Adaptación y validación de un cuestionario para evaluar las prácticas de autocuidado en población infantil sana residente en España.

OBJECTIVE: To adapt and validate the Child and Adolescent Self-Care Performance Questionnaire (CASPQ) to the context of healthy children aged 8 to 12years residing in Spain and evaluate their metric properties. DESIGN: Validation study based on Classical Test Theory. LOCATION: Four schools participating in the Salut i Escola programme of a Primary Care Centre of Barcelona (Spain). PARTICIPANTS: Four hundred and ninety-eight elementary school students participated in the study during the first six months of 2016. MAIN MEASUREMENTS: Cultural adaptation of the questionnaire was carried out. Response process and factorial structure were evaluated and the relationships of the adapted questionnaire scores with those of the KIDSCREEN-27 questionnaire were analysed. Likewise, internal consistency and reproducibility of the scores were evaluated. RESULTS: Four hundred and eighty-nine questionnaires were obtained. The confirmatory factor analysis of its theoretical structure showed a sufficient adjustment. A positive association was observed between the questionnaire scores and those of KIDSCREEN-27. The overall internal consistency was satisfactory; nevertheless, that of each factor was marginal or moderate. The reproducibility of the scores was optimal. CONCLUSIONS: The CASPQ adapted to the healthy child population of 8 to 12years old shows appropriate metric properties and similar to those of the original questionnaire. Therefore, it is a useful tool to assess self-care practices and plan interventions aimed at its promotion.

[Transcultural adaptation into Spanish of the Patient empowerment in long-term conditions questionnaire]. / Adaptación transcultural al español del cuestionario Patient empowerment in long-term conditions.

PURPOSE: To describe the process of translation and cultural adaptation of the Patient empowerment in long-term condition to the Spanish language. DESIGN: Translation, cross-cultural adaptation, and pilot testing (cognitive debriefing) LOCATION: Primary and Hospital care. PARTICIPANTS: Ten patients admitted to a cardiology department of a University Hospital MAIN MEASUREMENTS: 1) Direct translation, 2) conciliation and synthesis of the versions by expert panel, 3) back- translation, 4) agreement on the back-translated version with the author of the original version, 5) analysis of comprehensibility through cognitive interviews. RESULTS: There were no differences between the direct-translated versions. The expert panel introduced changes in 23 out of the 47 items of the questionnaire. The author of the original version agreed with the version of the back-translation. In the cognitive interviews, patients reported high difficulty in one item and low difficulty in 4. CONCLUSIONS: The Spanish version of the Patient Empowerment in long-term conditions questionnaire is semantically and conceptually equivalent to the original tool. The assessment of the psychometric properties of the Spanish version of the questionnaire will be carried out at a later stage.

The Spanish Psoriasis Patients' Association According to Its Members: Cross-Sectional Descriptive Study of Members' Opinions of the Association's Functions. / Función y respaldo a la asociación de pacientes con psoriasis en España según sus miembros: estudio descriptivo transversal.

INTRODUCTION: Patient associations form part of health care systems, but little is known about how their members' view the functionality of these associations and whether they endorse their goals and activities. OBJECTIVE: To study how the members of the leading Spanish association of patients with psoriasis and their relatives view the group's functioning. MATERIAL AND METHODS: Survey study using a self-administered questionnaire answered by members of the association (total membership, 26 349 persons). The credibility of the association and respondents' confidence in and satisfaction with it were studied and compared with their attitudes toward other agents in the health care system. A Rasch model was used to analyze respondents' ranking of functions. Analysis of variance was used to study between-group differences. RESULTS: A total of 746 members participated (response rate 2.83%). The association's credibility was rated in second place, after that of specialists who treat psoriasis. Support for the association functions was good (7.53 on a scale of 0 to 10). The function the members rated highest was the raising of societal awareness of psoriasis and its problems. Rated lowest were functions related to personal services for members. Educational level was the only participant factor associated with significant differences in evaluations (P<.05). CONCLUSIONS: The psoriasis association contributes by disseminating information about the disease and patient care, and it serves to represent patients. Health professionals and institutions should take the association into account in their efforts to deal with the disease and in designing effective policies.

[The challenges of human resources governance in public healthcare. SESPAS Report 2024]. / Los retos de la gobernanza de los recursos humanos de la sanidad pública. Informe SESPAS 2024.

Recurrent imbalances between supply, demand and personnel needs are one of the main challenges facing the National Health System (NHS). This situation has its origin both in supply factors and in the conditioning factors of the demand for human resources in the public health sector. The demographic structure of the NHS health professionals is generating an increasing number of outflows of doctors and nurses. On the other hand, the complex institutional architecture of the public health system produces dysfunctions in the structure of demand and in the form of recruitment. This paper argues for the need to articulate a strategic response that addresses the improvement of the governance of the human resources of the NHS and the reform of the instruments of coordination and harmonization of actions at the three levels of government of public healthcare.

[Assessment of exposure to seconhand smoke in health surveys in Spain]. / La valoración de la exposición al humo ambiental de tabaco en las encuestas de salud de España.

OBJECTIVE: To describe the questions used to assess exposure to secondhand smoke (SHS) in Spanish health surveys. METHOD: Extraction and analysis of the literals of the questions on SHS in the health surveys in Spain identified on the website of the Ministry of Health, the National Plan on Drugs and Health Departments of the autonomous communities. RESULTS: Three nationwide surveys assessed SHS exposure, with variability in questions, responses, and recall periods. Catalonia in 2022, and Galicia and the Basque Country in 2018, assessed exposure in detail. CONCLUSIONS: Questions assessing self-reported exposure to SHS are survey-dependent. There is a need for a set of questions to assess exposure in a homogeneous way in health surveys.

Assessment of postoperative morbidity in Spanish hospitals: Results from a national survey.

BACKGROUND: The methodology used for recording, evaluating and reporting postoperative complications (PC) is unknown. The aim of the present study was to determine how PC are recorded, evaluated, and reported in General and Digestive Surgery Services (GDSS) in Spain, and to assess their stance on morbidity audits. METHODS: Using a cross-sectional study design, an anonymous survey of 50 questions was sent to all the heads of GDSS at hospitals in Spain. RESULTS: The survey was answered by 67 out of 222 services (30.2%). These services have a reference population (RP) of 15 715 174 inhabitants, representing 33% of the Spanish population. Only 15 services reported being requested to supply data on morbidity by their hospital administrators. Eighteen GDSS, with a RP of 3 241 000 (20.6%) did not record PC. Among these, 7 were accredited for some area of training. Thirty-six GDSS (RP 8 753 174 (55.7%) did not provide details on all PC in patients' discharge reports. Twenty-four (37%) of the 65 GDSS that had started using a new surgical procedure/technique had not recorded PC in any way. Sixty-five GDSS were not concerned by the prospect of their results being audited, and 65 thought that a more comprehensive knowledge of PC would help them improve their results. Out of the 37 GDSS that reported publishing their results, 27 had consulted only one source of information: medical progress records in 11 cases, and discharge reports in 9. CONCLUSIONS: This study reflects serious deficiencies in the recording, evaluation and reporting of PC by GDSS in Spain.

The FlaQuM-Quickscan: A starting point to include primary care professionals' perspectives in the evaluation of hospital quality priorities.

INTRODUCTION: Today, primary care professionals' (PCPs) perspectives on hospital quality are unknown when evaluating hospital quality priorities. The aims of the present study were to identify key healthcare quality attributes from PCPs' perspective, to validate an instrument that measures PCPs' experiences of healthcare quality multidimensionally and to define hospital quality priorities based on PCPs' experiences. MATERIAL AND METHODS: Focus groups with PCPs were conducted to identify quality attributes through a qualitative in-depth analysis. A multicentre study of 18 hospitals was used to quantitatively assess construct, discriminant and criterion validity of the FlaQuM-Quickscan, an instrument that measures 'Healthcare quality for patients and kin' (part 1) and 'Healthcare quality for professionals' (part 2). To set quality priorities, scores on quality domains were analyzed descriptively and between-hospital variation was examined by evaluating differences in hospitals' mean scores on the quality domains using one-way Analysis of Variance (ANOVA). RESULTS: Identified key attributes largely corresponded with Lachman's multidimensional quality model. Including 'Communication' as a new quality domain was recommended. The FlaQuM-Quickscan was completed by 550 PCPs. Confirmatory factor analyses showed reasonable to good fit, except for the Root Mean Square Error of Approximation (RMSEA) in part 2. The 'Equity' domain scored the highest in parts 1 and 2. Domains 'Kin-centred care' and 'Accessibility and timeliness' scored the lowest in part 1 and 'Resilience' and 'Partnership and co-production' in part 2. Significant variation in hospitals' mean scores was observed for eleven domains in part 1 and sixteen domains in part 2. CONCLUSIONS: The results gained a better understanding of PCPs' perspective on quality. The FlaQuM-Quickscan is a valid instrument to measure PCPs' experiences of hospital quality. Identified priorities indicate that hospital management should focus on multifaceted quality strategies, including technical domains, person-and kin-centredness, core values and catalysts.

[Design and validation of a self-reported dietary polyphenol intake frequency questionnaire.] / Diseño y validación de un cuestionario autorreportado de frecuencia de consumo de polifenoles aportados por la dieta.

Introduction: Introduction: although there is evidence linking polyphenol consumption with better health outcomes, information on consumption patterns, particularly in Latin American countries, is scarce. Objective: to design and evaluate the validity of an online self-reported food frequency questionnaire to measure dietary total polyphenol intake in the Chilean adult population. Methods: the designed questionnaire (FFQ-P) was submitted to expert opinion for content validity coefficient estimation; then a pilot study was conducted in 47 adults who completed FFQ-P, in addition to a six-day food record as a reference method. Wilcoxon was applied in related samples, Spearman's correlation to determine the strength of association and Bland-Altman diagrams to examine the difference between methods. Results: content validity reflected concordant values for adequacy (0.94 ± 0.04) and relevance (0.93 ± 0.05). The percentage difference between both methods was 1.2 %, with greater variability observed in fruits (9 %) and alcoholic beverages (4 %). The Wilcoxon test showed no significant differences between food groups. Medium reliability was observed for vegetables, fruits, tea, and coffee (0.26 to 0.5) and moderate reliability for alcoholic beverages (0.5 to 0.75). The mean value of the difference was 9.8, being within a short distance of zero. Conclusion: FFQ-P is reliable for estimating polyphenol intake from fruits, vegetables, alcoholic beverages, tea, and coffee; however, the intake of non-alcoholic beverages, nuts and olives should be interpreted with reservation.

Introducción: Introducción: aun cuando existe evidencia que vincula el consumo de polifenoles con mejores resultados en salud, la información sobre patrones de consumo, particularmente en países latinoamericanos, es escasa. Objetivo: diseñar y evaluar la validez de un cuestionario en línea autorreportado de frecuencia de consumo de alimentos para medir la ingesta de polifenoles totales de la dieta en población adulta chilena. Métodos: el cuestionario diseñado (FFQ-P) se sometió a opinión de expertos para estimación de coeficiente de validez de contenido; luego se efectuó estudio piloto en 47 adultos, quienes completaron el FFQ-P, además de un registro de alimentos de seis días como método de referencia. Se aplicaron Wilcoxon en muestras relacionadas, correlación Spearman para determinación de fuerza de asociación y diagramas de Bland-Altman para examinar diferencia entre métodos. Resultados: la validez de contenido reflejó valores concordantes para adecuación (0,94 ± 0,04) y pertinencia (0,93 ± 0,05). La diferencia porcentual entre ambos métodos fue del 1,2 %, observándose mayor variabilidad en frutas (9 %) y bebidas alcohólicas (4 %). La prueba de Wilcoxon no mostró diferencias significativas entre los grupos de alimentos. Se observó confiabilidad media para verduras, frutas, té y café (0,26-0,5) y confiabilidad moderada en el caso de bebidas alcohólicas (0,5-0,75). El valor promedio de la diferencia fue de 9,8, a una corta distancia de cero. Conclusión: el FFQ-P es confiable para estimar ingesta de polifenoles de frutas, verduras, bebidas alcohólicas, té y café, sin embargo, la ingesta de bebidas no alcohólicas, frutos secos y aceitunas se debe interpretar con reservas.

Exploring the opinion of Spanish medical specialists about the usefulness of radiomics in oncology.

AIM: To describe the knowledge and opinion of health professionals regarding the usefulness of radiomics in oncology. METHODS: A 12-question questionnaire (multiple-choice responses, Likert-type scale, and open response) was developed and sent to professionals related to diagnosis/treatment of oncological diseases (Oncology, Radiodiagnosis, Nuclear Medicine, Radiation Oncology, Hematology-Oncology, Radiophysics and Pathology). Participants were classified into two groups according to their level of training: attending physicians and residents. RESULTS: 114 professionals completed the survey (54% residents, mostly from Nuclear Medicine and Radiodiagnostic specialties). Attending physicians obtained a better performance in the area pf knowledge compared to residents. Both groups of respondents agreed regarding the usefulness of radiomics to help make more accurate diagnoses and promoting the work of medical teams and the most frequent disadvantages were related to the lack of systematization in the acquisition of images and extraction of parameters, the need for the training of professionals and concern about the replacement of human work by technological tools. CONCLUSIONS: Radiomics is a novel field and the most general aspects are known by health professionals. The professionals surveyed were optimistic about the benefits provided by radiomics and other types of tools. The main problem detected was the lack of systematization in its implementation. The replacement of professionals and job loss is a concern, albeit less prevalent, and may respond to a generational phenomenon.

How do we diagnose acute diverticulitis? Results of a national survey about the role of imaging techniques.

INTRODUCTION: The choice of imaging techniques in the diagnosis of acute diverticulitis is controversial. This study aimed to determine radiologists' preferences for different imaging techniques in the management of acute diverticulitis and the extent to which they use the different radiologic techniques for this purpose. METHODS: An online survey was disseminated through the Spanish Society of Abdominal Imaging (Sociedad Española de Diagnóstico por Imagen del Abdomen (SEDIA)) and Twitter. The survey included questions about respondents' working environments, protocolization, personal preferences, and actual practice in the radiological management of acute diverticulitis. RESULTS: A total of 186 responses were obtained, 72% from radiologists working in departments organized by organ/systems. Protocols for managing acute diverticulitis were in force in 48% of departments. Ultrasonography was the initial imaging technique in 47.5%, and 73% of the respondents considered that ultrasonography should be the first-choice technique; however, in practice, ultrasonography was the initial imaging technique in only 24% of departments. Computed tomography was the first imaging technique in 32.8% of departments, and its use was significantly more common outside normal working hours. The most frequently employed classification was the Hinchey classification (75%). Nearly all (96%) respondents expressed a desire for a consensus within the specialty about using the same classification. Hospitals with >500 beds and those organized by organ/systems had higher rates of protocolization, use of classifications, and belief that ultrasonography is the best first-line imaging technique. CONCLUSIONS: The radiologic management of acute diverticulitis varies widely, with differences in the protocols used, radiologists' opinions, and actual clinical practice.

The effects of health belief model-based intervention on nurses' sterilizing practices when moistening surgical instruments.

OBJECTIVE: We investigated the effects of the Health Belief Model (HBM)-based intervention on nurses' behaviors in terms of keeping surgical instruments moist. MATERIALS AND METHODS: Pre- and post-training surveys about instrument moistening were conducted with the same 356 nurses from a hospital in China. Both of the surveys contained questionnaire concerning general knowledge relating to instrument moistening, perception scale-based questions concerning the same issue, and an inspection form concerning the implementation of moistening procedures. Three months' training was provided for the nurses. RESULTS: After training, the nurses' knowledge, attitudes, beliefs, and behaviors for instrument moistening were improved. CONCLUSIONS: The HBM-based intervention can bring about a significant improvement in nurses' compliance with surgical instrument moistening requirements, and corresponding improvements in instrument cleanliness and patient safety.

OBJETIVO: Investigar los efectos de la intervención basada en el modelo de creencias de salud en los comportamientos de las enfermeras en términos de mantener húmedos los instrumentos quirúrgicos. MÉTODO: Se realizaron encuestas previas y posteriores a la capacitación sobre la humectación de instrumentos con las mismas 356 enfermeras de un hospital en China. Ambas encuestas contenían un cuestionario sobre el conocimiento general relacionado con la humectación del instrumento, preguntas basadas en escalas de percepción sobre el mismo tema y un formulario de inspección sobre la implementación de los procedimientos de humectación. Se proporcionó una formación de 3 meses a las enfermeras. RESULTADOS: Después de la capacitación se mejoraron los conocimientos, las actitudes, las creencias y los comportamientos de las enfermeras para la humectación del instrumento. CONCLUSIONES: La intervención basada en el modelo de creencias en salud puede generar una mejora significativa en el cumplimiento de los requisitos de humectación del instrumental quirúrgico por parte de las enfermeras, y las correspondientes mejoras en la limpieza del instrumental y la seguridad del paciente.

[Translated article] Analysis of the degree of implementation of medication error prevention practices in Spanish hospitals (2022).

OBJECTIVE: To assess the degree of implementation of medication error prevention practices in Spanish hospitals. METHOD: Descriptive multicenter study of the degree of implementation of the safety practices included in the "Medication use-system safety self-assessment for hospitals. Version. II". Spanish hospitals that completed the questionnaire between October, 2021 and September, 2022 participated. The survey contains 265 items for evaluation grouped into 10 key elements. Mean score and mean percentages based on the maximum possible values for the overall survey, for the key elements, and for each individual item of evaluation were calculated. The results were compared with those of the previous 2011 study. RESULTS: A total of 131 hospitals from 15 autonomous regions participated in the study. The mean score of the overall questionnaire in all hospitals was 898.2 (57.4% of the maximum possible score). No differences were found according to dependency, size, or type of hospital, either in the overall questionnaire or in the key elements. The lowest values were found for key elements VIII, I and VI, on competence and training of health professionals in safety practices (45.1%), availability and accessibility of essential information on patients (48%), and devices for administering drugs (52.3%). With respect to 2011, significant increases were found both in the overall questionnaire and in the key elements, except V and VII, referring to standardization, storage, and distribution of medications, and environmental factors and human resources. Several evaluation items on the safe management of high-risk drugs, medication reconciliation, incorporation of clinical pharmacists into the healthcare teams, and implementation of technologies that allow full traceability throughout the medication system, showed low percentages. CONCLUSIONS: There has been appreciable progress in the degree of implementation of some medication error prevention practices in Spanish hospitals, but many proven efficacy practices recommended by the World Health Organization and safety organizations are still poorly implemented. The information obtained can be useful for prioritizing the practices to be addressed and as a new baseline for monitoring progress.

Analysis of the degree of implementation of medication error prevention practices in Spanish hospitals (2022). / Análisis del grado de implantación de las prácticas de prevención de errores de medicación en los hospitales españoles (2022).

OBJECTIVE: To assess the degree of implementation of medication error prevention practices in Spanish hospitals. METHOD: Descriptive multicenter study of the degree of implementation of the safety practices included in the "Medication use-system safety self-assessment for hospitals. Version. II". Spanish hospitals that completed the questionnaire between October/2021 and September/2022 participated. The survey contains 265 items for evaluation grouped into 10 key elements. Mean score and mean percentages based on the maximum possible values for the overall survey, for the key elements and for each individual item of evaluation were calculated. The results were compared with those of the previous 2011 study. RESULTS: A total of 131 hospitals from 15 autonomous regions participated in the study. The mean score of the overall questionnaire in all hospitals was 898.2 (57.4% of the maximum possible score). No differences were found according to dependency, size or type of hospital, either in the overall questionnaire or in the key elements. The lowest values were found for key elements 8, 1 and 6, on competence and training of health professionals in safety practices (45.1%), availability and accessibility of essential information on patients (48%), and devices for administering drugs (52.3%). With respect to 2011, significant increases were found both in the overall questionnaire and in the key elements, except 5 and 7, referring to standardization, storage and distribution of medications, and environmental factors and human resources. Several evaluation items on the safe management of high-risk drugs, medication reconciliation, incorporation of clinical pharmacists into the healthcare teams and implementation of technologies that allow full traceability throughout the medication system, showed low percentages CONCLUSIONS: There has been appreciable progress in the degree of implementation of some medication error prevention practices in Spanish hospitals, but many proven efficacy practices recommended by the World Health Organization and safety organizations are still poorly implemented. The information obtained can be useful for prioritizing the practices to be addressed and as a new baseline for monitoring progress.

Creation and validation of an instrument to quantify attitudes, knowledge and difficulties in the approach to social problems.

OBJECTIVES: The aim of the study was to develop and validate a questionnaire to assess attitudes, knowledge and difficulties in the management of social problems by paediatric care providers. METHODS: The development of the tool started with a conceptualization phase, followed by the design, pilot testing and psychometric evaluation of the questionnaire based on the responses obtained from 407 professionals. We performed exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) to assess the construct validity of the questionnaire. We used the normed fit index (NFI), the root mean square error of approximation (RMSEA), the χ2 test and the comparative fit index (CFI) to test the goodness of fit. We assessed reliability through the Cronbach's α coefficient of internal consistency. All quantitative analyses were performed with the Stata/SE software, version16.1. RESULTS: The EFA identified twelve factors. All factors exhibited a good internal consistency (Cronbach's α, 0.8434). The CFA showed the model was a good fit (RMSEA=0.037). The NAI and CAI values were 0.742 and 0.797, respectively. CONCLUSIONS: This questionnaire comprising 138 items distributed in twelve factors is a reliable and valid instrument to analyse the attitudes, knowledge and difficulties in the approach to social problems in children by paediatricians, which will allow the design of interventions according to the needs and deficiencies identified through it.