Monitoring of the Main Reasons for Early Abandonment of Breastfeeding during the First Six Months of Life: A Secondary Analysis.

The rate of six-month-old infants exclusively breastfed in Spain remains below the recommended rate. This study aimed to explore in detail the evolution of feeding during the first six months of life of a group of newborns, as well as to identify the reasons reported by the mothers for feeding change. A secondary analysis of two prospective longitudinal observational studies was conducted. In both studies, women participants, during the clinical puerperium, opted for exclusive breastfeeding for their newborns. The participants were followed up during the infants' first six months. A sample size of 314 participants was obtained, of which 77.1% (n = 232) were of Spanish origin, and 51% (n = 160) were primiparous. The prevalence of exclusive breastfeeding at six months was 55.4% (n = 174). During the first four months of life, the main reason for early abandonment of breastfeeding was the perception of insufficient milk production. After the fourth month, the predominant reason was starting work. Statistically significant differences were observed between the reasons for giving up and the total weeks of exclusive breastfeeding (p < 0.001) and total weeks of breastfeeding (p = 0.002). Early weaning from breastfeeding is a multifactorial phenomenon. However, depending on the moment cessation occurs, some reasons predominate over others and, in many cases, can be prevented. These results indicate the need to continue investing efforts to promote and protect breastfeeding in Spain.

Educational Intervention for the Management of Nonspecific Lower Back Pain in Nonprofessional Caregivers (TRANSFE Program): A Quasi-Experimental Study.

Nonspecific lower back pain is one of the main health issues experienced by nonprofessional caregivers of dependent individuals. The repetitive movements and efforts made by caregivers to assist dependent individuals are associated with the onset of this lower back pain. The main objective of this study was to assess the effectiveness of an educational intervention for the management of nonspecific lower back pain in nonprofessional caregivers of dependent individuals (TRANSFE program). The secondary objectives were to (i) evaluate the effectiveness of the TRANSFE program on other variables (caregiver burden, perceived social support, and health-related quality of life), (ii) obtain the sociodemographic profile of the sample, and (iii) determine the baseline of the study variables. A quasi-experimental study with post-intervention measurements at 3 months was conducted. Thirty-six nonprofessional caregivers of dependent individuals participated in this study. The presence of lower back pain (back pain index), low back pain (visual analogue scale), disability due to low back pain (Oswestry disability index), perceived social support (Duke-UNK scale), caregiver burden (Zarit burden scale), and health-related quality of life (EuroQol-5D) were assessed. The intervention significantly improved all the studied variables related to lower back pain (p < 0.001). The intervention was effective on other variables related to nonprofessional caregiving such as caregiver burden, perceived social support, and health-related quality of life, albeit with moderate results. An educational intervention for lower back pain experienced by caregivers of dependent individuals was effective in reducing lower back pain and addressing caregiver burden, perceived social support, and health-related quality of life. This study was registered retrospectively on the Open Science Framework platform on 20 June 2024, with the registration number 10.17605/OSF.IO/K7WTE.

Can Virtual Reality Help Improve Motor and Cognitive Function in Active Aging in Older Adults? A Scoping Review.

BACKGROUND: Active aging is considered one of the most effective methods for a healthy aging process. There are numerous clinical practice guidelines that address this model and propose multiple strategies for its achievement through the improvement of motor and cognitive function. Virtual reality is emerging as a potential tool, with various modalities focused on promoting good health maintenance in older adults. The objectives of this review were to map the potential benefits of virtual reality for active aging and delve into adaptability and adherence in older individuals. METHODS: A scoping review was conducted on studies published between 2013 and 2023 in English, Spanish, or Catalan, examining virtual reality interventions in older adults. The search was performed using the Medline, CINAHL, Scopus, and Web of Science databases. The methodological quality was assessed using CASPe and FLC 3.0 critical appraisal guidelines. The graphical data were reported narratively, grouping results based on the study characteristics and the impact of virtual reality. RESULTS: The review process resulted in the inclusion of 22 articles out of the initial 459 following the application of the selection criteria. Most articles were randomized controlled trials (45.4%; n = 10), systematic reviews (40.9%; n = 9), observational studies (9%; n = 2), and pilot studies (4.5%; n = 1). The information was organized based on the virtual reality modality (immersive, non-immersive, and 360) and application area (motor, cognitive, and mental health). CONCLUSIONS: Virtual reality (both immersive and non-immersive) is a valuable tool for promoting physical exercise in older adults, helping to prevent recurrent accidental falls. It also yields positive results for cognitive stimulation in healthy older individuals, improving memory, depression, and mental health in those with cognitive impairment. Virtual reality is generally well-received by older adults, achieving high adherence rates.

Nomophobia and Its Relationship with Social Anxiety and Procrastination in Nursing Students: An Observational Study.

Nomophobia is a phenomenon that describes the fear of not having one's mobile phone accessible. This study aimed to evaluate the presence of nomophobia among nursing students as well as its relationship with procrastination and social anxiety. METHODS: An observational, descriptive, cross-sectional study was conducted in a sample of 308 nursing students. Data were collected using the Nomophobia Questionnaire, Academic Procrastination Scale-Short Form, and Social Anxiety Questionnaire for Adults. Additionally, sociodemographic variables related to academic performance and smartphone use were collected. We performed a descriptive, bivariate, and multivariate analysis of the Nomophobia Questionnaire score. RESULTS: 19.5% (n = 60) of the students presented with or were at high risk of nomophobic behaviour. Moreover, nomophobic behaviour was positively correlated with high levels of social anxiety (p < 0.001), longer daily smartphone usage time (p < 0.001), and a high frequency of smartphone checking in class (p < 0.001). The predictive variables for nomophobic behaviour included age, variables related to smartphone use, social anxiety levels, work, procrastination tendency, sex, and self-reported average grade. CONCLUSION: One out of five students in the sample studied presented with or were at high risk of nomophobic behaviour. Additionally, nomophobic behaviour was associated with social anxiety and variables related to smartphone use. This study was not registered.

Development and Validation of a Meta-Instrument for the Assessment of Functional Capacity, the Risk of Falls and Pressure Injuries in Adult Hospitalization Units (VALENF Instrument) (Part II).

The nursing assessment is the first step of the nursing process and fundamental to detecting patients' care needs and at-risk situations. This article presents the psychometric properties of the VALENF Instrument, a recently developed meta-instrument with only seven items that integrates the assessment of functional capacity, risk of pressure injuries and risk of falls with a more parsimonious approach to nursing assessment in adult hospitalization units. A cross-sectional study based on recorded data in a sample of 1352 nursing assessments was conducted. Sociodemographic variables and assessments of the Barthel, Braden and Downton instruments were included at the time of admission through the electronic health history. Thus, the VALENF Instrument obtained high content validity (S-CVI = 0.961), construct validity (RMSEA = 0.072; TLI = 0.968) and internal consistency (Ω = 0.864). However, the inter-observer reliability results were not conclusive, with Kappa values ranging between 0.213 and 0.902 points. The VALENF Instrument has adequate psychometric properties (content validity, construct validity, internal consistency and inter-observer reliability) for assessing the level of functional capacity, risk of pressure injuries and risk of falls. Future studies are necessary to establish its diagnostic accuracy.

Development and Validation of the Breastfeeding Literacy Assessment Instrument (BLAI) for Obstetric Women.

BACKGROUND: Despite international efforts to protect and promote exclusive breastfeeding (EBF) for infants up to six months of age, global rates of EBF continue to fall short of the targets proposed by the WHO for 2025. Previous studies have shown a relationship between the level of health literacy and the duration of EBF, although this relationship was not determinant, probably due to the use of a generic health literacy questionnaire. Therefore, this study aims to design and validate the first specific breastfeeding literacy instrument. METHODS: A Breastfeeding Literacy instrument was developed. Content validation was carried out by a group of 10 experts in health literacy, breastfeeding or instrument validation, obtaining a Content Validity index in Scale (S-CVI/Ave) of 0.912. A multicentre cross-sectional study was carried out in three Spanish hospitals to determine the psychometric properties (construct validity and internal consistency). The questionnaire was administered to 204 women during the clinical puerperium. RESULTS: The Kaiser-Meier-Oklin Test (KMO = 0.924) and Bartlett's Test of Sphericity (X2 = 3119.861; p ≤ 0.001) confirmed the feasibility of the Exploratory Factor Analysis, which explained 60.54% of the variance with four factors. CONCLUSIONS: The Breastfeeding Literacy Assessment Instrument (BLAI) consisting of 26 items was validated.

Developing and validating an integrated instrument for nursing assessments in adult hospitalization units: Study protocol.

AIMS: To develop and validate an instrument that integrates functional capacity, risk of pressure ulcers and risk of falling with a more parsimonious approach towards nursing assessments in hospitalization units. DESIGN: Cross-sectional validation multicentre study. METHODS: Socio-demographic variables and assessments of Barthel Index, Braden Index and Downton Scale are included via electronic health records. Instrument's development process will include: (i) conceptual assessments; (ii) content validity; (iii) construct validity; (iv) internal consistency and (v) interobserver reliability. The analysis will consider possible differences in medical and surgical hospitalization units, hospitalization type or being a COVID-19 patient. This study was accepted for funding in November 2020 and approved by the Ethics and Research Committee in January 2021. RESULTS: An integrated instrument that lowers the administrative load of nursing assessments and allows at-risk patients to be detected with at least the same validity and reliability as the original instruments is expected to be obtained.

Breastfeeding and Obstetric Violence during the SARS-CoV-2 Pandemic in Spain: Maternal Perceptions.

Catalan legislation, a pioneer in Europe, has defined obstetric violence (OV) as "preventing or hindering access to truthful information, necessary for autonomous and informed decision-making". The definition also states that OV can affect physical and mental health, as well as sexual and reproductive health. Some authors have expressed concern about an increase in OV during the SARS-CoV-2 pandemic. During the pandemic, recommendations were also openly offered on the non-establishment and/or early abandonment of breastfeeding without scientific evidence to support them. Experiencing a traumatic childbirth can influence breastfeeding outcomes. Here, we conducted a cross-sectional study using a self-administered online questionnaire. The sample consisted of women who gave birth in Spain between March 2020 and April 2021. The mean age was 34.41 (±4.23) years. Of the women, 73% were employed, 78.2% had a university education, and almost all were Caucasian. Among the subjects, 3.3% were diagnosed with SARS-CoV-2 during pregnancy and 1% were diagnosed during delivery. Some of the women (1.6%) were advised to stop breastfeeding in order to be vaccinated. Women diagnosed with SARS-CoV-2 during delivery (p = 0.048), belonging to a low social class (p = 0.031), with secondary education (p = 0.029), or who suffered obstetric violence (p < 0.001) perceived less support and that the health care providers were less inclined to resolve doubts and difficulties about breastfeeding. Breastfeeding has been significantly challenged during the pandemic. In addition to all the variables to be considered that make breastfeeding support difficult, we now probably need to add SARS-CoV-2 diagnosis and OV.

Development and Validation of a Meta-Instrument for Nursing Assessment in Adult Hospitalization Units (VALENF Instrument) (Part I).

Nursing assessment is the basis for performing interventions that match patient needs, but nurses perceive it as an administrative load. This research aims to develop and validate a meta-instrument that integrates the assessment of functional capacity, risk of pressure ulcers and risk of falling with a more parsimonious approach to nursing assessment in adult hospitalization units. Specifically, this manuscript presents the results of the development of this meta-instrument (VALENF instrument). A cross-sectional study based on recorded data was carried out in a sample of 1352 nursing assessments. Socio-demographic variables and assessments of Barthel, Braden and Downton indices at the time of admission were included. The meta-instrument's development process includes: (i) nominal group; (ii) correlation analysis; (iii) multiple linear regressions models; (iv) reliability analysis. A seven-item solution showed a high predictive capacity with Barthel (R2adj = 0.938), Braden (R2adj = 0.926) and Downton (R2adj = 0.921) indices. Likewise, reliability was significant (p < 0.001) for Barthel (ICC = 0.969; τ-b = 0.850), Braden (ICC = 0.943; τ-b = 0.842) and Downton (ICC = 0.905; κ = 7.17) indices. VALENF instrument has an adequate predictive capacity and reliability to assess the level of functional capacity, risk of pressure injuries and risk of falls.

Root cause analysis for understanding patient safety incidents in nursing student placements: A qualitative content analysis.

AIM: to explore nursing students' experiences with the use of RCA technique in patient safety-related incidents during clinical placements. A secondary descriptive qualitative content analysis BACKGROUND: Patient safety education for nursing students is an international priority. While early detection and intervention strategies, such as the root cause analysis technique, have been found to be effective for near misses and errors, little is known about how these strategies facilitate nursing students understand how patient safety incidents happen. DESIGN: A secondary qualitative content analysis was conducted as part of a larger patient safety research project. METHODS: Data were collected from nursing students at [Hidden for blinding purposes]. This study included 108 third-year undergraduate nursing students enroled in the Care Management in the Socio-Health Care Settings for the academic years 2017-2018 and 2018-2019. During hospital clinical placements, nursing students were asked to do a coursework describing a patient safety incident and using the root cause analysis technique for its analysis. A content analysis was used to provide an in-depth analysis of the collected data. RESULTS: Two main themes were identified after the data analysis process: (i) patient safety incident as learning events: highlights how these incidents were turned into learning opportunities and how the root cause analysis guided them in identifying and addressing critical incidents to prevent similar situations in the future; and (ii) strategies for improving patient safety culture: depicts how nursing students realised that following protocols and evidence-based practice reduces incidents related to patient safety and the value of reporting errors in avoiding and minimising the recurrence of similar mistakes. CONCLUSIONS: The root cause analysis technique is a versatile and flexible learning resource for nursing students that can help them understand complex patient safety incidents while also fostering critical and problem-solving thinking, teamwork and systematic communication.

Integrative review of the literature on screening for gender-based violence during pregnancy: Barriers, facilitators, and tools.

An integrative review of the literature has been developed to explore barriers and facilitators in screening for gender-based violence in pregnant women and identify available tools for this screening. Studies were identified via a systematic search on the PubMed, CINAHL Plus (Cumulative Index of Nursing and Allied Health Literature Complete), Scopus, and LILACS (Latin American and Caribbean Health Sciences Literature) databases and a manual reverse reference search to obtain literature published between 2015 and 2020. The methodology followed the recommendations made by Whittemore & Knafl. The quality of studies was evaluated using the Critical Skills Appraisal Program tool. Twenty-three of the 4202 articles fulfilled the inclusion criteria. The principal barriers identified were lack of training for professionals (mainly nurses and midwives), lack of support policies, and lack of human and material resources. The main facilitators were to increase professional training programs on case detection, availability of effective instruments, and greater investment in resources to guarantee safety and referral of cases. With regard to the available tools, the Abuse Assessment Screen (AAS) continues to be the most widely used, although others such as the Humiliation, Afraid, Rape, and Kick questionnaire (HARK) could be suitable for antenatal care settings.

Influence of Health Literacy on Maintenance of Exclusive Breastfeeding at 6 Months Postpartum: A Multicentre Study.

Background: International organizations recommend initiating breastfeeding within the first hour of life and maintaining exclusive breastfeeding for the first 6 months. However, worldwide rates of exclusive breastfeeding for 6-month-old infants is far from meeting the goal proposed by the World Health Organization, which is to reach a minimum of 50% of infants. Education is one of the factors affecting the initiation and continuation of breastfeeding, and incidentally, it is also related to lower health literacy. This study explored the influence of health literacy on maintenance of exclusive breastfeeding at 6 months postpartum. Methods: A longitudinal multicenter study with 343 women were recruited between January 2019 and January 2020. The first questionnaire was held during the puerperium (24−48 h) with mothers practicing exclusive breastfeeding, with whom 6-month postpartum breastfeeding follow-up was performed. Socio-demographic, clinical and obstetric variables were collected. Breastfeeding efficiency was assessed using the LATCH breastfeeding assessment tool. The health literacy level was evaluated by the Newest Vital Sign screening tool. A multivariate logistic regression model was used to detect protective factors for early exclusive breastfeeding cessation. Results: One third of the women continued exclusive breastfeeding at 6 months postpartum. Approximately half the participants had a low or inadequate health literacy level. An adequate health literacy level, a high LATCH breastfeeding assessment tool score (>9 points) and being married were the protective factors against exclusive breastfeeding cessation at 6 months postpartum. Conclusion: Health literacy levels are closely related to maintaining exclusive breastfeeding and act as a protective factor against early cessation. A specific instrument is needed to measure the lack of "literacy in breastfeeding", in order to verify the relationship between health literacy and maintenance of exclusive breastfeeding.

Characteristics and determinants of the academic goals in nursing education: A cross-sectional study.

BACKGROUND: Academic goals guide the learning mode of nursing students, focus their objectives and influence the acquisition of skills. However, research on academic goals and related variables is scarce. OBJECTIVE: To study the relationship between different sociodemographic and academic variables with the type of academic goal in nursing students at the Universitat Jaume I (Spain). DESIGN: Cross-sectional study conducted between September 2020 and June 2021. SETTINGS AND PARTICIPANTS: Undergraduate nursing students at Universitat Jaume I (n = 263). METHODS: The Academic Goal Orientation questionnaire was administered. In addition, the variables age, gender, route to university, previous health studies, previous training in critical thinking, degree year and average grade on academic record were collected. A descriptive analysis of the sample and an analysis of the association between variables were performed. In addition, exploratory multinomial logistic regression was performed. RESULTS: The nursing students preferred the Learning Goal (95.8%; n = 263), and this increased among the students as their average grade increased. The results of the multivariate analysis indicated that students with a lower average grade, those from advanced years and those without previous training in critical thinking preferred the Work Avoidance and Self-defeating Ego Goals. CONCLUSION: The preferred goal among the students was learning. The variables that influenced the type of goal were year, average grade and previous training in critical thinking.

Perception of obstetric violence in a sample of Spanish health sciences students: A cross-sectional study.

BACKGROUND: Obstetric violence is a problem that has grown worldwide, and a particularly worrying one in Spain. Such violence has repercussions for women, and for the professionals who cause them. Preventing this problem seems fundamental. OBJECTIVE: This study evaluated how health sciences students perceived obstetric violence. DESIGN: A cross-sectional study conducted between October 2019 and November 2020. PARTICIPANTS: A sample of Spanish health sciences students studying degrees of nursing, medicine, midwifery, and psychology. METHODS: A validated questionnaire was used: Perception of Obstetric Violence in Students (PercOV-S). Socio-demographic and control variables were included. A descriptive and comparative multivariate analysis was performed with the obtained data. RESULTS: 540 questionnaires were completed with an overall mean score of 3.83 points (SD ± 0.63), with 2.83 points (SD ± 0.91) on the protocolised-visible dimension and 4.15 points (SD ± 0.67) on the non-protocolised-invisible obstetric violence dimension. Statistically significant differences were obtained for degree studied (p < 0.001), gender (p < 0.001), experience (p < 0.001), ethnic group (p < 0.001), the obstetric violence concept (p < 0.001) and academic year (p < 0.005). There were three significant multivariate models for the questionnaire's overall score and dimensions. CONCLUSIONS: Health sciences students perceived obstetric violence mainly as non-protocolised aspects while attending women. Degree studied and academic year might be related to perceived obstetric violence.

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

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

Student satisfaction level, clinical learning environment, and tutor participation in primary care clinical placements: An observational study.

BACKGROUND: Competence evaluations in the clinical setting represent approximately 50% of the nurse training process. Factors, such as perceived learning environment and clinical nurse participation, may influence nursing student satisfaction during clinical placements. OBJECTIVE: To evaluate the relationship between the levels of nursing student satisfaction with clinical placements, the clinical learning environment, and the level of nurse tutor participation. DESIGN: A cross-sectional study. SETTING AND PARTICIPANTS: We included 61 nursing students and 45 clinical nurses from 35 primary care centres assigned to the Universitat Jaume I. VARIABLES AND DATA COLLECTION: We assessed the overall level of student satisfaction with clinical placements, students' perception of the learning environment, tutors' level of participation, and socio-demographic variables. DATA ANALYSIS: We performed a descriptive analysis of the study sample, as well as correlation and simple linear regression analyses. Questionnaire results were analysed depending on the nature of the variables. RESULTS: The students' perception of the learning environment was 4.39 ± 0.48 points out of 5. The overall satisfaction level was 8.89 ± 1.22 points out of 10. Tutor participation level in students learning was 3.91 ± 0.58 points out of 5. CONCLUSIONS: Both student perception of the learning environment in the clinical setting and their overall level of satisfaction with clinical placements in the primary care centres were considered high. Tutors were participative, but poorly satisfied.

Healthcare Management and Quality during the First COVID-19 Wave in a Sample of Spanish Healthcare Professionals.

The aim of this study was to assess how the healthcare professionals in the Castellón Province (Spain) perceive healthcare quality and management during the first COVID-19 wave. A cross-sectional study was carried out. An online survey on healthcare quality and management during the first COVID-19 wave was sent to healthcare professionals. Almost half of the sample believed that healthcare quality worsened during the first COVID-19 wave (45.3%; n = 173). Heavier workload (m = 4.08 ± 1.011) and patients' complexity (m = 3.77 ± 1.086) were the factors that most negatively impacted healthcare quality. Health department 3, primary care center, and other doctors assessed human and material resources management as significantly worse (p < 0.05). Human and material resources management and the healthcare organization negatively affected healthcare quality during the first COVID-19 wave. Significant differences were observed according to departments, services, and professionals.

Validation of the attitudes to patient safety questionnaire for nursing students in the Spanish context.

BACKGROUND: There are different instruments to assess the attitudes of nursing students towards patient safety. However, no questionnaire validated in Spanish with this objective was identified. The objective of this study was to validate the Attitudes to Patient Safety (APS) questionnaire for nursing students in Spain and to study the attitudes towards patient safety of nursing students at the Universitat Jaume I (Spain). DESIGN: Cross-sectional psychometric study developed in a sample of 177 undergraduate nursing students. The study was carried out in the second semester of 2016. METHODS: First, a nominal group was created to perform cross-cultural adaptation and determine content validity of the Attitude to Patient Safety Questionnaire (APQS-III). Second, a cross-sectional study was conducted to determine the psychometric properties of the questionnaire and to study nursing student attitudes towards patient safety. RESULTS: Exploratory factorial analysis explained 53.82 % of the variance, with good internal consistency (α = 0.808), and confirmatory factor analysis indicate an adequate fit between the model and the data (χ2 = 366; p < 0.001; χ2/df = 1.886; RMSEA = 0.07; IC95 %=0.059-0.081; CFI = 0.885). Intra-observer reliability was good (ICC = 0.792, p < 0.001). The mean overall score of the questionnaire was 3.92 (95 % CI = 3.88-4.03). Significant differences were observed regarding whether the students had completed a clinical practicum (p = 0.012) and the academic year (p = 0.25). CONCLUSIONS: The psychometric properties of the APS questionnaire adapted for Spanish nursing students are adequate. Students show an adequate attitude towards patient safety; however, it is necessary to develop a strategy to guarantee the acquisition of competency for patient safety as well as to design and evaluate specific educational interventions.

Breastfeeding knowledge in university nursing students. A multicentre study in Spain.

BACKGROUND: Exclusive breastfeeding is one of the main health and infant survival elements. To start and maintain breastfeeding, health professionals must receive culturally sensitive evidence-based breastfeeding training to offer future mothers the required information and support. While studying the nursing degree, acquiring the necessary knowledge and skills to successfully perform this work is essential. OBJECTIVE: Study the level of nursing students' breastfeeding knowledge at three Spanish public universities; explore which variables are related to acquire this knowledge. DESIGN: An observational, descriptive, cross-sectional multicentre study. METHODS: Participants were the students registered for the 4 nursing degree years at the three participating universities (N = 1540). They were asked about their breastfeeding knowledge with the self-administered AprendeLact Questionnaire; breastfeeding-related socio-demographic variables were included. RESULTS: The overall mean score of the 684 returned questionnaires was 4.659 (±2.377) out of 10. The year-4 students from the Castellón university obtained significantly higher mean scores and had been on practicals in maternity or neonatology units, belonged to breastfeeding associations and were artificially fed as infants. University belonged to, current academic year and placements in maternity or neonatology units were relevant factors for acquiring breastfeeding knowledge. CONCLUSIONS: Syllabi based on progressive transversal learning, and participating in real maternity-related health settings, could be facilitating strategies to acquire a suitable level of breastfeeding knowledge.

Health literacy and its relation to continuing with breastfeeding at six months post-partum in a sample of Spanish women.

AIM: To explore the relation between health literacy (HL) and continuing breastfeeding (BF) at 6 months post-partum. DESIGN: Observational, longitudinal and prospective study between December 2018-May 2019. The STROBE checklist was used. METHODS: 114 mother/baby pairings from a Spanish Hospital were included. Mothers' health literacy was studied with the Newest Vital Sign and Short Assessment of Health Literacy for Spanish Adults 50 (SAHLSA-50). Before hospital discharge, BF efficiency was studied using the LATCH BF score and BF continuity was followed for 6 months. Survival analysis and Cox regression were done. RESULTS: Health literacy levels and BF effectiveness were adequate before hospital discharge. At 6 months post-partum, less than half the sample still exclusively breastfed. The main reason for early exclusive BF cessation was lower than the recommended newborn weight gain. The HL level acted as a protective factor against abandonment of BF.