COVID-19 infection: Positive mental health, psychological vulnerability and sex: Cross-sectional study.

Since mid-March 2020, a state of emergency was decreed in Portugal due to the COVID-19 pandemic and, consequently, measures were implemented to protect public health, such as social isolation, which will certainly have a notable impact on the mental health of the population, especially in the most vulnerable groups. Positive Mental Health (PMH) is essential to deal with adversity, in this case with the pandemic, and to live better and with greater satisfaction. We consider it relevant to investigate how PMH was used as a resource to deal with the pandemic, depending on the level of vulnerability and sex. A, cross-sectional study was carried out whose the aim was to evaluate the levels of PMH and psychological vulnerability in people with COVOD-19 infection and analyze the association between PMH and psychological vulnerability among men and women. METHODS: The instruments used were a sociodemographic characterization questionnaire, the Positive Mental Health Questionnaire, and the Psychological Vulnerability Scale (PVS), that were sent and filled out online. A quantitative, cross-sectional, descriptive, and correlational study was carried out. RESULTS: After analyzing the results, it was found that approximately 50.4% of the respondents (n = 387) had global PMH values that place them in quartile 50. There was also a statistically significant difference between female and male PMH, with women showing greater psychological vulnerability and lower overall PMH. CONCLUSIONS: We conclude that the women present a greater psychological vulnerability and a lower level of PMH when compared to men. RELEVANCE TO CLINICAL PRACTICE: Considering the study's statistically significant results, when we talk about mental health, we should always consider the sex variable as a vulnerability factor, in a pandemic or non-pandemic phase.

Nurses' promotion of Mental Health First Aid Training Programmes for upper secondary students: a modified Delphi approach.

BACKGROUND: Mental Health First Aid Training Programmes can be carried out by nurses in schools. Adolescents have reported the importance of these interventions, the contents to be addressed, and intervention strategies that should be used. Mental health nurses have also discussed the characteristics of these training programmes. This study sought to create a consensus on the features of Mental Health First Aid Training Programmes promoted by nurses aimed at upper secondary students. METHODS: A descriptive mixed method study was developed using the modified e-Delphi technique. Original statements on the topic were drawn from the results section of previous studies with nurses and adolescents. The statements were included in a structured online questionnaire. An expert panel of 78 mental health nurses participated in the two-rounds online survey from October to December 2021. Absolute and relative frequencies of responses were analysed. The experts' comments were also considered. RESULTS: In the first round, experts suggested 4 new ideas about training programmes. Experts took a position on a total of 59 declarations. At least 75% of participants agreed with 58 statements about training programmes, namely about facilitators, intervention foci, evaluation methodology, participants, the implementation context, period and regularity, intervention strategies and content. The experts' opinions differed only in one statement that expressed the impaired sexual behaviour as a mental health problem to be addressed in the training programmes. CONCLUSIONS: Mental health nurses can lead the delivery of training programmes in upper secondary schools, improving adolescent competencies in mental health. Several educational approaches can be used to teach about mental health, related problems and actions underlying these conditions. Valid and appropriate assessment methods must be used. Our findings guide the planning, implementation and evaluation of these interventions in upper secondary schools and encourage nurses to explore these programmes and include them in their educational curricula.

Development of a Clinical Data Model Addressing the Nursing Focus "Anxiety": A Consensus Development Study.

Anxiety disorders are among the most prevalent mental disorders worldwide. However, anxiety is not exclusive to anxiety disorders. In fact, the nursing discipline approaches anxiety as a human response to health conditions/life processes. Health information systems should primarily contribute to improving the quality of care, patient safety, and the effectiveness of care delivery. Nevertheless, nursing information systems still fail to incorporate evidence-based clinical data models addressing the nursing focus "anxiety." Thus, this study aimed to obtain consensus on the data to be included in a clinical data model addressing the nursing focus "anxiety," its organization, and its interrelationships by using a brainstorming session and a modified e-Delphi technique with a panel of nurse experts from across Portugal. Eight experts participated in the brainstorming session. A total of 59 and 54 participants completed the survey in e-Delphi rounds 1 and 2, respectively. Consensus was achieved to all data presented to the participants, and these data were later included in the clinical data model. This evidence-based clinical data model, grounded on a nursing theory and with standardized nursing language, will substantially contribute to nursing documentation and, consequently, to nursing care targeted at patients with anxiety.

Spanish adaptation of the quality in psychiatric care-outpatient (QPC-OP) instrument community mental health patients' version: psychometric properties and factor structure.

BACKGROUND: Health systems in the field of mental health are strongly committed to community models that allow patients to be attended in their own environment. This helps them to maintain their family and social ties while trying to avoid costly hospital admissions. The patients' perspective is a key component in the assessment of the quality of psychiatric care and can even determine their adherence to the devices where they are treated. However, there are few instruments with adequate psychometric properties for the evaluation of the quality of psychiatric care in community mental health. The Quality in Psychiatric Care - Outpatient (QPC-OP) instrument has adequate psychometric properties to assess the quality of psychiatric care from the patients' perspective. The aim of this study was to adapt and validate the Spanish version of the QPC-OP instrument. METHODS: A translation and back-translation of the instrument was carried out. To examine its psychometric properties, the instrument was administered to 200 patients attending various community mental health services. To assess test-retest reliability, the instrument was readministered after 7-14 days (n = 98). RESULTS: The Confirmatory Factor Analysis revealed a structure of 8 factors identical to the original version, with an adequate model fit. The internal consistency coefficient (Cronbach's alpha) was 0.951. The intraclass correlation coefficient was 0.764 (95% IC: 0.649 - 0.842), and higher than 0.70 in 5 of the 8 factors. Additionally, an EFA was performed and revealed that the instrument could behave in a unifactorial or four factor manner in the sample analyzed. CONCLUSIONS: Results show that the Spanish version of the QPC-OP instrument is valid and reliable for the assessment of quality of psychiatric care in the community setting.

Resilience and job satisfaction among out-of-hospital emergency medical service professionals: A cross-sectional multi-centric study.

AIM: We aim to describe the relationship between job satisfaction and compare levels of resilience among out-of-hospital emergency medical service professionals. BACKGROUND: The study of the impact of the working environment on health professionals has raised great interest. Job-related variables and resilience can be a protective factor against stressful and demanding events at work. METHODS: A cross-sectional survey comprising sociodemographic and job-related variables was conducted among 406 workers (doctors, nurses, psychologists, and ambulance technicians) from the out-of-hospital emergency medical system in Spain. Resilience was self-reported using the Connor-Davidson Resilience Scale. RESULTS: Nursing professionals were less resilient compared with ambulance technicians (score difference 1.709, p = .008). As age increased, resilience was lower (r = -.118). Professionals with higher resilience scores were more satisfied in their work (OR = 1.06, 95% CI: 1.02-1.11), and professionals with higher psychological strength, gained from working with other colleagues, also showed greater job satisfaction (OR = 5.47, 95% CI: 2.55-11.73). CONCLUSION: There was a positive association between resilience, job satisfaction and collaborative work. Professionals with greater psychological strength, gained from working with other colleagues, also showed higher levels of job satisfaction. IMPLICATIONS FOR NURSING MANAGEMENT: Managers can use these results to influence the work environment to enhance job satisfaction and hence improve the resilience of the out-of-hospital emergency health care professionals.

Validation of a Questionnaire to Analyze the Expectations of First-Year Nursing Students.

AIM: The aim of this study was to design and validate a questionnaire to analyze students' expectations, along with their level of interest and overall satisfaction with their nursing studies. BACKGROUND: The expectations of students on entering university are closely related to the level of interest that they have in their area of study and their general satisfaction with it. This is certainly a conditioning factor in their learning. In this regard, there are few quantitative instruments that measure the expectations of first-year nursing students. METHOD: A mixed questionnaire was constructed using items validated in previous studies, along with new items formulated following a review of the literature. The questionnaire was validated with a sample of 339 first-year degree program nursing students. RESULTS: The scales of expectations and degree of interest showed strong internal consistency (Cronbach's α > .7). CONCLUSION: The questionnaire to evaluate the expectations and interest of students demonstrated satisfactory psychometric properties.

A Spanish adaptation of the Quality in Psychiatric Care-Inpatient (QPC-IP) instrument: Psychometric properties and factor structure.

BACKGROUND AND AIM: Western countries share an interest in evaluating and improving quality of care in the healthcare field. The aim was to develop and examine the psychometric properties and factor structure of the Spanish version of the Quality in Psychiatric Care-Inpatient (QPC-IP) instrument. METHODS: A psychometric study was conducted, translating the QPC-IPS instrument into Spanish, revision of the instrument by a panel of experts, and assessing its psychometric properties. 150 psychiatric inpatients completed the QPC-IP. Test-retest reliability was assessed by re-administering the questionnaire to 75 of these patients. RESULTS: After conducting pilot testing and a cognitive interview with 30 inpatients, it was determined that the QPC-IPS was adequate and could be self-administered. A Cronbach's alpha of 0.94 was obtained for the full instrument and values of 0.52-0.89 for the various dimensions of the questionnaire. Test re test reliability: The Intraclass Correlation Coefficient for the full questionnaire was 0.69, while for the individual dimensions values between 0.62 and 0.74 were obtained, indicating acceptable temporal stability. Convergent validity was analysed using 10-point numerical satisfaction scale, giving a positive correlation (0.49). Confirmatory factor analysis revealed six factors consistent with the original scale. The Spanish version yielded adequate results in terms of validity and reliability. CONCLUSION: Our findings provide evidence of the convergent validity, reliability, temporal stability and construct validity of the Spanish QPC-IP for measuring patient quality in psychiatric care in Spanish hospitals. Hospital administrators can use this tool to assess and identify areas for improvement to enhance quality in psychiatric care.

Development and psychometric testing of a scale for assessing the associative stigma of mental illness in nursing.

AIMS AND OBJECTIVES: To develop a new scale for assessing the associative stigma of mental illness in nursing based on Peplau's model of psychodynamic nursing and to examine its psychometric properties. BACKGROUND: The stigma of mental illness continues to cause problems today for patients, families and mental health professionals. For individuals with a mental disorder, stigma can result in restricted opportunities, social exclusion and the denial of rights. Associative stigma in mental health professionals is becoming a major problem and is related to increased depersonalisation, higher levels of emotional exhaustion and diminished job satisfaction among mental health professionals. Nursing may play a key role in reducing the stigma associated with mental illness, but there are no specific scales for the measurement of associative stigma in nursing. DESIGN: Development of an instrument. A STROBE checklist was completed. METHODS: This study involved two stages: (a) item generation and content validation; (b) examining the reliability and convergent/discriminant validity of the scale. A developmental and methodological design was used. Data were collected between November 2016-December 2017 from a sample of 737 nursing undergraduates. RESULTS: The results indicated good internal consistency for the final 20-item scale for assessing the associative stigma of mental illness in nursing, which is considered in terms of three dimensions: Violence/Dangerousness, Disability, and Irresponsibility/Lack of Competence. Exploratory and confirmatory factor analyses supported a three-factor structure consistent with the theoretical model. CONCLUSIONS: The 20-item EVEPEM (from its Spanish acronym) derived from Peplau's theory was shown to be a valid and reliable tool for assessing the stigma of mental illness in the nursing setting. RELEVANCE TO CLINICAL PRACTICE: Reliable instruments are needed to measure the effectiveness of anti-stigma interventions for mental health professionals. The results indicate that the tool developed is a valid and reliable instrument for use in the nursing setting.

A multi-centre, randomized, 3-month study to evaluate the efficacy of a smartphone app to increase caregiver's positive mental health.

BACKGROUND: To assess the effectiveness of a smartphone app-based intervention compared to a regular intervention of caregivers in primary health care institutions. The intervention is aimed at increasing positive mental health and decreasing caregiver's burden. METHODS/DESIGN: Randomized and controlled trial with an experimental group and a control group. SUBJECTS: 108 caregivers over 18, with a minimum of 4 months of experience as caregivers. Description of the intervention: an intervention with a smartphone app (n = 54) or a regular intervention for caregivers (n = 54). Each caregiver installs a smartphone app and uses it for 28 days. This app offers them a daily activity (Monday-Friday). These activities are related to the Decalogue of Positive Mental Health, which was designed ad hoc by a group of experts. The outcomes will be the score of caregiver burden, the positive mental health and participant satisfaction. These results will be assessed after the first, third and sixth month. DISCUSSION: The results of this study will offer evidence of the effectiveness of an intervention using a free smartphone app. If its effectiveness is proven and the results are acceptable, this could lead to a rethinking of the intervention offered to caregivers in primary care. TRIAL REGISTRATION: Clinical Register ISRCTN14818443 (date: 24/05/2019).

Instruments to assess mental health-related stigma among health professionals and students in health sciences: A systematic psychometric review.

AIM: To evaluate the psychometric properties of the instruments to assess the mental health-related stigma among health professionals and students in health sciences. BACKGROUND: Evidence on the stigmatization by health professionals of people with mental health illness is increasingly compelling. Valid and reliable instruments are needed for the assessment of mental health-related stigma and effectiveness of anti-stigma interventions. DESIGN: Systematic psychometric review. DATA SOURCES: MEDLINE (via PubMed), CINAHL (via EBSCO), PsycINFO, Scopus, and Open Grey from their inception to August 2017. No limits were applied. REVIEW METHODS: We included studies on the development of a measurement instrument or on the evaluation of one or more of its measurement properties. The methodological quality of the included studies and quality of the measurement instruments identified were assessed using the COnsensus-based Standards for the selection of health status Measurement INstruments (COSMIN) checklist. RESULTS: We included 25 studies involving 15 measurement instruments. The "Atributtion Questionnaire" (five studies) and the "Opening Minds Scale for Health Care providers (OMS-HC)" (four studies) were the most investigated instruments. Internal consistency, content validity, structural validity, and hypothesis testing were the measurement properties most commonly evaluated. Measurement error and responsiveness were investigated in only two studies. Eight psychometric properties of OMS-HC were evaluated, three of which have a positive strong level of evidence. CONCLUSIONS: A substantial number of instruments have been developed to assess mental health-related stigma among health professionals. There is a lack of any assessment of certain measurement properties. The OMS-HC is the instrument that had the strongest evidence.

Level of satisfaction of critical care patients regarding the nursing care received: Correlation with sociodemographic and clinical variables.

BACKGROUND: The satisfaction of critical care patients regarding the nursing care received is a key indicator of the quality of hospital care. It is, therefore, essential to identify the factors associated with the level of satisfaction of critical care patients. OBJECTIVES: To analyse the level of satisfaction of critical care patients in relation to the nursing care received and to determine the relationship between the level of satisfaction and the sociodemographic and clinical variables. METHODS: This is a prospective and descriptive correlational study. The population were all patients discharged (January 2013 to January 2015) from three intensive care units of a third-level hospital (n = 200). The data on the satisfaction level were collected using the previously validated Nursing Intensive-Care Satisfaction Scale, and the sociodemographic and clinical data were recorded by means of a questionnaire. RESULTS: Mean participants' age in the study (n = 200) was 65.9 years (standard deviation 13.4 years), with a 66% proportion of men (n = 132). There was a very high level of satisfaction regarding the nursing care received during the patients' stay in the intensive care unit, with a rating of 5.73 (standard deviation 0.41). There is no correlation between the level of satisfaction and the sociodemographic variables collected. However, there were statistically significant differences in the average score of the overall level of satisfaction (rho = 0.182, p = 0.010) with respect to the perception of the state of health. CONCLUSION: Critical care patients expressed very high rates of satisfaction, for both the scale as a whole and each of the factors. A high level of satisfaction is strongly influenced by the perception of the state of health.

A randomized controlled trial of a nursing psychotherapeutic intervention for anxiety in adult psychiatric outpatients.

AIM: To evaluate the short-term efficacy of a psychotherapeutic intervention in nursing on Portuguese adult psychiatric outpatients with the nursing diagnosis "anxiety." BACKGROUND: Several efficacious forms of treatment for anxiety are available, including different forms of psychotherapy and pharmacotherapy. However, literature tends to favour findings from studies on the efficacy of psychotherapies and therapies provided by nurses to the detriment of those arising from studies on the efficacy of nursing psychotherapeutic interventions (interventions which are classified, for instance, on Nursing Interventions Classification). DESIGN: Randomized controlled trial. METHODS: The study was performed, between November 2016 - April 2017, at a psychiatry outpatient ward. Participants were randomly allocated to an intervention group (N = 29) or a treatment-as-usual control group (N = 31). Patients in the intervention group received psychopharmacotherapy with interventions integrated in the Nursing Interventions Classification for the nursing diagnosis "anxiety." A treatment-as-usual control group received only psychopharmacotherapy (if applicable). Anxiety level and anxiety self-control were the primary outcomes. RESULTS: Patients from both groups had reduced anxiety levels, between the pre-test and the posttest assessment; however, according to analysis of means, patients in the intervention group displayed significantly better results than those of the control group. Furthermore, only patients in the intervention group presented significant improvements in anxiety self-control. CONCLUSION: This study demonstrated the short-term efficacy of this psychotherapeutic intervention model in nursing in the decrease of anxiety level and improvement of anxiety self-control in a group of psychiatric outpatients with pathological anxiety. TRIAL REGISTRATION NUMBER: NCT02930473.

Psychometric properties of instruments measuring quality and satisfaction in mental health: A systematic review.

AIM: To identify the methodological quality of each study and analyse the psychometric properties of instruments measuring quality and satisfaction with care from the perspective of mental health patients and professionals. BACKGROUND: In recent years, interest in rigorously assessing quality of care in mental health and nursing has increased. Health professionals and researchers should select the most adequate instrument based on knowledge of its measurement properties. REVIEW DESIGN: A psychometric review was conducted of the instruments from the perspectives of both patients and professionals according to the COnsensus-based Standards for the selection of health Measurement INstruments panel (COSMIN). DATA SOURCES: Articles published from January 2005 - September 2016 were identified in a search of MEDLINE, CINAHL, and SCOPUS. We included studies in English, Spanish, and Portuguese. REVIEW METHODS: Inclusion criteria were applied to all articles validated and reviewed by a second independent reviewer. The analysis included the use of the COSMIN checklist and the Terwee quality criteria. RESULTS: In the 34 studies selected, a total of 22 instruments which measure quality and satisfaction with care provided, according to patients and/or professionals, were identified. Most are instruments with sound, contemporary theoretical foundations. They vary to the extent to which they have been used in empirical studies and with respect to evaluation of their validity and reliability, although five instruments stand out as yielding good-excellent values in quality criteria. CONCLUSION: The present psychometric review found that five of the instruments met valid psychometric criteria. In light of the current economic situation, future reviews should include analysis of the usefulness of instruments based on cost-effectiveness, acceptability, and educational impact.

Instruments to assess self-care among healthy children: A systematic review of measurement properties.

AIM: To identify, critically appraise and summarize the measurement properties of instruments to assess self-care in healthy children. BACKGROUND: Assessing self-care is a proper consideration for nursing practice and nursing research. No systematic review summarizes instruments of measurement validated in healthy children. DESIGN: Psychometric review in accordance with the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) panel. DATA SOURCES: MEDLINE, CINAHL, PsycINFO, Web of Science and Open Grey were searched from their inception to December 2016. REVIEW METHODS: Validation studies with a healthy child population were included. Search was not restricted by language. Two reviewers independently assessed the methodological quality of included studies using the COSMIN checklist. RESULTS: Eleven studies were included in the review assessing the measurement properties of ten instruments. There was a maximum of two studies per instrument. None of the studies evaluated the properties of test-retest reliability, measurement error, criterion validity and responsiveness. Internal consistency and structural validity were rated as "excellent" or "good" in four studies. Four studies were rated as "excellent" in content validity. Cross-cultural validity was rated as "poor" in the two studies (three instruments) which cultural adaptation was carried out. CONCLUSION: The evidence available does not allow firm conclusions about the instruments identified in terms of reliability and validity. Future research should focus on generate evidence about a wider range of measurement properties of these instruments using a rigorous methodology, as well as instrument testing on different countries and child population.

Development and Psychometric Properties of the Nursing Critical Thinking in Clinical Practice Questionnaire.

BACKGROUND AND AIM: A complex healthcare environment, with greater need for care based on the patient and evidence-based practice, are factors that have contributed to the increased need for critical thinking in professional competence. At the theoretical level, Alfaro-LeFevre () put forward a model of critical thinking made up of four components. And although these explain the construct, instruments for their empirical measurement are lacking. The purpose of the study was to develop and validate the psychometric properties of an instrument, the Nursing Critical Thinking in Clinical Practice Questionnaire (N-CT-4 Practice), designed to evaluate the critical thinking abilities of nurses in the clinical setting. METHODS: A cross-sectional survey design was used. A pool of items was generated for evaluation by a panel of experts who considered their validity for the new instrument, which was finally made up of 109 items. Following this, validation was carried out using a sample of 339 nurses at a hospital in Barcelona, Spain. Reliability was determined by means of internal consistency and test-retest stability over time, although the validity of the construct was assessed by means of confirmatory factor analysis. RESULTS: The content validity index of the N-CT-4 Practice was .85. Cronbach's alpha coefficient for the whole instrument was .96. The intraclass correlation coefficient was .77. Confirmatory factor analysis showed that the instrument was in line with the four-dimensional model proposed by Alfaro-LeFevre (). LINKING EVIDENCE TO ACTION: The psychometric properties of theN-CT-4 Practice uphold its potential for use in measuring critical thinking and in future research related with the examination of critical thinking.

Nursing psychotherapeutic interventions: a review of clinical studies.

AIMS AND OBJECTIVES: To summarise current knowledge about nursing psychotherapeutic interventions in adults. BACKGROUND: In Portugal, the provision of psychotherapeutic interventions is considered a competence of mental health nurses. However, literature is not totally clear about the differences between 'psychotherapy' and 'psychotherapeutic interventions' and about the specific characteristics that define a nursing psychotherapeutic intervention. DESIGN: Narrative review. METHODS: A literature review utilising MEDLINE, PsycINFO, CINAHL, the Web of Science, Psychology and Behavioral Sciences Collection, and MedicLatina computerised databases for the period from 2003-2013. A total of 151 eligible articles were identified. Relevant data were extracted, and findings were synthetised in a narrative synthesis. RESULTS: Nursing psychotherapeutic interventions are frequently based on 'Cognitive-Behavioural' rationale. The usual length of these interventions varies between 5-16 weeks, in a total of 5-12 sessions of 45-60 minutes. The mechanisms of change are heterogeneous, but the therapeutic relationship between the nurse and the client seems to be the most important positive predictive factor of nursing psychotherapeutic interventions. Some of the most used outcome assessment measures include the Beck Depression Inventory, the Hospital Anxiety and Depression Scale, and the CORE-OM. The effectiveness of nursing psychotherapeutic interventions has been widely demonstrated in many studies. However, the need of further studies to prove its cost effectiveness is evident. CONCLUSIONS: It is necessary to have a better understanding of nursing psychotherapeutic interventions, one that explains its conceptual limits, to improve mental health nursing knowledge and create suitable models of psychotherapeutic intervention in nursing. RELEVANCE TO CLINICAL PRACTICE: The findings of this review can create awareness for some weaknesses of nursing knowledge about the psychotherapeutic intervention and for the need to produce knowledge, to nurture the nursing discipline in the area of psychotherapeutic intervention with even more theoretical and practical support.

Critical thinking in nursing: Scoping review of the literature.

This article seeks to analyse the current state of scientific knowledge concerning critical thinking in nursing. The methodology used consisted of a scoping review of the main scientific databases using an applied search strategy. A total of 1518 studies published from January 1999 to June 2013 were identified, of which 90 met the inclusion criteria. The main conclusion drawn is that critical thinking in nursing is experiencing a growing interest in the study of both its concepts and its dimensions, as well as in the development of training strategies to further its development among both students and professionals. Furthermore, the analysis reveals that critical thinking has been investigated principally in the university setting, independent of conceptual models, with a variety of instruments used for its measurement. We recommend (i) the investigation of critical thinking among working professionals, (ii) the designing of evaluative instruments linked to conceptual models and (iii) the identification of strategies to promote critical thinking in the context of providing nursing care.

Hereditary Cancer Syndrome Carriers: Feeling Left in the Corner.

OBJECTIVES: There is limited evidence on health promotion interventions in people with hereditary cancer syndromes or on their main sources of support and information. This study aimed to understand these patients' experiences and needs, including their information needs, their views on prevention and mental health, and the support they want from nurses. METHODS: This qualitative study included 22 people (8 previvors and 14 survivors) with hereditary breast and ovarian syndrome or Lynch syndrome from 10 European countries. Participants underwent individual semi-structured interviews, which were recorded and transcribed for reflexive thematic analysis. The patient and public involvement panel provided input on study design and thematic analysis. RESULTS: Patient experiences were similar regardless of the country and access to testing and screening. Participants reported receiving little information on the importance of health behaviors for cancer risk and expressed their wish to be followed by cancer professionals. They felt compelled to seek support and information from the internet and patient groups. The main themes identified were: (unmet) informational and support needs, seeing life in a different way, and limitations of health care providers. CONCLUSIONS: People with hereditary cancer syndromes need professionals to be involved in their long-term management and to provide reliable information. As genomics are increasingly integrated in oncology, the need for professionals to support these populations will increase. IMPLICATIONS FOR NURSING PRACTICE: Nurses are crucial for promoting self-management and advocating for patient decision-making; however, they need skills and knowledge to do so. There is a need for nurses to get more involved in understanding hereditary cancer syndromes and an opportunity to take the lead in the care of these people.

Positive mental health and sense of coherence among emergency medical service professionals.

Background: Positive mental health (PMH) is a construct used to define and evaluate health from a positive perspective. Healthcare professionals in the emergency ambulance service are more likely to experience mental health disorders than the overall population. The demographic and occupational variables and Sense of Coherence (SOC) can act as predictors of PMH and can serve as protective elements against stress and demanding situations in the work environment. Objective: This study aimed to evaluate PMH and its relationship with demographic and occupational variables and determine if SOC is a predictive variable for PMH in health professionals working in the emergency ambulance service. Methods: A descriptive, cross-sectional, and correlational study was conducted with a sample of 406 healthcare professionals from the emergency ambulance service in eight health regions of Catalonia, Spain. The following variables were analyzed: Age, biological sex, household members, dependents family members, professional category, type of contract, job satisfaction and sense of collaboration with other institutions. The following assessment instruments were used: Positive Mental Health Questionnaire and Sense of Coherence scale. Results: High scores were obtained in Positive Mental Health (PMH). Study participants who reported feeling completely satisfied in their work also showed a significant relationship with all PMH factors: greater satisfaction with their personal life, in their helpful prosocial attitude toward others, in their capability to deal effectively with stress and navigate conflict scenarios, in their ability to solve problems and self-realization, greater empathy and ability to understand the feelings of others, greater ability to establish interpersonal relationships. Comprehensibility, as a dimension of SOC, was identified as a predictor for some factors of PMH: a greater personal satisfaction, self-control, autonomy, interpersonal skills and total PMHQ. More than 43% of positive mental health in health professionals is explained by higher Meaningfulness and Comprehensibility values of the SOC, the absence of dependent family members and having a non-graduate background. Conclusion: Healthcare workers in the emergency ambulance service had high PMH. Meaningfulness (ME) and Comprehensibility (C), dimensions of SOC, were identified as model predictors of greater PMH, showing higher scores in most of PMH factors. To enhance SOC as a mental health promotion measure, resilience programs should be implemented to help professionals develop skills to face and overcome adverse situations. Educating in stress management thought networks are key elements to strengthen SOC. Managers in emergency medical services play a key role in transforming healthcare work environments to promote positive outcomes in the mental health of their healthcare workers.