Development, Validity and Reliability of Objective Structured Clinical Examination in Nursing Students.

Introduction: The adoption of measurement instruments such as the Objective Structured Clinical Examination (OSCE) is essential to assess clinical competencies in nursing students. Objective: The purpose of this study is to develop an OSCE, analyze its validity and reliability in the nursing curriculum and measure self-assessment, stress and satisfaction. Methods: The observational validation study of a measurement instrument was carried out in two phases: the design and development of the OSCE and validity and reliability analysis. Results: A total of 118 students participated in the study. Ten scenarios were designed that incorporated six competency components extracted from the curriculum. Good results were obtained in face validity, content validity (CVI .82-.95), criterion validity (r = .71, p < .001), and reliability (α Cronbach .84). Satisfaction and stress scores were high, and self-assessment scores were lower than the scores obtained. Conclusion: A rigorously designed OSCE provides a reliable and valid method for assessing the clinical competence of nursing students.

Usability of a mobile application for health professionals in home care services: a user-centered approach.

The use of mobile devices by healthcare professionals has led to rapid growth in the development of mobile healthcare applications designed to improve healthcare services. This study was conducted to assess the acceptability and usability of a mobile application for health professionals in relation to their work in hospitalization at home. A mixed methods approach was used. Acceptance, included the satisfaction of the professionals, attitudes toward using the application, and intention or willingness to continue using the application. Usability tests were performed in laboratory analyzing five controlled clinical tasks, and the interaction of the participants with the mobile application was based on the six basic facial expressions published by the American Psychological Association. Perceived satisfaction was assessed using the computer system usability questionnaire. Thirty-two participants completed the task scenarios and questionnaire. More than 90 per cent of participants were able to complete the tasks with only some difficult with vital signs. Satisfaction had a score of 6.18/7 (SD: 0.76), and recommendation of the mobile application had a score of 6.21/7 (SD: 0.81). This study showed a significant usability and acceptability of this mobile application, in terms of effectiveness, efficiency, and satisfaction.

COVID-19 Incidence and Mortality in Patients Operated on for Breast Cancer. Comparison with the General Population.

BACKGROUND: Breast Cancer (BC) remains the most diagnosed malignancy and the most common cause of cancer-related mortality in women worldwide. Covid-19 mortality in BC patients has been linked to comorbid conditions rather than to cancer treatment itself, although this was not confirmed by a meta-analysis. Also, during Covid-19 outbreaks, a great deal of health care resources is reassigned to critical Covid-19 patients. PATIENTS AND METHODS: During 5 consecutive trimesters (from 1/12/2020 to 31/3/2021) 2511 BC patients older than 20 years from our institution were surveyed. 1043 of them had received a Covid test and these made our study group, which was conveniently compared with the Covid-19 tested background feminine Catalan population. RESULTS: 13.1% of our patients presented with a positive Covid-19 test, whereas confirmed COVID-19 infection amounted to 7.1% of the feminine Catalan tested population. The COVID-19-specific mortality rate was 11.7% (16/137) in the study group, which compares with a 4.7% rate for the overall population. Most deaths occurred in patients over 70. CONCLUSION: Three clinical factors were significantly associated with Covid-19 mortality in BC, namely lack of hormone therapy, distant metastases, and BC dwelling in nursing homes. BC patients are at a higher risk of Covid-19 infection and mortality in comparison with the reference group without BC.

Perception of the Online Learning Environment of Nursing Students in Slovenia: Validation of the DREEM Questionnaire.

At the time of the outbreak of the coronavirus pandemic, several measures were in place to limit the spread of the virus, such as lockdown and restriction of social contacts. Many colleges thus had to shift their education from personal to online form overnight. The educational environment itself has a significant influence on students' learning outcomes, knowledge, and satisfaction. This study aims to validate the tool for assessing the educational environment in the Slovenian nursing student population. To assess the educational environment, we used the DREEM tool distributed among nursing students using an online platform. First, we translated the survey questionnaire from English into Slovenian using the reverse translation technique. We also validated the DREEM survey questionnaire. We performed psychometric testing and content validation. I-CVI and S-CVI are at an acceptable level. A high degree of internal consistency was present, as Cronbach's alpha was 0.951. The questionnaire was completed by 174 participants, of whom 30 were men and 143 were women. One person did not define gender. The mean age of students was 21.1 years (SD = 3.96). The mean DREEM score was 122.2. The mean grade of student perception of learning was 58.54%, student perception of teachers was 65.68%, student academic self-perception was 61.88%, student perception of the atmosphere was 60.63%, and social self-perception of students was 58.93%. Although coronavirus has affected the educational process, students still perceive the educational environment as positive. Nevertheless, there is still room for improvement in all assessed areas.

Adaptation and validation of a Spanish version of the KidSIM Team Performance Scale.

BACKGROUND: Interprofessional education offers students from different disciplines the opportunity to share learning experiences. PURPOSE: To develop and validate a Spanish version of the KidSIM Team Performance Scale, thus providing a tool for assessing the team performance of undergraduate health professionals in our cultural context. METHOD: Descriptive observational study consisting of two phases: a) translation and adaptation of the original instrument, b) validation of the Spanish version. RESULTS: The Spanish version comprises 11 items and is linguistically and conceptually equivalent to the original scale. Factor analysis yielded a model comprising three factors: roles and leadership capacity, communication, and use of resources. Internal consistency was good (Cronbach's alpha = 0.85), while inter-observer agreement was moderate (Cohen's kappa = 0.58). The RMSEA fit index was acceptable (0.0801 [0.0618-0.115]). CONCLUSION: The Spanish version of the KidSIM Team Performance Scale is a valid and reliable tool for assessing simulated teamwork among undergraduate health professionals.

Magnetic resonance imaging in the preoperative setting for breast cancer patients with undetected additional disease.

OBJECTIVE: The last few years have witnessed a significant increase in the preoperative use of Magnetic Resonance Imaging (MRI) for staging purposes in breast cancer (BC) patients. Many studies have confirmed the improvement that MRI can provide in terms of diagnostic assessment, especially with regard to additional disease foci. In the present study, we address the advantages and disadvantages of MRI in the preoperative setting for BC patients. PATIENTS AND METHODS: There were 1513 consecutive breast MRI studies performed in patients with either primary or recurrent BC, who were scheduled for surgery. RESULTS: Beyond the primary lesion, 10.4% of our cases had additional disease at the final histological assessment. MRI overall sensitivity, when considering tumour size and additional foci together, was 74.3%, and 80.3% when considering additional foci exclusively. MRI specificity for additional disease was 95.3%, positive predictive value was 77.4%, and negative predictive value was 94.6%. Nevertheless, 5% of cases had additional tumours that were missed by MRI or, conversely, had additional foci on MRI that were not confirmed by histology. Age (p=0.020) and lobular carcinomas (p=0.030) showed significance in the multivariate analysis by logistic regression, using the presence of additional foci diagnosed by MRI as a dependent variable. CONCLUSION: Preoperative MRI seems to have a role in preoperative tumour staging for breast cancer patients, as it discloses additional disease foci in some patients, including contralateral involvement. However, given the lack of absolute accuracy, core-needle biopsy cannot be neglected in the diagnosis of such additional malignant foci, which could result in a change in surgical treatment.

Developing a decision aid to support informed choices for newly diagnosed patients with localized prostate cancer.

BACKGROUND: Decision aids (DAs) have been developed in several health disciplines to support decision making informed by evidence, such as the benefits and risks of different treatment options. Decision aids can improve the decision-making process by reducing decisional conflict and helping patients to participate in decision making. OBJECTIVE: The aim of this study was to design and develop a DA for treatment decision making in localized prostate cancer in Spain with regard to surgery, radiotherapy, or watchful waiting. INTERVENTIONS/METHODS: We developed a DA based on the principles of the International Patient Decision Aid Standards Collaboration and according to the Ottawa Decision Support Framework. The structural development process involved DA developers, expert feedback, use of the Delphi method, and patient feedback. We conducted a pilot test on 34 men with localized prostate cancer. RESULTS: The DA is a structured booklet. According to the International Patient Decision Aid Standards checklist, the DA scored 22 of 27 points (81.48%). The development process section scored 22 of 24 points (91.6%), and the effectiveness of the decision-making process section scored 6 of 6 (100%). The clinical pilot test yielded positive feedback regarding the design, images, understandability, usability, explanations, and amount of information in the DA. CONCLUSIONS: We developed a Spanish DA with a strong quality score to help patients make an informed choice regarding their prostate cancer treatment. Future research will assess the impact of the DA and its association with improved decision making. IMPLICATIONS FOR PRACTICE: This tool provides information about the risks and benefits of different treatment options and helps patients to understand the importance of their own values for informing treatment choices.

A Decision Aid to Support Informed Choices for Patients Recently Diagnosed With Prostate Cancer: A Randomized Controlled Trial.

BACKGROUND: Decision aids provide balanced information about the benefits and risks of treatment options and improve the match between patient preferences and the treatment received. OBJECTIVE: To assess the impact of a decision aid regarding the treatment options for patients with localized prostate cancer. METHODS: A 2-arm randomized controlled trial was used to compare booklet patient decision aid (intervention group n = 61) with standard information for localized prostate cancer (control group n = 61). The study was conducted at 3 hospitals between 2011 and 2013. The main outcome measures were knowledge, decisional conflict, satisfaction with the decision-making process, and coping. RESULTS: The respective mean Decisional Conflict Scale scores before and after the intervention were 53.0 ± 16.9 and 31.2 ± 10.2 in the intervention group and 49.1 ± 13.7 and 51.7 ± 13.3 in the control group (P < .001). Mean Knowledge scores were 38.6 ± 16.5 and 75.7 ± 19.0 in the intervention group and 42.0 ± 17.6 and 49.9 ± 16.0 in the control group (P < .001). Mean Satisfaction With Decision Scale scores were 81.1 ± 8.92 and 95.7 ± 6.89 in the intervention group and 82.5 ± 12.0 and 79.3 ± 10.3 in the control group (P < .001). CONCLUSIONS: Decision aid not only improved patient knowledge about localized prostate cancer and its treatment and their satisfaction with decision making but also decreased their decisional conflict. IMPLICATIONS FOR PRACTICE: Decision aid represents a rather innovative approach for a health insurance fund to develop and offer this format of information and decision support. This opens a new field of study for nurses to empower patients in the decision-making process and develop new roles in this area.

[Spanish version of the Satisfaction With Decision scale: cross-cultural adaptation, validity and reliability]. / Versión española de la Satisfaction With Decision scale: adaptación transcultural, validez y fiabilidad.

OBJECTIVE: The aim of this study is to develop a Spanish version of the Satisfaction With Decision scale (SWDs) and analyse the psychometric properties of validity and reliability. DESIGN: An observational, descriptive study and validation of a tool to measure satisfaction with the decision. SETTING: Urology, Radiation oncology, and Medical oncology Departments of the Hospital Universitari Germans Trias i Pujol, Institut Català d'Oncologia and the Institut Oncològic del Vallès - Hospital General de Catalunya. PARTICIPANTS: A total of 170 participants diagnosed with prostate cancer, and who could read and write in Spanish and gave their informed consent. MAIN MEASUREMENTS: A translation, back-translation and cross-cultural adaptation to Spanish was performed on the SWDs. The content validity, criterion validity, construct validity and reliability (internal consistency and stability) of the Spanish version were evaluated. RESULTS: The SWDs contains 6 items with 5-item Likert scales. A Spanish version (ESD) was obtained that was linguistically and conceptually equivalent to the original version. Criterion validity, the ESD correlated with "satisfaction with the decision" using a linear analogue scale, was significant (r=0.63, P<.01) for all items. The factorial analysis showed a unique dimension to explain 82.08% of the variance. The ESD showed excellent results in terms of internal consistency (Cronbach alpha=0.95) and good test-retest reliability with intraclass correlation coefficient of 0.711. CONCLUSIONS: The ESD is a validated Spanish scale to measure the satisfaction with the decisions taken in health, and demonstrates a correct validity and reliability.