Psychometric Evaluation of a Rubric to Assess Basic Performance During Simulation in Nursing.

AIM: This study was conducted to evaluate the psychometric properties of a rubric to assess nursing student performance in medium- and low-fidelity simulation. METHOD: A psychometric study was carried out. Content validity was explored by a group of experts. Internal consistency was determined by means of Cronbach's coefficient alpha. Interrater agreement and the level of concordance were established by the kappa coefficient and intraclass correlation index. RESULTS: The relevance of the dimensions and the definition of each category scored higher than 3.25 on a Likert-type scale (maximum value of 4); content validity ratio values were close to +1. The kappa index was above 0.61 (p < .001) in all dimensions, thereby indicating a good level of interrater agreement; the intraclass correlation index showed values above .82 (p < .001). CONCLUSION: The rubric appears to be psychometrically sound, thus supporting its reliability.

Humanizing Birth in a Third-Level Hospital: Revealing the Benefits of Natural Cesarean Sections.

BACKGROUND AND AIMS: Efforts to humanize childbirth focus on promoting skin-to-skin contact, labor accompaniment, and breastfeeding. Despite these advancements, cesarean sections often lack a consideration of immediate mother-child contact, early breastfeeding initiation, and follow-up. This underscores the need for a 'natural' approach to cesarean sections, aiming to 'humanize' the procedure and emulate some aspects of vaginal birth. MATERIALS AND METHODS: An observational longitudinal cohort study was conducted, involving pregnant women scheduled for a cesarean section. Two comparison groups were established: one undergoing conventional cesarean sections and the other receiving a humanization intervention. While in "conventional cesarean sections," newborns are separated from mothers at birth, preventing actions such as early breastfeeding or skin-to-skin contact, and maternal companionship is lacking in the operating room, the intervention of cesarean section humanization was based on avoiding the separation of the mother and newborn, promoting skin-to-skin contact, early breastfeeding, and maternal accompaniment during surgery. Descriptive data on maternal and neonatal variables, including breastfeeding initiation, maintenance, and baby weight trends, were collected. Additionally, a validated survey assessed the pain, satisfaction, and anxiety among the 73 participating women. RESULTS: Women undergoing natural cesarean sections reported higher satisfaction, lower anxiety, and reduced postoperative pain, requiring less analgesia. Although their exclusive breastfeeding rates at 10 days postpartum showed no significant difference, statistically significant differences favored natural cesarean sections at 3 months (67.5% vs. 25%) and 6 months (50% vs. 4.5%). Neonates in the natural cesarean group exhibited greater weight gain at 10 days postpartum compared to those delivered conventionally (+49.90 g vs. -39.52 g). No significant differences in blood counts were observed between the groups. CONCLUSIONS: This study underscores the manifold advantages offered by the natural cesarean procedure compared to the conventional cesarean approach. Notably, a NC demonstrates superior outcomes in terms of heightened maternal satisfaction with the obstetric process, the enhanced sustainability of exclusive breastfeeding, and augmented neonatal weight gain.

Psychological distress in relatives of critically ill patients: Risk and protective factors.

The admission to an intensive care unit can result in a significant burden of emotional distress in the family. This study analyzes the psychological distress of 89 relatives of intensive care unit patients and the potential risk/protective factors for such distress. Families show high levels of anxiety, depression, and stress. Regarding risk factors, having steady partner, being a woman, and being a mother are associated with increased risk of anxiety, depression, and stress. Contrarily, being younger and having higher educational level are associated with reduced anxiety and stress. Influencing these trends could change positively the suffering course experienced by relatives and intensive care unit patients indirectly.