Leadership and contagion by COVID-19 among residence hall students: A social network analysis approach.

University students have changed their behaviour due to the COVID-19 pandemic. In this paper, we describe the characteristics of PCR+ and PCR- nodes, analyse the structure, and relate the structure of student leaders to pandemic contagion as determined by PCR+ in 93 residential university students. Leadership comes from the male students of social science degrees who have PCR +, with an eigenvector centrality structure, ß-centrality, and who are part of the bow-tie structure. There was a significant difference in ß-centrality between leaders and non-leaders and in ß-centrality between PCR+ and non-leaders. Leading nodes were part of the bow-tie structure. MR-QAP results show how residence and scientific branch were the most important factors in network formation. Therefore, university leaders should consider influential leaders, as they are vectors for disseminating both positive and negative outcomes.

Men who have sex with men: An approach to social network analysis.

BACKGROUND: Dating apps for men who have sex with men (MSM) have favored unprotected sexual encounters; other unsafe practices, including drug use, are widespread. No evidence is available from the perspective of the structure of their relationships, a personal aspect included in all nursing meta-paradigms. AIM: To study the structure of MSM networks through dating and contact applications and this relationship to risky sexual activities such as condom use, chemsex (sex while using drug), and group sex. DESIGN: Descriptive cross-sectional study. SAMPLE: A total of 32 MSM participants from Madrid (Spain). MEASUREMENTS: Socio-demographic and structural variables with Social Network Analysis (SNA) metrics. Data on condom use, drug use during encounters, and group sex were included. RESULTS: Twenty-five percent of respondents practiced chemsex, and 75% of these used poppers. MSM with higher socioeconomic status participated in group sex sessions more frequently than those with lower socioeconomics. Within the network analysis, the relationships strong showed greater ease in having unprotected anal intercourse. CONCLUSION: SNA can be effective in the study of MSM sexual networks and their risk behaviors for community nurses to improve their interventions in sexual health promotion.

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.

Development and validation of a questionnaire for assessing patients´ perceptions of interprofessional integration in health care.

The integration of care between primary, secondary, tertiary health care and social care needs to be interprofessional and patient-centered. The aim of this study was to develop and validate a questionnaire for measuring patients' perception of integration across health care teams and social services. Data for psychometric assessment of our questionnaire were collected from patients who attended at eleven Primary Care Centers and one tertiary referral Hospital in Spain from March to October 2018. The questionnaire was tested in a pilot study with 40 patients before being administered in a sample of 279 patients. The questionnaires were distributed in urban Health Centers, peri-urban or rural Health Centers (67%) and a tertiary referral hospital (33%). The questionnaire included 9 items that measured patient perceived experiences about care coordination, data accessibility and delivery of clinical information. The model explained 51% of the variation in the data and Cronbach's alpha was 0.8. Two factors comprising perception of coordination and assessment of patient-centered care were identified. The overall perception for integration was low. The reliability and validation of our questionnaire showed its potential as a valuable instrument for assessing patients' perception of the integration of care and can be used within the quality metrics to assess the success of integrated health care management programs.

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.

Thermal Infrared Imaging to Evaluate Emotional Competences in Nursing Students: A First Approach through a Case Study.

During university studies of nursing, it is important to develop emotional skills for their impact on academic performance and the quality of patient care. Thermography is a technology that could be applied during nursing training to evaluate emotional skills. The objective is to evaluate the effect of thermography as the tool for monitoring and improving emotional skills in student nurses through a case study. The student was subjected to different emotions. The stimuli applied were video and music. The process consisted of measuring the facial temperatures during each emotion and stimulus in three phases: acclimatization, stimulus, and response. Thermographic data acquisition was performed with an FLIR E6 camera. The analysis was complemented with the environmental data (temperature and humidity). With the video stimulus, the start and final forehead temperature from testing phases, showed a different behavior between the positive (joy: 34.5 °C-34.5 °C) and negative (anger: 36.1 °C-35.1 °C) emotions during the acclimatization phase, different from the increase experienced in the stimulus (joy: 34.7 °C-35.0 °C and anger: 35.0 °C-35.0 °C) and response phases (joy: 35.0 °C-35.0 °C and anger: 34.8 °C-35.0 °C). With the music stimulus, the emotions showed different patterns in each phase (joy: 34.2 °C-33.9 °C-33.4 °C and anger: 33.8 °C-33.4 °C-33.8 °C). Whenever the subject is exposed to a stimulus, there is a thermal bodily response. All of the facial areas follow a common thermal pattern in response to the stimulus, with the exception of the nose. Thermography is a technique suitable for the stimulation practices in emotional skills, given that it is non-invasive, it is quantifiable, and easy to access.

Co-operative Networks and their Influence on Engagement: A Study with Students of a Degree in Nursing.

At present, the European Higher Education Area (EHEA) emphasizes the importance of collaborative learning in University education. Previous studies have found evidence to support collaborative activities; however, none have analyzed the influence of contact networks among students on their engagement and performance. This paper reports an intervention with nursing degree students aimed at facilitating an interdependent network to promote engagement and improve academic performance. The intervention was based on recording a video during a case study. The variables analyzed were network centrality, engagement and performance. The UCINET program was used to analyse social networks. The results showed a more cohesive network after the intervention and a high level of academic performance. The use of contact networks among students could be used as an academic strategy to build bridges between students in the classroom and even between these and students in other classrooms or centres.

Changes in use, knowledge, beliefs and attitudes relating to tobacco among nursing and physiotherapy students: a 10-year analysis.

AIM: To analyse changes in prevalence, knowledge, beliefs and attitudes relating to smoking among undergraduate nursing and physiotherapy students over a 10-year period. BACKGROUND: Few studies have been performed to describe changes in the use of tobacco and associated characteristics. DESIGN: This study was a sequential cross-sectional study. METHODS: A self-administered survey was performed during three academic years among nursing and physiotherapy students in a Spanish Faculty of Health Sciences. FINDINGS: The proportion of smokers among nursing and physiotherapy students in 2003, 2008 and 2013 was 29·3%, 24·7% and 18·2% respectively. The ages when participants first smoked did not vary over the years. The Fagerström test showed low nicotine dependence. A significantly high percentage of students stated they were unaware of the link between smoking and bladder cancer and oral leukoplakia. Students declared they were unaware of the association between under-weight new-borns and second-hand smoke. The majority of students recognized that healthcare professionals were role models in society, there being little variation over the years studied. In relation to education and training, the study showed a need to inform students about methods and strategies to help people quit smoking. CONCLUSIONS: The prevalence of smoking among nursing and physiotherapy students decreased over the ten years. Active programmes should be implemented to encourage those university students who smoke to break this habit. The decline over the years in knowledge about smoking provided evidence of a significant deficit in undergraduate training.

Adolescent relational behaviour and the obesity pandemic: A descriptive study applying social network analysis and machine learning techniques.

AIM: To study the existence of subgroups by exploring the similarities between the attributes of the nodes of the groups, in relation to diet and gender and, to analyse the connectivity between groups based on aspects of similarities between them through SNA and artificial intelligence techniques. METHODS: 235 students from 5 different educational centres participate in this study between March and December 2015. Data analysis carried out is divided into two blocks: social network analysis and unsupervised machine learning techniques. As for the social network analysis, the Girvan-Newman technique was applied to find the best number of cohesive groups within each of the friendship networks of the different classes analysed. RESULTS: After applying Girvan-Newman in the three classes, the best division into clusters was respectively 2 for classroom A, 7 for classroom B and 6 for classroom C. There are significant differences between the groups and the gender and diet variables. After applying K-means using population diet as an input variable, a K-means clustering of 2 clusters for class A, 3 clusters for class B and 3 clusters for class C is obtained. CONCLUSION: Adolescents form subgroups within their classrooms. Subgroup cohesion is defined by the fact that nodes share similarities in aspects that influence obesity, they share attributes related to food quality and gender. The concept of homophily, related to SNA, justifies our results. Artificial intelligence techniques together with the application of the Girvan-Newman provide robustness to the structural analysis of similarities and cohesion between subgroups.

Impact of COVID-19 on Adherence to Treatment in Patients with HIV.

In patients with human immunodeficiency virus (HIV), adherence to treatment is affected by the adverse effects of treatment, the presence of additional comorbidities, the complexity of dosage, and family and community support. However, one recent circumstance that was likely to have influenced therapeutic adherence was the COVID-19 pandemic and the applied containment measures. An observational retrospective study of a sample of patients with HIV was conducted to establish the relationship between sociodemographic, clinical, and pharmacological variables and therapeutic adherence before and after the pandemic. Adherence was measured using the validated simplified medication adherence questionnaire (SMAQ) and medication possession rate. A statistical analysis was performed to determine the mean, standard deviation, and median of the quantitative variables and the frequencies of the qualitative variables, and the relationship between the dependent and independent variables was analysed using the chi-squared test and Student's t-test. No statistically significant differences were found between treatment adherence measured before and 22 months after the start of the pandemic. Sex, occupation, treatment regimen, viral load levels, and COVID-19 disease status did not influence adherence during either period. However, the age of patients with HIV had an impact on adherence during both periods (p = 0.008 and p = 0.002, respectively), with the age group under 45 years being less adherent. In addition, experiencing adverse drug reactions (ADRs) was shown to have an impact on adherence before the pandemic (p = 0.006) but not afterwards. The COVID-19 pandemic was not shown to have an impact on the degree of adherence to antiretroviral treatment in patients with HIV. Instead, adherence was influenced by patient age and ADR occurrence; therefore, measures must be taken in this regard. The SMAQ demonstrated sensitivity in assessing adherence.

Life Habits of Healthcare Professionals during the Third Wave of COVID-19: A Cross-Sectional Study in a Spanish Hospital.

(1) Background: To describe sleep quality, eating behaviour and alcohol, tobacco and illicit drug use among healthcare staff in a Spanish public hospital. (2) Methods: Cross-sectional descriptive study examining sleep quality (Pittsburg Sleep Quality Index), eating behaviour (Three Factor Eating Questionnaire (R18)), tobacco and drug use (ESTUDES questionnaire) and alcohol use (Cut down, Annoyed, Guilty, Eye-opener). (3) Results: 178 people, of whom 87.1% (155) were women, with an average age of 41.59 ± 10.9 years. A total of 59.6% of the healthcare workers had sleep problems, to a greater or lesser degree. The average daily consumption was 10.56 ± 6.74 cigarettes. The most commonly used drugs included cannabis, occasionally used by 88.37%, cocaine (4.75%), ecstasy (4.65%) and amphetamines (2.33%). A total of 22.73% of participants had increased their drug use, and 22.73% had increased their consumption during the pandemic, with beer and wine accounting for 87.2% of drinks consumed during this period. (4) Conclusions: In addition to the psychological and emotional impact already demonstrated, the COVID-19 crisis has repercussions on sleep quality, eating behaviour and alcohol, tobacco and drug consumption. Psychological disturbances have repercussions on physical and functional aspects of healthcare workers. It is feasible that these alterations are due to stress, and it is necessary to act through treatment and prevention as well as promote healthy habits.

Effects of Formula Milk Feeding in Premature Infants: A Systematic Review.

The preterm baby is born at a critical period for the growth and development of the gastrointestinal and neuromotor systems. Breast milk is the food of choice for infants during the first months of life, as it provides multiple short- and long-term benefits to preterm and sick newborns. Despite this, breastfeeding is often nutritionally insufficient, requiring the addition of fortifiers. In other cases, it is important to ensure the necessary nutrients and calories, which can be provided by formula milk or pasteurized and fortified donated human milk. However, the specific guidelines for the use of formula milk have not yet been determined. Therefore, a systematic search was considered necessary in order to identify the effects of feeding with formula milk in preterm infants. A systematic search in Scopus, Medline, Pubmed, Cinahl, ClinicalTrials and Web of Science with the terms Infant Formula and Infant Premature was conducted. A total of 18 articles were selected, of which, eight were experimental and ten were observational studies. Among the objectives of the analyzed investigations, we distinguished nine that compared the effects of feeding with formula milk, breast milk and donated human milk, five that evaluated the effects of different compositions of formula milk and/or fortifiers and four investigations that compared the effects of formula milk and donated human milk. In conclusion, when breast milk is insufficient or unavailable, formula milk is a good nutritional option, due to its higher caloric density and protein content. Nevertheless, the preterm infant's diet should incorporate breast milk to reduce the incidence of morbidities such as necrotizing enterocolitis and sepsis (related to hospital handling of fortifiers and formula milk).

The Influence of the Locus of Control Construct on the Efficacy of Physiotherapy Treatments in Patients with Chronic Pain: A Systematic Review.

The biopsychosocial paradigm contemplates the patient's personality traits in physiotherapy treatments for chronic pain. Among these traits, the locus of control has a direct relationship with the person's coping strategies in the face of their health problems. The objective of this systematic review was to assess the influence of locus of control on the efficacy of physiotherapy treatments in patients with chronic pain. A systematic review of the publications of the last ten years in Pubmed, Scopus, Science Direct and Web of Science databases was conducting with the terms physical therapy modalities, chronic pain, internal-external control, self-management, physical therapy and physiotherapy. The inclusion criteria were participants with chronic pain lasting at least three months who have received at least one session of physical therapy; the studies should have collected the patient's locus of control as a prognostic factor at the beginning of physiotherapy treatment; the variables studied should include the pain intensity or clinical variables related to pain. A total of 13 articles were found, of which three were experimental studies and ten were observational studies. The included samples had chronic knee pain, nonspecific back pain, low back pain or neck pain; were people over 65 years of age or patients who had undergone hand surgery. In patients with chronic pain for more than three months, the locus of control construct participates as a predictor of the results of physiotherapy treatment. The presence of an internal locus of control favors better results. The personality traits of the subjects represent an important factor to take into account when planning physiotherapy treatments.

The use of social network analysis in social support and care: a systematic scoping review protocol.

BACKGROUND: In recent decades, the literature on Social Network Analysis and health has experienced a significant increase. Disease transmission, health behavior, organizational networks, social capital, and social support are among the different health areas where Social Network Analysis has been applied. The current epidemiological trend is characterized by a progressive increase in the population's ageing and the incidence of long-term conditions. Thus, it seems relevant to highlight the importance of social support and care systems to guarantee the coverage of health and social needs within the context of acute illness, chronic disease, and disability for patients and their carers. Thus, the main aim is to identify, categorize, summarize, synthesize, and map existing knowledge, literature, and evidence about the use of Social Network Analysis to study social support and care in the context of illness and disability. METHODS: This scoping review will be conducted following Arksey and O'Malley's framework with adaptations from Levac et al. and Joanna Briggs Institute's methodological guidance for conducting scoping reviews. We will search the following databases (from January 2000 onwards): PubMed, MEDLINE, Web of Science Core Collection, SCOPUS, CINAHL, PsycINFO, Cochrane Database of Systematic Reviews, PROSPERO, and DARE. Complementary searches will be conducted in selected relevant journals. Only articles related to social support or care in patients or caregivers in the context of acute illnesses, disabilities or long-term conditions will be considered eligible for inclusion. Two reviewers will screen all the citations, full-text articles, and abstract the data independently. A narrative synthesis will be provided with information presented in the main text and tables. DISCUSSION: The knowledge about the scientific evidence available in the literature, the methodological characteristics of the studies identified based on Social Network Analysis, and its main contributions will highlight the importance of health-related research's social and relational dimensions. These results will shed light on the importance of the structure and composition of social networks to provide social support and care and their impact on other health outcomes. It is anticipated that results may guide future research on network-based interventions that might be considered drivers to provide further knowledge in social support and care from a relational approach at the individual and community levels. TRIAL REGISTRATION: Open Science Framework https://osf.io/dqkb5 .

Anxiety, Stress, and Social Support in Pregnant Women in the Province of Leon during COVID-19 Disease.

The COVID-19 pandemic has posed a high risk to the mental health of the entire population. Pregnant women are strongly affected by the consequences of COVID-19, resulting in increased anxiety and stress. Social support can be a protective factor when it comes to mental health disturbances such as anxiety, fear, or stress in pregnant women. This research aims to describe the anxiety and stress of women in the first trimester of pregnancy in times of pandemic and its relationship with social support. A quantitative, descriptive, cross-sectional study was conducted. A total of 115 women in the first trimester of pregnancy participated. Anxiety was found in 78.3% of the women. Self-perceived stress correlated significantly with the dimensions "concern for changes in oneself", "feelings about oneself", "concern about the future", and very weakly with social support. In addition, a negative correlation was observed between "feelings about oneself" and social support. During the COVID-19 pandemic, anxiety levels of women in our population are elevated. Pregnant women during the first trimester of pregnancy showed higher levels of fear of childbirth and concern about the future than multiparous women. Increased social support and decreased stress seem to influence "feeling about oneself".

SBAR Method for Improving Well-Being in the Internal Medicine Unit: Quasi-Experimental Research.

SBAR (Situation, Background, Assessment, Recommendation) is a tool for standardizing and improving interprofessional communication. This study aims to explore the impact of SBAR in healthcare professionals' wellbeing, through concepts such as job satisfaction, engagement, resilience, and job performance, in the internal medicine unit of a university hospital in the province of León (Spain). This is an observational, descriptive, longitudinal case study with a pre- and post-intervention approach. Questionnaires were distributed to a group of doctors, nurses, and healthcare assistants before and after the implementation of the SBAR tool in the ward. The use of SBAR was monitored to ensure staff compliance. Data statistical analysis was performed using the SPSS program. Resilience levels increased significantly post-intervention. Job satisfaction and engagement levels remained neutral, slightly decreasing post-intervention. Besides' being a useful tool to improve communication, SBAR was effective in improving resilience among staff. Several aspects related to hospital management may have had an impact on job satisfaction and engagement results.

Descriptive Study of Friendship Networks in Adolescents and Their Relationship with Self-Efficacy and Alcohol Consumption Using Social Network Analysis.

Alcohol is a widely used legal drug. Self-efficacy takes on great importance in an adolescent's development. Levels of self-efficacy can contribute to the decision-making process of the adolescent. In this phase, a group of friends becomes increasingly important. Alcohol is present in different social aspects. Adolescents use alcohol as a social facilitator or as part of the development of their autonomy. The purpose of this study is to describe and analyze the structure of the friendship network, self-efficacy, and alcohol consumption in adolescents. METHODS: We used an online platform with validated self-reported questionnaires to collect the data. The sample consisted of 195 adolescents aged between 16 and 18, from different educational centers in Bierzo (Spain). RESULTS: It was found that 43.6% of the adolescents in our research were high-risk consumers. Significant differences were obtained in terms of self-efficacy and different network metrics. These networks were represented by considering the levels of alcohol consumption. In the friendship network, we observed how the central adolescents presented higher levels of self-efficacy and lower alcohol consumption. CONCLUSIONS: Self-efficacy is established as a predictor of coping and not consuming alcohol and adolescence as a crucial moment to implement prevention strategies. Social Network Analysis is a useful tool that provides an image of the context in which adolescents find themselves.

eHealth Intervention to Improve Health Habits in the Adolescent Population: Mixed Methods Study.

BACKGROUND: Technology has provided a new way of life for the adolescent population. Indeed, strategies aimed at improving health-related behaviors through digital platforms can offer promising results. However, since it has been shown that peers are capable of modifying behaviors related to food and physical exercise, it is important to study whether digital interventions based on peer influence are capable of improving the weight status of adolescents. OBJECTIVE: The purpose of this study was to assess the effectiveness of an eHealth app in an adolescent population in terms of improvements in their age- and sex-adjusted BMI percentiles. Other goals of the study were to examine the social relationships of adolescents pre- and postintervention, and to identify the group leaders and study their profiles, eating and physical activity habits, and use of the web app. METHODS: The BMI percentiles were calculated in accordance with the reference guidelines of the World Health Organization. Participants' diets and levels of physical activity were assessed using the Mediterranean Diet Quality Index (KIDMED) questionnaire and the Physical Activity Questionnaire for Adolescents (PAQ-A), respectively. The variables related to social networks were analyzed using the social network analysis (SNA) methodology. In this respect, peer relationships that were considered reciprocal friendships were used to compute the "degree" measure, which was used as an indicative parameter of centrality. RESULTS: The sample population comprised 210 individuals in the intervention group (IG) and 91 individuals in the control group (CG). A participation rate of 60.1% (301/501) was obtained. After checking for homogeneity between the IG and the CG, it was found that adolescents in the IG at BMI percentiles both below and above the 50th percentile (P50) modified their BMI to approach this reference value (with a significance of P<.001 among individuals with an initial BMI below the P50 and P=.04 for those with an initial BMI above the P50). The diet was also improved in the IG compared with the CG (P<.001). After verifying that the social network had increased postintervention, it was seen that the group leaders (according to the degree SNA measure) were also leaders in physical activity performed (P=.002) and use of the app. CONCLUSIONS: The eHealth app was able to modify behaviors related to P50 compliance and exert a positive influence in relation to diet and physical exercise. Digital interventions in the adolescent population, based on the improvement in behaviors related to healthy habits and optimizing the social network, can offer promising results that help in the fight against obesity.

The socialisation of the adolescent who carries out team sports: a transversal study of centrality with a social network analysis.

OBJECTIVES: To analyse the physical activity carried out by the adolescents in the study, its relationship to being overweight (overweight+obese) and to analyse the structure of the social network of friendship established in adolescents doing group sports, using different parameters indicative of centrality. SETTING: It was carried out in an educational environment, in 11 classrooms belonging to 5 Schools in Ponferrada (Spain). PARTICIPANTS: 235 adolescents were included in the study (49.4% female), who were classified as normal weight or overweight. PRIMARY AND SECONDARY OUTCOME MEASURES: Physical Activity Questionnaire for Adolescents (PAQ-A) was used to study the level of physical activity. A social network analysis was carried out to analyse structural variables of centrality in different degrees of contact. RESULTS: 30.2% of the participants in our study were overweight. Relative to female participants in this study, males obtained significantly higher scores in the PAQ-A (OR: 2.11; 95% CI: 1.04 to 4.25; p value: 0.036) and were more likely to participate in group sport (OR: 4.59; 95% CI: 2.28 to 9.22; p value: 0.000). We found no significant relationship between physical activity and the weight status in the total sample, but among female participants, those with overweight status had higher odds of reporting high levels of physical exercise (OR: 4.50; 95% CI: 1.21 to 16.74; p value: 0.025). In terms of centrality, differentiating by gender, women who participated in group sports were more likely to be classified as having low values of centrality, while the opposite effect occurred for men, more likely to be classified as having high values of centrality. CONCLUSIONS: Our findings, with limitations, underline the importance of two fundamental aspects to be taken into account in the design of future strategies: gender and the centrality within the social network depending on the intensity of contact they have with their peers.

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.