Utilizing supply-demand bundles in Nature-based Recreation offers insights into specific strategies for sustainable tourism management.

Balancing supply and demand in Nature-based Recreation (NbR) has the potential to yield co-benefits across multiple Ecosystem Services (ES), helping to make tourism activities more sustainable. However, a comprehensive understanding of supply-demand mismatches in NbR is challenging due to the complex interaction among various social, economic and ecological factors. This paper investigates mismatches in NbR supply and demand to provide insights for informing spatial and regional planning to achieve sustainable tourism. To this end, the paper uses a wide range of indicators such as biophysical attributes, accessibility and social indicators to map and assess NbR supply and demand, followed by the application of spatial statistics to analyse supply-demand mismatches. Cluster analysis was performed based on the supply-demand relationship to identify a typology of NbR ES across the study area in the north of Iran. The paper proposes an innovative application of recreation ES bundles with potential implications for sustainable tourism in a region marked as a hot spot for tourism. The analysis generated a typology of five bundles of NbR ES with differing recreational opportunities. Bundles 1 and 2, characterized by a supply surplus and substantial ecological value, are suitable for NbR activities such as camping, hiking, climbing, and birdwatching. In contrast, bundle 4 and 5 associated with urban centres, experience a supply deficit, making them less suitable for NbR. Bundle 3, characterized by a mixture of natural and productive lands, plays an important role in maintaining a balanced supply-demand state. This region holds potential for diverse forms of tourism, including rural and agricultural recreation such as farm tours and farm life experiences. Based on findings, the paper provides valuable insights for spatial and regional planning by proposing targeted strategies to sustainably manage tourism activities.

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

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

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

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

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

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

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

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

Nursing students faced with organ donation: Multicenter stratified national study.

AIM: To analyze the attitude of university nursing students at Spanish universities toward organ donation and transplantation and the factors affecting to their attitude. BACKGROUND: The opinion of future nurses toward organ transplant donation could have an important influence on the population. Knowing that opinion and what factors influence it is important to improve the attitude towards organ donation and transplantation. DESIGN: A multicenter, sociological, interdisciplinary and observational study including university nursing diploma students in a complete academic year. METHODS: Selected and randomized sample was taken of students from 52 of the 111 faculties and nursing schools and faculties in Spain with teaching activity PARTICIPANTS: A sample of 10,566 students was selected stratified by geographical area and year. MEASUREMENT INSTRUMENT: The instrument used was a validated questionnaire of attitude toward organ donation and transplantation, self-administered and completed anonymously. RESULTS: Completion rate: 85 % (n = 9001). Of the students surveyed, 78 % (n = 7040) would donate their organs after dying. Variables related to a favourable attitude: (1) Interest in listening to a talk about organ donation and transplantation [Odds ratio 1.66, 95 % confidence interval 2.05-1.35]; (2) Family discussion [Odds ratio 2.30, 95 % confidence interval 2.79-1.90] or discussion with friends about organ donation and transplantation [Odds ratio 1.56, 95 % confidence interval 1.86-1.31]; (3) Knowing that one's father [Odds ratio 1.54, 95 % confidence interval 1.94-1.22], mother's [Odds ratio 1.44, 95 % confidence interval 1.82-1.13] or partner [Odds ratio 1.28, 95 % confidence interval 1.60-1.03] has a favourable opinion; (4) Having a good self-assessment of information about organ donation and transplantation [Odds ratio 2.94, 95 % confidence interval 4.90-1.78]; (5) Not being worried about possible mutilation of the body after donation [Odds ratio 2.73, 95 % confidence interval 3.36-1.72]. CONCLUSIONS: Nursing students in Spain tend to have a favourable attitude toward organ donation and transplantation although more than 20 % of those surveyed are not in favour. TWEETABLE ABSTRACT: To maintain a high rate of organ donation for organ transplantation, it is necessary to improve the social awareness of future generations of nurses towards organ donation.

A competency model for nurse executives.

BACKGROUND: Nurses capable of adequately developing their competencies in the management field are essential for the sustainability of health-care organizations. Such competencies should be included in a model of specific competencies. AIM: The aim of this research is to propose a competency model for nurse executives. METHODS: The Delphi method was applied to reach a consensus on the required competencies, and Principal Component Analysis (PCA) was applied to determine the construct validity and reduce the data set's dimensionality. Consensus was defined based on at least 80% of the experts agreeing with the proposed competencies. For each competency, the development levels were beginner, advanced beginner, competent, highly competent and expert. RESULTS: From among the 51 competencies that were identified to define a model for nurse executives, decision-making, leadership and communication stood out. The PCA indicated the structural validity of the proposed model by saturation of the principal components (Cronbach's α > 0.631). CONCLUSION: Nurses wishing to develop their professional careers as nurse executives must first develop the competencies shown in the proposed model. Nurse executives should follow the educational programmes specified in this study, to adapt their knowledge to this role's requirements.

Biodiversity and ecosystem services mapping: Can it reconcile urban and protected area planning?

Land-use changes, especially urbanization, have largely impacted the capacity of ecosystems to deliver ecosystem services (ES) on which human wellbeing depends. The current sectorial landscape and territorial planning approaches that separately address protected areas and urban areas have proven ineffective in conserving biodiversity. To address this important challenge, integrated territorial planning has been claimed to be able to better reconcile interests between nature conservation and urban planning, and ES supply and demand mapping may be a useful tool for such purposes. In this study, we quantitatively mapped biodiversity and the supply and demand of eight ES along an urban-rural gradient in the region of Madrid (Spain). Then, we clustered the municipalities in this gradient into four groups based on their common biodiversity and ES supply and demand characteristics. Additionally, we reviewed the urban plans from these municipalities and the management plans of three protected areas, analysed the references to ES in the plans, and searched for potential conflicts between urban and protected area planning aims. We found that municipalities with highly coupled ES supply and demand are in high altitude areas, coinciding with protected areas, while in urban areas, the ES demand exceeds the supply. Municipalities exhibiting a high demand for regulating ES usually include them in their plans, while municipalities with a high supply of regulating ES do not. Given the several conflicts between protected areas and urban planning that we detected, we discuss the utility of mapping biodiversity and ES supply and demand beyond administrative boundaries to overcome the challenge of integrating spatial planning approaches, especially in the context of urban-rural gradients and megacities. We also explore the utility of these methods for coordinating urban planning tools to achieve integrated territorial planning.

Nursing care and prevalence of adverse events in prone position: Characteristics of mechanically ventilated patients with severe SARS-CoV-2 pulmonary infection.

BACKGROUND: Because of the coronavirus disease 2019 (COVID-19) pandemic, the use of prone positioning has dramatically increased in the intensive care unit (ICU). Because this manoeuvre is related to several complications, it must be performed in a protocolized manner by the appropriate personnel. AIM: To determine the prevalence of adverse events (AEs) in patients admitted to the ICU with a diagnosis of COVID-19-related acute respiratory distress syndrome (C-ARDS) undergoing mechanical ventilation in prone position (PP). DESIGN: Descriptive ambispective study of patients admitted to the ICU diagnosed with C-ARDS undergoing mechanical ventilation who were in the PP at least once. The number of PP manoeuvres and the time spent in the PP were recorded for each subject. AEs proportions and frequencies were calculated, and analysis of variance was used to assess mean differences in the number of manoeuvres and total hours in PP stratified by the number of facial pressure ulcers. IBM SPSS Statistics v.25.0. and EPIDAT 4.1 software were used. RESULTS: Forty-four patients were analysed, and 130 PP manoeuvres were performed. The most frequently observed AEs were facial oedema in 26 patients (80.3%) and facial pressure ulcers in 20 (60.6%). There was a significant positive association between the time spent in PP and the development of facial pressure ulcers (P < .001). Enteral nutrition was well tolerated, and no serious AEs or sentinel events were noted. CONCLUSION: Despite the stressful, demanding situation during the peak of the pandemic, the large number of PP manoeuvres, and long duration spent in this position, no serious AEs occurred. This study highlights the need to implement preventive measures to avoid the development of pressure ulcers secondary to prone positioning. RELEVANCE TO PRACTICE: Prone positioning requires a nursing protocol to prevent the occurrence of AEs that may reduce the quality of nursing care.

The relationship between clinical placement duration and students' satisfaction with the quality of supervision and learning environment: A mediation analysis.

Multiple factors that influence the learning experience of nursing students while they are in clinical training have been identified, such as the clinical learning environment, the supervision provided by supervisors, and the level of cooperation with the nurse teacher. The objective was to examine whether the relationship between the clinical placement duration and overall satisfaction with clinical training is mediated by the supervisory relationship and learning environment. A secondary analysis was conducted using the data from a cross-sectional study conducted in 17 higher educational institutions in nine European countries with the Clinical Learning Environment, Supervision and Nurse Teacher scale (n = 1903 pre-registration nursing students). Satisfaction with the supervisor and a good learning environment mediated the relationship between clinical placement duration and overall satisfaction as perceived by the students. Nursing students with longer clinical placement durations were more satisfied with clinical training as a result of both their satisfaction with their supervisor and their perceptions of good learning environment. The optimal duration a nursing student should remain in the different practice settings is approximately 7 weeks.

Nurse managers' competencies: A scoping review.

AIM: To describe and synthesize scientific literature on nurse managers' competencies. BACKGROUND: The key strategy for the success of health organisations currently resides in the capacity of the nurse manager to develop advanced competencies in management. However, there is a lack of systematic reviews that synthesize knowledge about nurse managers' competencies. EVALUATION: A scoping review was conducted using electronic databases including Web of Science, Scopus, PubMed and Cumulative Index to Nursing and Allied Health Literature. KEY ISSUES: After the first analysis, 392 competencies were observed from 76 studies. Finally, 53 competencies were grouped according to their characteristics. The two most-cited competencies were communication and finance. CONCLUSIONS: Knowing the competencies required by nurse managers can help organisations create strategies to develop competent managers. In addition, from the results we can infer what might be the core competencies, since 22 main competencies from the total number were identified. IMPLICATIONS FOR NURSING MANAGEMENT: The competencies identified constitute the body of knowledge necessary for nurse managers. In addition, it is possible to generate a pathway for learning and professional development for nurses before they work at the microlevel of management. The starting point for this pathway could be the 22 core competencies.

Competency Model for the Middle Nurse Manager (MCGE-Logistic Level).

Healthcare systems are immersed in transformative processes, influenced by economic changes, together with social and health instability. The middle nurse manager plays a fundamental role, since he or she is responsible for translating the strategic vision, values and objectives of the organization. The objective of this study was to propose the model of competencies to be developed by the middle nurse manager in the Spanish healthcare system. Our methodology consisted in the application of the Delphi method in order to reach an agreement on the necessary competencies, and principal component analysis (PCA) was used to determine the construct validity, reducing the dimensionality of the set of data. Fifty-one competencies were identified for the definition of the model, highlighting decision-making, leadership and communication. The PCA pointed out the structural validity of the proposed model through the saturation of the main components (α Cronbach > 0.631). The results show the model of competencies which the middle nurse manager in the Spanish healthcare system must develop. Middle nurse managers may use these as criteria to plan their professional strategies in the context of management. This model of competencies can be applied to establishing selection processes or training programs for the role of middle nurse manager.

Preliminary Report on a Novel Virtual Reality Perimeter Compared With Standard Automated Perimetry.

PRECIS: The VisuALL head-mounted perimetry in normal subjects and glaucoma patients had a moderate to strong correlation with the Humphrey Field Analyzer (HFA). PURPOSE: Visual field testing has a vital role in diagnosing and managing glaucoma. The current clinical practice relies on large, table-based testing units. This study investigated the performance of a novel virtual reality head-mounted visual perimetry device (VisuALL), in normal and glaucoma patients. METHODS: This prospective observational study was conducted on 50 eyes of 25 healthy subjects (normal group) and 52 eyes of 26 patients with a controlled mild or moderate stage of glaucoma (glaucoma group). All participants had visual field testing with VisuALL and the HFA (24-2, Swedish Interactive Threshold Algorithm). The mean sensitivity of the whole visual field and each quadrant were compared between both machines and the receiver operating characteristic was used to compare the diagnostic abilities and the Bland-Altman plot to evaluate the agreement of the 2 perimeters. RESULTS: The global mean sensitivity of the VisuALL and the HFA correlated significantly in both normal (r=0.5, P=0.001) and glaucoma (r=0.8, P<0.001) groups. The mean sensitivity of all quadrants also correlated significantly in both groups. The VisuALL mean sensitivity had a greater (0.98) receiver operating characteristic curve than HFA (0.93) mean sensitivity (P=0.06) in discriminating normal versus glaucoma. CONCLUSION: There was an excellent correlation between the VisuALL and the Standard Automated Perimetry in normal and glaucoma patients and VisuALL showing high diagnostic performance.

The Mediating and Moderating Effects of Physical Fitness of the Relationship between Adherence to the Mediterranean Diet and Health-Related Quality of Life in University Students.

The aim of this study was to estimate the relationship between the adherence to the Mediterranean diet (MD) and health-related quality of life (HRQoL) in university students and to assess whether this relationship is mediated or moderated by cardiorespiratory fitness (CRF) and handgrip strength. A cross-sectional study was performed involving 310 first-year Spanish university students. Adherence to the MD was evaluated with the 14-item Mediterranean Diet Adherence Screener (MEDAS), and the HRQoL was evaluated with the Short Form-12 (SF-12) questionnaire. CRF was assessed by the 20 m shuttle run test, and the handgrip strength was determined by dynamometry. ANCOVA models showed that participants with higher CRF and handgrip strength levels had significantly higher scores in the physical component summary (PCS) and mental component summary (MCS) of the SF-12 and in the MEDAS questionnaire than those with medium and low scores (p < 0.050). Additionally, the ANCOVA models showed that students with good adherence to the MD showed higher scores in the MCS of HRQoL than those with low adherence (p = 0.044, ES = 0.013), but these results did not appear for the PCS of HRQoL (p = 0.728, ES = 0.001). In the mediation analysis, it was found that CRF and handgrip strength acted as full mediators of the relationship between adherence to the MD and the MCS of HRQoL. In the moderation analysis, it was evidenced that CRF and handgrip strength did not act as moderators in the relationship between adherence to the MD and the MCS of HRQoL. In conclusion, adherence to the MD does not seem to have a direct effect on the MCS of HRQoL because this association seems to be fully mediated by CRF and handgrip strength.

Barriers and Facilitators Perceived by Spanish Experts Concerning Nursing Research: A Delphi Study.

The identification of research priorities in line with current health needs and nursing competencies is a priority. Nevertheless, barriers and facilitators perceived by nurses to performing nursing research have scarcely been investigated. The main aim of this study was to explore the situation in nursing research in Spain, as perceived by Spanish experts. A Delphi study technique in two phases was applied using an online survey tool. A panel of 20 nursing experts in nursing, teaching and management positions participated. The strengths highlighted were the possibility of reaching the PhD level, the possibility of receiving continuous training in research methodology, and access to scientific knowledge through the Internet. The weaknesses identified were the lack of Spanish nursing journals in which to publish the research results, the lack of funding in nursing care research, and the lack of connection between the healthcare institutions and the university. According to the experts, elements that could enhance leadership in research are the creation of nursing research units in hospitals, the economic recognition of nurses with PhDs, and considering research work as part of their daily tasks in clinical settings. The idea of being subordinated to physicians still remains in nurses' ways of thinking.

Exploring Health Science Students' Notions on Organ Donation and Transplantation: A Multicenter Study.

The knowledge acquired during university education about organ donation and transplantation (ODT) decisively influences the information future health professionals transmit. This is important in ODT where the participation of the general public is essential to obtain organs. OBJECTIVE: To determine notions of Spanish medicine and nursing students on ODT and its relationship with attitude toward ODT. METHODS AND DESIGN: and design. We conducted a sociologic, multicenter, and observational study. The population for our study consisted of medical and nursing students in Spanish universities. Our database was the Collaborative International Donor Project, stratified by geographic area and academic course. A validated questionnaire (PCID-DTO-RIOS) was self-administered and completed anonymously. Our sample consisted of 9598 medical and 10,566 nursing students (99% confidence interval; precision of ±1%), stratified by geographic area and year of study. RESULTS: The completion rate for our study was 90%. Only 20% (n=3640) of students thought their notions on ODT were good; 41% (n=7531) thought their notions were normal; 36% (n=6550) thought their notions were scarce. Comparing groups, there were differences between those who believed that their notions on ODT were good (44% nursing vs 56% medical students; P < .000), and those who believed it scarce (54% nursing vs 46% medical students; P < .000). Notions on ODT were related with attitude toward the donation of one's own organs: those who considered their notions were good were more in favor then those who considered it scarce (88% vs 72%; P < .000). CONCLUSION: Only 20% of Spanish medical and nursing students thought their notions on ODT were good. Having good knowledge is related to a favorable attitude towards ODT. Receiving specific information on the subject could improve their knowledge about ODT during their training.

The effectiveness of high-intensity interval training on body composition, cardiorespiratory fitness, and cardiovascular risk factors in children: A protocol for a systematic review.

BACKGROUND: No previous systematic review has examined the effect of high-intensity interval training (HIIT) interventions on body composition, cardiometabolic risk factors and cardiorespiratory fitness (CRF) in healthy schoolchildren from 5 to 12 years old. METHODS: This study will be conducted by following the guideline of the preferred reporting items for systematic review and meta-analysis protocols. An electronic search in MEDLINE (via PubMed), EMBASE (via Scopus), SPORTDiscus, Cochrane Library and Web of Science databases of all dates from inception will be conducted. We will include randomized controlled trials aimed to assess the effectiveness of HIIT to improve cardiometabolic risk factors, body composition, and CRF in children. Two authors will perform the study selection and data collection; disagreements will be solved by a third reviewer. The methodological quality of studies will be assessed by the Cochrane Collaboration's tool for assessing risk of bias (RoB2). Data analysis and synthesis will be performed by Comprehensive Meta-analysis Software and StataSE software, version 15. CONCLUSION: The results should be disseminated through publication in a peer-reviewed journal. Since the data used in systematic reviews of this type will be extracted exclusively from published studies, approval form and ethics committee will not be required.

Organ Donation Related With Attitude Toward the Law of Presumed Consent: Spanish University Medical and Nursing Students Study.

INTRODUCTION: Information provided by health care professionals is crucial to create a climate of social opinion. This is important in organ donation and transplantation (ODT), where the participation of the general public is essential to obtain organs. OBJECTIVE: To determine the attitude toward the Law of Presumed Consent (LPC) among Spanish university students and to analyze their relation with attitude toward ODT. METHODS: and design. The type of study was a sociologic, multicenter, observational study. The population included medical and nursing students in Spanish universities. Database of Collaborative International Donor Project was used stratified by geographic area and academic course. A validated questionnaire (Collaborative International Donor Project, organ donation and transplantation questionnaire in Spanish [PCID-DTO-RIOS]) was self-administered and completed anonymously. A sample of 9598 medical and 10,566 nursing students was analyzed (99% confidence and precision of ±1%) and stratified by geographic area and year of study. RESULTS: Completion rate was 90%. Regarding attitude toward LPC, 66% of the students were against the law, whereas 34% accepted it. Of the students surveyed, 9% considered the law as a gesture of solidarity, 25% as an effective way of not wasting organs, 48% as an abuse of power, and 18% as offenses against the family. Those students who were in favor of LPC also had a more favorable attitude toward ODT (86% vs 76%; P < .001). Comparing groups, nursing students were less in favor of LPC than medical students (32% vs 36%; P < .000). CONCLUSION: Sixty-six percent of Spanish university medical and nursing students were against the LPC. The favorable attitude toward ODT is associated with considering the law as a gesture of solidarity or as an effective way of not wasting organs.

Confident Perception of Primary Care Physicians Correlates to the Attitude Toward Donation and Organ Transplantation: A Multicenter Study of Medical And Nursing Spanish Students.

A primary care physician (PCP) not only accompanies the patient in the process of an illness, but throughout his or her life. The confidence we have in these health professionals is fundamental, and their favorable attitude toward organ donation and transplantation (ODT) has a significant influence on the population. OBJECTIVE: To analyze trust in PCPs among Spanish medical and nursing students, the relationship with their attitude toward ODT, and the factors that condition it. METHODS AND DESIGN: A sociologic, multicenter, and observational study. POPULATION: medical and nursing students in Spanish universities. DATABASE: Collaborative International Donor Project, stratified by geographic area and academic course. A validated questionnaire (PCID-DTO-RIOS) was self-administered and completed anonymously. A sample of 9598 medical and 10,566 nursing students (99% confidence and precision of ±1%), stratified by geographic area and year of study. RESULTS: Completion rate: 90%. With respect to students' trust in their physician, 18% (n = 3267) of them totally trust (completely), 45% (n = 8101) trust enough, 30% (n = 5478) of them have not enough trust, and 7% not at all. Comparing groups, medical students totally trust more in PCPs than nursing students (55% vs 45%; P < .000), however, nursing students have less than enough trust in their PCP than medical students (53% vs 47%; P < .000). Students that totally trust in their PCP were more in favor toward ODT than students with not enough trust (83% vs 77%; P < .000). CONCLUSION: Only 18% of Spanish medical and nursing students totally trust in their PCP. Attitude toward ODT is related to a higher level of trust in PCPs among these students.

Nursing Students' Knowledge About Organ Donation and Transplantation: A Spanish Multicenter Study.

Health care professionals and the information that they provide to the public on organ donation and transplantation (ODT) influence attitudes toward this option. OBJECTIVE: The objective was to analyze the knowledge of university nursing students at Spanish universities toward ODT and the factors affecting it. METHODS AND DESIGN: The methods and design included a multicenter, sociologic, and observational study including university nursing diploma students in a complete academic year. PARTICIPANTS: A sample of 10,566 students was selected stratified by geographic area and year. INSTRUMENT: A validated questionnaire of knowledge toward ODT (PCID-DTO RIOS), self-administered and completed anonymously. RESULTS: Questionnaire completion rate: 85% (n = 9001). Only 18% (n = 1580) believed that their knowledge about ODT was good, 40% (n = 3578) believed that the information they had was normal, and 39% believed that their knowledge was sparse. Of the students, 96% believed that organ needs are not covered and 79% that they might need a transplant in the future. Only 39% (n = 3493) had attended a talk about ODT. Furthermore, 83% (n = 7435) believed that attending a talk would be interesting. The following variables were associated with having a more adequate knowledge: gender (62% men vs 57% women; P < .001); academic year (P < .001); knowing a donor (P < .001); knowing a transplant patient (P < .001); believing the possibility of needing a transplant oneself in the future (P < .001); attitude toward deceased donation (P < .001); and interest in receiving an informative talk about ODT (P < .001). CONCLUSION: Only 18% of nursing students in Spain believed that their knowledge about ODT was adequate. These results must be considered for possible training plans for these future professionals.