Evidence-based healthcare competence of social- and healthcare educators: A cross-sectional study.

AIM: The purpose of the study was to describe social and healthcare educators' evidence-based healthcare competence and explore the associated factors. DESIGN: A descriptive, cross-sectional study was carried out. METHODS: The research spanned 5 universities, 19 universities of applied sciences, and 10 vocational colleges in Finland from September to December 2022. Social and healthcare educators (n = 256), of which 21 worked at universities, 176 worked at universities of applied sciences, and 49 worked at vocational colleges. Data collection employed a self-assessed instrument that was designed to measure evidence-based healthcare competence based on the JBI Model of Evidence-based Healthcare. Competence profiles were formed using K-cluster grouping analysis. RESULTS: The educators' self-evaluations of their level of evidence-based healthcare competence were generally at a satisfactory level, with subsequent analyses identifying four distinct profiles of evidence-based healthcare competence. The profiles demonstrated statistically significant differences in terms of evidence synthesis and evidence transfer competencies. The factors associated with evidence-based healthcare competence included level of education, the year in which a professional had obtained their highest degree, current organization of employment, and participation in continuing education. CONCLUSIONS: Educators require various types of support for developing high levels of evidence-based healthcare competence. The identification of distinct competence profiles can be pivotal to providing educators with training that is tailored to their exact needs to provide an individualized learning path. WHAT PROBLEM DID THE STUDY ADDRESS?: Educators value the role of evidence in teaching, which reinforces the need to integrate aspects of the JBI Model of evidence-based healthcare into educators' competencies. Aspects of the JBI Model of evidence-based healthcare have not been holistically measured, with only certain components of the model considered separately. Educators need to better understand the global healthcare environment so they can identify research gaps and subsequently develop healthcare systems through their educational role. Higher academic education, work experience, organizational support, and continuous education play essential roles in the development of educators' evidence-based healthcare competence. WHAT WERE THE MAIN FINDINGS?: Educators generally have high levels of competence in evidence-based healthcare. Educators have mastered the different components of the JBI model of evidence-based healthcare but need to improve in areas such as the transfer and implementation of evidence. WHERE AND ON WHOM WILL THE RESEARCH HAVE AN IMPACT?: Determining evidence-based healthcare competence profiles for educators can be used to provide individualized learning paths for the development of evidence-based healthcare competence. Educators need to further develop their competence in evidence-based healthcare to ensure successful implementation and high-quality education in the future. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

Effectiveness of a Digital Health Game Intervention on Early Adolescent Smoking Refusal Self-Efficacy.

Smoking poses a significant threat to adolescent health because of its immediate and long-term detrimental health effects. Smoking refusal self-efficacy predicts smoking behavior in adolescence. In adolescents' health education, digital interventions are potential tools to support smoking refusal self-efficacy. The aim of this two-arm cluster randomized controlled trial was to evaluate the effectiveness of a digital health game intervention compared with a no-intervention control group on smoking refusal self-efficacy in 10- to 13-year-old Finnish early adolescents. The early adolescents (n = 781) were randomized to the control group (n = 394) and the health game intervention group (n = 387). Smoking refusal self-efficacy, sources of smoking and snus refusal self-efficacy, and motivation to decline smoking and snus use in the future were measured at baseline, 2-week postintervention, and 3-month follow-up. Data were analyzed using linear mixed model and Wilcoxon rank-based test for clustered data. According to the results, the intervention group made improvements in sources of smoking and snus refusal self-efficacy between baseline and postintervention, and in sources of snus refusal self-efficacy between baseline and follow-up, compared with the control group. The intervention group showed improvements in smoking refusal self-efficacy among 12-year-olds between baseline and follow-up, and postintervention and follow-up compared with the control group. Similar improvements were also found among those with a smoking friend or a smoking parent between postintervention and follow-up. The results were promising for the use of digital health game interventions to promote early adolescent smoking refusal self-efficacy and preventing smoking experimentation. Further research can evaluate the long-term effects for adolescents.

Actualization of evidence-based nursing in primary, specialized, and social care settings-A cross-sectional survey.

BACKGROUND: Basing practice on evidence is a widely acknowledged requirement for nursing, but shortcomings still exist. An increased understanding of the actualization of evidence-based nursing (EBN) across different nursing contexts is needed to develop better support for EBN and promote uniform high-quality nursing. AIMS: The aim of this study was to compare the actualization of EBN in different organizational contexts in Finland. METHODS: Data for this survey were collected in 2021. The actualization of EBN in primary, specialized, and social care organizations was evaluated with the Actualization of Evidence-Based Nursing instrument, nurses' version, which focuses on individual and organizational-level EBN support structures. Differences between (1) specialized and primary healthcare, and (2) different nursing practice settings were tested with Welch's two sample t-test, the Kruskal-Wallis rank sum test, and the Wilcoxon rank sum test. RESULTS: Based on nurse (n = 1020) evaluations, those working in specialized healthcare hold more positive attitudes toward EBN (p = .021) and evaluated their organization's methods for monitoring and evaluating nursing practices (p = .004) more positively than those working in primary healthcare. Regarding different nursing practice settings (n = 1241), the most positive results were observed within preventive healthcare where nurses evaluated their attitudes toward EBN, EBN competence, and personal evidence-based practices more positively compared to other nursing practice settings. The results were parallel regarding several organizational structures for EBN. Positive results were also observed within somatic units at university hospitals, and most negative results were within institutional care settings, health centers, and home care settings. LINKING EVIDENCE TO ACTION: There is a need for targeted support to strengthen EBN across different organizational contexts, with special attention to those contexts where nursing professionals with lower education levels work. Future research needs to focus on further analyzing the organizational differences and what can be learned, especially from preventive healthcare but also somatic units at university hospitals.

Development and psychometric testing of the actualisation of evidence-based nursing instrument.

AIM: To describe the development of the Actualisation of Evidence-Based Nursing instrument targeted at nurses working in clinical practice (ActEBN-nurses), meant for evaluating the actualisation of individual and organisational-level support structures for evidence-based nursing within social and healthcare organisations, and to test its validity and reliability. DESIGN: Cross-sectional survey. METHODS: The FinYHKÄ model was used as the theoretical background of the instrument development and supplemented with the JBI Model of Evidence-Based Healthcare, previous literature and items from a previous instrument, the Evidence-Based Practice Process Assessment Scale, with permission of the copyright holders. After two rounds of expert panel and piloting, a national survey was conducted with the instrument in 2021. The target group consisted of nurses working in clinical practice. Psychometric testing included internal consistency (Omega, item analysis) confirmatory factor analysis and t-test for comparison of two groups' differences (sensitivity). RESULTS: A new instrument, ActEBN-nurses was developed, comprising two parts: Individual-level (32 items, 5-point Likert-scale) and Organisational-level support structures for evidence-based nursing (37 items, 5-point Likert-scale). In total, 1289 nurses participated in the survey. The ActEBN-nurses proved to have good internal consistency in both parts (Omega ω .931 and .966), structural validity and sensitivity based on the two educational levels within the sample. The structure of both parts was slightly modified, based on the CFA modification indices, considering the impact of the reverse worded items in part Individual and redundant items within both parts. CONCLUSION: The ActEBN-nurses has promising psychometrics, and it can be used for evaluating individual and organisational-level support structures for evidence-based nursing within social and healthcare organisations. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: Evaluation of the support structures within social and healthcare organisations is needed to recognise shortcomings in current structures and advance evidence-based nursing across different contexts. REPORTING METHOD: The authors state that they have adhered to relevant EQUATOR guidelines: STROBE statement for cross-sectional studies. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

Effectiveness of exercise interventions on urinary incontinence and pelvic organ prolapse in pregnant and postpartum women: umbrella review and clinical guideline development.

INTRODUCTION AND AIMS: Dysfunction related to pelvic floor muscles (PFM) is common among pregnant and postpartum women and can cause symptoms such as urinary incontinence or pelvic organ prolapse (POP). As part of developing a nationwide clinical practice guideline for nursing in Finland, the aim of this umbrella review is to summarize the existing evidence about the effectiveness of exercise interventions on urinary incontinence and POP in pregnant and postpartum women. To promote knowledge translation, recommendations for health care professionals are presented. METHODS: We conducted an umbrella review to summarize the existing evidence. The JBI methodology for umbrella reviews was used to guide the review. The level of evidence was evaluated using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach, and recommendations based on the evidence were formulated by a clinical guideline working group. RESULTS: Altogether, 9 systematic reviews, reporting findings from 89 original studies, were included. The methodological quality of the reviews was evaluated using JBI's checklist. The highest level of evidence was found for preventing the symptoms of postpartum urinary incontinence through exercise and pelvic floor muscle training (PFMT) during pregnancy. Moderate-level evidence showed that exercise and PFMT are likely to reduce the symptoms and severity of urinary incontinence, but the level of evidence was low on PFMT reducing the symptoms of POP. CONCLUSION: We recommend encouraging and guiding pregnant and postpartum women to exercise and train PFM. We also recommend identifying pregnant and postpartum women with symptoms of PFM dysfunction and directing them to a physiotherapist or other health care professional specializing in pelvic floor function.

Clinical decision support in promoting evidence-based nursing in primary healthcare: a cross-sectional study in Finland.

INTRODUCTION AND AIMS: The aim was to explore clinical decision support (CDS) use in the practice of primary healthcare nurses. The objectives were to recognize to what extent nurses (registered nurses, public health nurses, and practical nurses) use CDS, what factors were associated with the CDS used, what kind of organizational support nurses need, and what were nurses' views about CDS development needs. METHODS: The study was conducted with a cross-sectional study design, using an electronic questionnaire developed for this purpose. The questionnaire contained 14 structured questions and nine open-ended questions. The sample consisted of randomly selected primary healthcare organizations ( N  = 19) in Finland. Quantitative data were analyzed using cross-tabulation and Pearson's chi-squared test, and qualitative data with quantification. RESULTS: A total of 267 healthcare professionals (age range 22-63 years) volunteered to participate. Participants were mainly registered nurses, public health nurses, and practical nurses (46.8, 24, and 22.9%, respectively). Overall, 59% of the participants had never used CDS. The majority (92%) found it necessary to develop nursing-specific content for CDS. The most commonly used features were medication recommendations and warnings (74%), reminders (56%), and calculators (42%). Half of the participants (51%) had not received training on the use of CDS. The older age of participants was associated with the feeling of not having enough training to use CDS ( P  = 0.039104). Nurses felt that CDS was helpful in their clinical work and decision-making, promoting evidence-based practice, and narrowing the research-into-practice gap, improving patient safety and the quality of care, and helping those who are new in their work. CONCLUSION: CDS and its support structures should be developed from a nursing perspective to achieve the full potential of CDS in nursing practice.

Systematic review of digital interventions to support refusal self-efficacy in child and adolescent health promotion.

Refusal self-efficacy protects against risky health behavior. Digital interventions have the potential to support self-efficacy due to the enactive experience provided by digital technologies. The aim of this systematic literature review was to evaluate the evidence of digital interventions to support refusal self-efficacy in child and adolescent health promotion. Following the Cochrane Collaboration guidelines, five electronic databases were searched from 2009 to 2020. The studies were assessed by two independent reviewers according to the eligibility criteria. Eligible studies were included in the review, assessed for risk of bias, synthesized narratively and assessed for evidence quality with the GRADE approach. Twenty-three studies, that examined 18 different interventions, were included in the review. The interventions included various digital elements as means to support the child and adolescent refusal self-efficacy (e.g. games, videos, feedback and activities for regulating feelings). The interventions improving refusal self-efficacy were more often used at home setting and addressed the four sources of self-efficacy with different digital elements regardless of intervention duration and intensity. Although the results on intervention effects varied and the evidence quality remained low, the overall evidence concerning these interventions was encouraging. Based on the subgroup analysis, the results were mainly encouraging among girls. When these interventions are implemented in health promotion, their benefits and weaknesses need to be considered comprehensively. The results provide information for designing and developing digital interventions to support child and adolescent refusal self-efficacy. Further research with larger sample sizes and more rigorous study designs is needed to strengthen the evidence of these interventions.

Refusal self-efficacy determines children's and adolescents' health behavior, for example when they are being offered cigarettes or alcohol and they face the challenge of refusing it. Since digital interventions are potential tools to support refusal self-efficacy, this review examined digital interventions to support refusal self-efficacy in child and adolescent health promotion. Twenty-three studies that examined such interventions were found. Most of the interventions that improved child and adolescent refusal self-efficacy were used in home settings and addressed all sources of self-efficacy regardless of intervention duration. Although the results varied, the interventions in general seemed to improve refusal self-efficacy, especially among girls. However, this study suggests that more high-quality research with more study participants is still needed to make stronger conclusions. Also, the benefits and weaknesses of digital interventions to support refusal self-efficacy need to be considered comprehensively before using them in child and adolescent health promotion.

Supporting LGBTQ+ Students: A Focus Group Study with Junior High School Nurses.

LBGTQ+ students often miss the support and information they need in the school nursing, but little is known about junior high school (JHS) nurses' work with LGBTQ+ students. 15 JHS nurses were interviewed in focus groups about their perceptions of supporting LGBTQ+ students. Four interconnected themes were identified with inductive thematic analysis: (1) JHS nurses' professional identity and practice; (2) Recognition of sexual and gender diversity in school; (3) Family acceptance process; and (4) LGBTQ+ students as school nursing clients. JHS nurses self-identified as accepting professionals, but having limited skills, knowledge, and education needed in supporting LGBTQ+ students. Supporting LGBTQ+ students is a complex phenomenon, and to enhance JHS nurses' competence in providing care for these students, sexual and gender diversity needs to be included in evidence-based nursing information sources, covered in nursing education, and the school needs to be secured as LGBTQ+ safe place.

Developing a Health Game to Prepare Preschool Children for Anesthesia: Formative Study Using a Child-Centered Approach.

BACKGROUND: Every year, millions of children undergo medical procedures that require anesthesia. Fear and anxiety are common among young children undergoing such procedures and can interfere with the child's recovery and well-being. Relaxation, distraction, and education are methods that can be used to prepare children and help them cope with fear and anxiety, and serious games may be a suitable medium for these purposes. User-centered design emphasizes the involvement of end users during the development and testing of products, but involving young, preschool children may be challenging. OBJECTIVE: One objective of this study was to describe the development and usability of a computer-based educational health game intended for preschool children to prepare them for upcoming anesthesia. A further objective was to describe the lessons learned from using a child-centered approach with the young target group. METHODS: A formative mixed methods child (user)-centered study design was used to develop and test the usability of the game. Preschool children (4-6 years old) informed the game design through playful workshops (n=26), and usability testing was conducted through game-playing and interviews (n=16). Data were collected in Iceland and Finland with video-recorded direct observation and interviews, as well as children's drawings, and analyzed with content analysis and descriptive statistics. RESULTS: The children shared their knowledge and ideas about hospitals, different emotions, and their preferences concerning game elements. Testing revealed the high usability of the game and provided important information that was used to modify the game before publishing and that will be used in its further development. CONCLUSIONS: Preschool children can inform game design through playful workshops about health-related subjects that they are not necessarily familiar with but that are relevant for them. The game's usability was improved with the participation of the target group, and the game is now ready for clinical testing.

Experiences of people with progressive memory disorders participating in non-pharmacological interventions: a qualitative systematic review.

OBJECTIVE: The objective of this review was to identify, critically appraise, and synthesize the available evidence on the experiences of people with progressive memory disorders who are involved in non-pharmacological interventions. INTRODUCTION: Non-pharmacological interventions are widely used to improve the quality of life and general well-being of people with progressive memory disorders. While many intervention effects have been studied, a systematic review of experiences is needed. First-hand knowledge and experience provides insight into noteworthy aspects of the use and timing of non-pharmacological interventions both in the community and institutionalized care. INCLUSION CRITERIA: The review included studies of people of all ages with progressive memory disorders who described their experiences participating in professionally delivered non-pharmacological interventions. Interventions delivered in all settings were eligible, with the aim of supporting the well-being of people with progressive memory disorders. METHODS: The search strategy used a three-step approach and sought to locate both published and unpublished studies. Key databases included MEDLINE (PubMed), CINAHL (EBSCO), Medic, Scopus (Elsevier), and PsycArticles (ProQuest). MedNar was used to search for unpublished studies. The databases were searched from the date of inception of the database to May 2020, and a mix of controlled vocabulary (ie, MeSH, CINAHL headings) and keywords were used to capture all existing qualitative studies related to the experiences of people of all ages with progressive memory disorders participating in non-pharmacological interventions. Only English, Swedish, and Finnish studies were included during the screening of the study titles and abstracts. The recommended JBI approach was used for study selection, critical appraisal, data extraction, and data synthesis. RESULTS: Forty-six studies were included in the review. The study designs included qualitative descriptions (n = 31), mixed methods (n = 8), grounded theory (n = 5), and ethnography (n = 2). The total number of participants was 444. The overall quality of the studies was rated as low or very low on the ConQual score, with dependability rated as low or moderate and credibility as moderate. Altogether, 189 findings were aggregated into eight categories and three synthesized findings. The synthesized findings describing the experiences of people with progressive memory disorders participating in a non-pharmacological intervention were as follows: i) it strengthened the sense of personhood; ii) it lightened up my life; and iii) what I find meaningful is that it was meant for us. CONCLUSIONS: People with progressive memory disorders welcome non-pharmacological interventions. It is noteworthy that, regardless of what the interventions entailed, the participants experienced strengthened self-esteem and positive alterations to their daily life. To achieve the desired benefits, intervention development should embody communication based on equality and respect for those with memory disorders. However, the level of evidence of the review findings was evaluated as low or very low, which needs to be considered when applying the results in clinical practice.

Factors determining nurses' knowledge of evidence-based pressure ulcer prevention practices in Finland: a correlational cross-sectional study.

BACKGROUND: Pressure ulcers cause economic burden, human suffering, pain and decreased health-related quality of life in patients. Pressure ulcers are preventable in most cases, and nursing staff knowledge is a key factor in successful pressure ulcer prevention. Further evidence is needed to better tailor pressure ulcer prevention training programmes to the nursing staff. AIM: To evaluate the level of nursing staff knowledge about evidence-based pressure ulcer prevention practices in both primary and specialised care, and to identify what factors determine nurses' knowledge levels. METHODS: A correlational, cross-sectional study was conducted from 2018 to 2019 in two hospital districts in Finland. The Pressure Ulcer Prevention Knowledge test was used to collect data, and the Attitude towards Pressure ulcer Prevention (APuP) instrument was used as a background variable. The data were statistically analysed with Wilcoxon and Kruskal-Wallis tests, Spearman correlations and multiple linear regression. RESULTS: The pressure ulcer prevention knowledge of the participating registered nurses, practical nurses and ward managers (N = 554) was on average 24.40 (max. 35.00). There was no difference in the participants' knowledge based on the type of unit in which they were working (primary or specialised care). The participants' attitudes (p < 0.0001), current position (p = 0.0042), frequency of taking care of patients with pressure ulcers (p = 0.0001) and self-evaluated training needs (p < 0.0001) independently explained the variation in the knowledge scores. CONCLUSIONS: Special attention needs to be paid to the knowledge of those nurses working in positions that require lower levels of education and those who rarely take care of patients with pressure ulcers. Supporting nurses' positive attitudes towards pressure ulcer prevention should be an essential part of pressure ulcer prevention training. Nurses' self-evaluations of their training needs can be used to target training. The limitations of the study should be considered when generalising the results.

Examining Empowerment Interventions With Families and Preschool Children: Systematic Review of Randomized Controlled Trials.

Empowerment is a core construct in health behavior and an emerging trend in pediatrics. Although it has been suggested as an approach that may promote the person's participation in health care decisions and positive outcomes, little is known about the nature and effectiveness of interventions to support empowerment in families and preschool-age children. The aim of this review is to identify, appraise, and synthesize the evidence on health interventions explicitly using empowerment as an orienting concept with families and their preschool-age children. We identified randomized controlled trials (RCTs) through systematic searches of eight databases for articles published between 1986 and January 2019 and included RCTs that addressed empowerment as a health intervention approach or outcome and that studied families with 3- to 5-year-old children. The application of empowerment theory, the family and child involvement, and the use of behavior change techniques (BCTs) were assessed through appropriate frameworks. Ten interventions were identified, and 50% of them showed positive outcomes. Most studies claimed a theoretical base. However, the studies provided limited details on theory application in intervention planning, implementation, and evaluation, and the children's involvement in the interventions was generally scarce. The most commonly applied BCT was "instruction in how to perform the behavior." We identified 16 potentially effective BCTs. The evidence was not sufficiently robust to determine the effectiveness of empowerment interventions with families and preschool-age children. Additional high-quality studies are needed to produce clearer conclusions. Our results are useful for the design and evaluation of future interventions.

Attitudes of nursing staff towards pressure ulcer prevention in primary and specialised health care: A correlational cross-sectional study.

The aim of this correlational, cross-sectional study was to assess the pressure ulcer prevention attitudes of the nursing staff and to identify factors associated with it both in primary and special health care. The study was conducted with nursing staff (N = 554) working in primary and special health care units in two hospital districts in Finlandin 2018 to 2019. Attitude towards Pressure ulcer Prevention instrument was used for data collection. Demographic data, Pressure Ulcer Prevention Knowledge test, and Pressure Ulcer Prevention Practice instrument were used as background variables. Data were analysed with statistical tests. Nursing staff working in primary care (n = 327) had more positive attitudes towards pressure ulcer prevention than those in specialised care (n = 209; P = .047). Working as a wound care nurse (P = .0005), working experience after graduation (P = .0017), self-reported pressure ulcer prevention and early detection skills (P < .0001), pressure ulcer prevention knowledge (P = .0002), and views about the realisation of their unit's pressure ulcer prevention practices (P < .0001) independently explained variation in participants' attitudes. Attention should be placed on the pressure ulcer prevention attitudes of nurses who are less experienced or less skilled and who have lower pressure ulcer prevention knowledge. Positive organisational culture towards evidence-based pressure ulcer prevention practices should be promoted.

Efetividade da versão portuguesa do Fume na literacia em saúde de adolescentes acerca do tabaco / Effectiveness of the Portuguese version of Fume in adolescents' health literacy about tobacco / Efectividad de la versión portuguesa de Fume en la alfabetización en salud de los adolescentes sobre el tabaco

Resumo Objetivo Avaliar a efetividade da versão traduzida para português europeu do mobile health game Fume (No Fume), no que diz respeito à literacia em saúde de adolescentes em contexto escolar sobre as questões relacionadas com o tabaco. Método Estudo quantitativo, quase-experimental, com avaliação pré-teste e pós-teste, com uma amostra por conveniência de 144 adolescentes, dividida por um grupo experimental e um grupo de controle, realizado em duas escolas públicas do 2º e 3º ciclo do ensino básico de uma cidade do distrito de Coimbra, região centro de Portugal. Resultados Verificou-se, nos adolescentes que utilizaram o No Fume (grupo experimental), uma evolução favorável, estatisticamente significativa, nas expetativas negativas sobre fumar (p = 0,033). Conclusão O No Fume revelou um efeito positivo nas expetativas negativas sobre fumar dos adolescentes. Deve investir-se no desenvolvimento do No Fume para maximizar o seu potencial de utilização pois, enquanto tecnologia educativa baseada na gamificação, poderá contribuir para o alargamento e disseminação de intervenções inovadoras promotoras da saúde mental dos adolescentes

Abstract Objective To evaluate the effectiveness of the version translated into European Portuguese of the Fume mobile health game (No Fume), with regard to the health literacy of adolescents in the school context on tobacco-related issues. Method A quantitative and quasi-experimental study, with pre-test and post-test evaluation, conducted with a convenience sample of 144 adolescents, divided into an experimental group and a control group, carried out in two public schools serving the 2nd and 3rd cycles of elementary education from a city in the district of Coimbra, central region of Portugal. Results Among the adolescents who used No Fume (experimental group), a statistically significant and favorable evolution was verified in the negative expectations about smoking (p = 0.033). Conclusion No Fume revealed a positive effect on the negative expectations about smoking among the adolescents. Investments should be made in developing No Fume in order to maximize its potential for use since, as an educational technology based on gamification, it may come to contribute to the expansion and dissemination of innovative interventions that promote adolescents' mental health.

Resumen Objectivo Evaluar la efectividad de la versión traducida al portugués europeo del mobile health game Fume (No Fume) en la alfabetización en salud de los adolescentes en un contexto escolar sobre temas relacionados con el tabaco. Método Estudio cuantitativo, cuasiexperimental, con evaluación pretest y postest, con una muestra por conveniencia de 144 adolescentes dividida en un grupo experimental y un grupo de control, realizado en dos escuelas públicas del segundo y tercer ciclo de educación básica de una ciudad en el distrito de Coímbra, región central de Portugal. Resultados Los adolescentes que utilizaron No Fume (grupo experimental), tuvieron una evolución favorable estadísticamente significativa en las expectativas negativas sobre fumar (p = 0,033). Conclusión No Fume reveló un efecto positivo sobre las expectativas negativas sobre fumar en los adolescentes. Se debe invertir en el desarrollo de No Fume para maximizar su potencial de uso porque, como tecnología educativa basada en la gamificación, puede contribuir a la expansión y difusión de intervenciones innovadoras que promuevan la salud mental de los adolescentes.

Measuring Empowerment Counselling in Routine Primary Health Care: Psychometric Properties of a Portuguese Adaptation of the Empowering Speech Practices Scale.

PURPOSE: Empowerment is a widely accepted approach to health promotion in which primary care nurses play an important role. Despite its clinical importance, empirical knowledge is low, mainly due to the lack of instruments to measure this construct. The Empowering Speech Practices Scale (ESPS) is a Finnish measure used to assess the empowerment process in counselling sessions. We designed this study to assess the psychometric properties of a Portuguese adaptation of the ESPS for families of 5-year-old children and nurses in well-child visits. DESIGN AND METHODS: We used a cross-sectional survey design. The ESPS was translated and adapted to the context of children and family health promotion. We administered a sociodemographic questionnaire and the Portuguese ESPS to a sample of 82 families attending a 5-year-old well-child visit and 25 primary care nurses in Portugal. We evaluated the Portuguese ESPS for construct validity and internal consistency. RESULTS: Exploratory factor analysis supported a 44-item scale, two-component model, which is similar to the original version, explaining 73.79% of the total variance. Each subscale presented excellent internal consistency and distinguished consultations conducted by nurses with academic training in empowerment patient education. CONCLUSIONS AND IMPLICATIONS: The Portuguese ESPS is a valid and reliable instrument for assessing empowerment in health counselling with families in well-child visits. It looks at the process from two perspectives: the nurses' and the families' perspectives. It can be useful to evaluate quality of care, to identify areas of improvement, and to delve deeper into relationships between empowerment and health outcomes.

LGBTQ+ Students' Experiences of Junior High School Nursing in Finland: A Qualitative Study.

Previous research shows that lesbian, gay, bisexual, transgender, queer/questioning, and other (LGBTQ+) students can experience substantial emotional- and health-related issues at school, but research into LGBTQ+ students' experiences of school nursing is limited. This qualitative study describes the experiences of Finnish LGBTQ+ students engaging with junior high school nurses. Data were collected from 35 LGBTQ+ students using an online survey tool comprising of a set of open-ended questions. Two interconnecting themes were identified following thematic analysis: (1) junior high school nurse engagement: a mixed or unsatisfactory experience and (2) LGBTQ+ students' needs for diversity-affirming junior high school nursing. Findings show that LGBQT+ students felt junior high school nurse engagement was often unsupportive with issues around their sexuality and gender identity. LGBTQ+ students expressed the need for diversity-affirming information and support in school settings. Further research from school nurses' perspective is needed to increase understanding of this topic.

Instrumentos de avaliação da literacia em saúde acerca do tabaco: tradução e adaptação para português europeu / Instrumentos para evaluar la alfabetización en salud sobre el tabaco: traducción y adaptación al portugués europeo / Instruments for assessing tobacco-related health literacy: translation and adaptation to european portuguese

RESUMO Objetivo traduzir e adaptar culturalmente para português europeu os instrumentos de avaliação da literacia em saúde acerca do tabaco Attitudes Towards Tobacco Use, Tobacco-Use Motives e Motivation to Decline Tobacco Use in the Future, e Smoking Outcome Expectation Scale e Anti-Smoking Self-Efficacy Scale, e realizar validação preliminar Método tradução e adaptação transcultural de acordo com as recomendações do Institute for Work and Health e validação preliminar em 144 adolescentes de duas escolas públicas da região central de Portugal, em abril e maio de 2019 Resultados foram retirados itens relativos a snus, por não apresentarem relevância no contexto português. Assim, dois instrumentos passaram a ser constituídos apenas por um item. Os valores de alfa de Cronbach das versões em português europeu foram 0,799, 0,673, 0,905 e 0,890 Conclusão contribui para a existência de instrumentos de avaliação da literacia em saúde acerca do tabaco, adaptados para português europeu, para a população dos adolescentes

RESUMEN Objetivo traducir y adaptar culturalmente al portugués europeo los instrumentos de evaluación de la alfabetización en salud sobre el tabaco Attitudes Towards Tobacco Use, Tobacco-Use Motives y Motivation to Decline Tobacco Use in the Future, y Smoking Outcome Expectation Scale y Anti-Smoking Self-Efficacy Scale, y realizar una validación preliminar Método traducción y adaptación transcultural según las recomendaciones del Institute for Work and Health y validación preliminar en 144 adolescentes de dos escuelas públicas de la región central de Portugal, en abril y mayo de 2019 Resultados se eliminaron los artículos relacionados con la snus, ya que no eran relevantes en el contexto portugués. De este modo, dos instrumentos se componen de un solo ítem. Los valores del alfa de Cronbach de las versiones en portugués europeo fueron 0,799, 0,673, 0,905 y 0,890 Conclusión contribuye a la existencia de instrumentos de evaluación de la alfabetización en salud sobre el tabaco, adaptados al portugués europeo, para la población adolescente

ABSTRACT Objectives To translate and culturally adapt to European Portuguese the tobacco-related health literacy assessment instruments "Attitudes Towards Tobacco Use," "Tobacco-Use Motives," "Motivation to Decline Tobacco Use in the Future," "Smoking Outcome Expectation Scale," and "Anti-Smoking Self-Efficacy Scale"; and to conduct the preliminary validation of the translated versions Methodology Translation and cross-cultural adaptation in accordance with the Institute for Work & Health recommendations and preliminary validation study using a sample of 144 adolescents from two public schools in central Portugal in April and May 2019 Results Snus-related items were removed due to their lack of relevance in the Portuguese context. Thus, two instruments consisted of only one item each. The European Portuguese versions of the instruments presented Cronbach's alpha scores of 0.799, 0.673, 0.905, and 0.890 Conclusion The present study contributed to developing European Portuguese versions of instruments for assessing tobacco-related health literacy among adolescents

Two sides of the same well-child visit: Analysis of nurses' and families' perspectives on empowerment in health counselling.

AIMS: To explore the degree of empowering health counselling in well-child visits, considering nurse and family perspectives and to examine its associated factors. BACKGROUND: Empowerment has gained high priority in the world health strategy, being claimed for its benefits for people's health and well-being. DESIGN: The design includes an exploratory cross-sectional, correlational study. METHODS: We collected data between January 2018-October 2019 from a convenience sample of 82 families attending a 5-year-old well-child visit and 25 nurses at Portuguese health centres. Families and nurses assessed the same counselling session using parallel statements of the Portuguese Empowering Speech Practice Scale, grouped in two subscales (nurses' action and families' action). Questionnaires also included the Parent's Longitudinal Continuity in Primary Care scale, the Family Nutrition and Physical Activity tool and anthropometric and sociodemographic questions. We employed descriptive statistics, paired-samples t-test, analysis of variance and regression analysis. RESULTS: Both nurses and families reported that empowerment had been practiced in high degree. The most practiced elements were those from nurses' action subscale (e.g. constructing a positive atmosphere) and the least practiced were from families' action (e.g. disclosure). A discrepancy between nurses' and families' ratings were found for individualized information and advice, disclosure and asking questions, with families reporting higher scores. Nurses' formal training in empowerment and obesity was associated with higher scores on the nurses' action subscale. The families' limited experience with a regular health centre and nurse and families having children with overweight were both associated with lower scores on the two subscales. CONCLUSIONS: Although the positive experience by nurses and families is an important finding, the reasons for the differences in perceptions of empowerment require further research. IMPACT: The Portuguese Empowering Speech Practice Scale can be a useful tool to evaluate services, both from professionals' and families' perspectives and to identify areas of improvement.

Experiences of people with progressive memory disorders receiving non-pharmacological interventions: a qualitative systematic review protocol.

OBJECTIVE: This systematic review aims to identify, critically appraise, and synthesize the best available literature on the experiences of people with progressive memory disorders who are involved in non-pharmacological interventions. INTRODUCTION: Some non-pharmacological interventions have been demonstrated to have a significant effect in reducing functional decline in people with progressive memory disorders. Additionally, there is evidence that people with progressive memory disorders have a need for activities tailored to their abilities and interests. INCLUSION CRITERIA: This review will consider studies that describe the experiences of people with progressive memory disorders with non-pharmacological interventions. No limitations regarding care facilities will be made. METHODS: The databases to be searched will include PubMed, CINAHL, Medic, Scopus and PsycARTICLES, as well as MedNar for unpublished studies. Studies published in English, Finnish and Swedish will be considered for inclusion in this review, which will use a three-step search strategy. The papers selected for retrieval will be assessed by two independent reviewers for methodological validity prior to inclusion in the review using standardized critical appraisal instruments and findings will be pooled using meta-aggregation.