Impact of the COVID-19-pandemic and perception of self-efficacy on the mental health of out-of-hospital emergency healthcare professionals by modality of care.

OBJECTIVE: To analyse the influence of the COVID-19 pandemic and the perception of self-efficacy on the health professionals of the Spanish out-of-hospital emergency services. DESIGN: Observational, cross-sectional and descriptive with a survey methodology of 1710 participants from Spain (1 February-30 April, 2021). METHODS: The mental health of healthcare workers was assesed in terms of stress, anxiety and depression, as well as their self-efficacy. Linear and logistic regression models were fitted to predict these variables. A moderation analysis was conducted to determine the effect of self-efficacy on mental health. RESULTS: The means of the sample for stress, anxiety, depression and self-efficacy were 20.60, 15.74, 13.07 and 70.87, respectively. In the regression models, being a woman was the most significant factor for severe mental health impairment. Female gender was also a relevant factor for self-efficacy. Self-efficacy had a direct effect on the mental health for working in patient care. CONCLUSIONS: Healthcare workers showed moderate stress, severe anxiety, mild depression and good self-efficacy. Direct patient care was associated with more stress and severe anxiety. Age, female gender, job changes and job adjustment were associated with levels of stress, anxiety and depression. Self-efficacy is a determining factor of mental health in the direct care modality. IMPLICATIONS: The mental health of healthcare workers has been of great importance in the aftermath of the pandemic, but out-of-hospital emergency workers have been neglected in research. The levels of stress, anxiety and depression during the pandemic justify the creation of prevention and early diagnosis programmes, as they are essential in a health disaster. Surprisingly, their high level of perceived self-efficacy directly impact on the mental health of patient helthcare workers, so improving it will reduce the psychological risk. REPORTING METHOD: We have followed the STROBE guidelines. It has been partially funded by the Asistencia Sanitanitaria Interprovincial de Seguros - ASISA Foundation (Spain). PATIENT OR PUBLIC CONTRIBUTION: 'No patient or public involvement'.

Consequences of the COVID-19 pandemic on the mental health of nurses in the Spanish out-of-hospital Emergency Service.

OBJECTIVE: To analyse the impact of the COVID-19 pandemic on the mental health of nurses in Spanish out-of-hospital Emergency Services, identifying predictor factors of greater severity. METHOD: A multicentre cross-sectional descriptive study was designed, including all nurses working in any Spanish out-of-hospital Emergency Services between 01/02/2021 and 30/04/2021. The main outcomes were the level of depression, anxiety and stress assessed through the DASS-21 scale. Sociodemographic, clinical, and occupational information was also collected. Univariate and multivariate analyses were conducted to determine possible associations between variables. RESULTS: The sample included 474 nurses. 32.91%, 32.70% and 26.33% of the participants had severe or extremely severe levels of depression, anxiety and stress, respectively. Professionals with fewer competencies to handle stressful situations, those who had used psychotropic drugs and/or psychotherapy on some occasion before the pandemic onset, or those who had changed their working conditions presented more likelihood of developing more severe levels of depression, anxiety and/or stress. CONCLUSION: Nurses in Spanish out-of-hospital Emergency Services have presented medium levels of depression, anxiety and stress during the pandemic. Clinical and occupational factors have been associated with a higher degree of psychological distress. It is necessary to adopt strategies that promote professionals' self-efficacy and mitigate the triggers of negative emotional states.

Experiences of Spanish out-of-hospital emergency workers with high levels of depression during the COVID-19 pandemic: a qualitative study.

BACKGROUND: The COVID-19 pandemic had a major psychological impact on health care workers (HCWs). This study was embedded in a larger quantitative study on the mental health care of out-of-hospital HCWs in Spain. To better understand this, a qualitative study was conducted to explore the experiences, coping strategies, and influencing factors of out-of-hospital HCWs who scored high (> 25 points) on the Depression Anxiety Stress Scale (DASS-21) in a previous quantitative mental health study. METHODS: A qualitative study was conducted using six in-depth interviews with individuals who scored high on the depression scale and agreed to be contacted by email between May and June 2021, using the phenomenological approach. The data were analysed using Brawn and Clare's method. RESULTS: The main results findings related to four themes. The emotional impact of assuming a professional role with high self-demands and responsibilities; Factors influencing the development of negative emotions such as the cruelty of the pandemic, the helplessness in relation to health management and policy, the changing role of the professional and the relationship with society; Personal protection through coping strategies to manage negative emotions such as support from colleagues and family; Good practices for the future looking for different management strategies that can influence individuals and their personal, professional, and social relationships. CONCLUSION: The strong impact of the circumstances experienced points to the need to develop psychological support programmes that can protect people's mental health from depression during a crisis and improve the relationship between workers and their managers.

RESUMEN: ANTECEDENTES: La pandemia de COVID-19 tuvo un gran impacto psicológico en el personal sanitario. Este estudio forma parte de un estudio cuantitativo más amplio sobre la atención a la salud mental de los trabajadores sanitarios extrahospitalarios en España. Para comprenderlo mejor, se llevó a cabo un estudio cualitativo para explorar las experiencias, estrategias de afrontamiento y factores de influencia de los trabajadores extrahospitalarios que obtuvieron puntuaciones altas (> 25 puntos) en la Escala de Depresión, Ansiedad y Estrés (DASS-21) en un estudio cuantitativo previo sobre salud mental. MéTODOS: Se realizó un estudio cualitativo mediante seis entrevistas en profundidad con individuos que puntuaron alto en la escala de depresión y aceptaron ser contactados por correo electrónico entre mayo y junio de 2021, utilizando el enfoque fenomenológico. Los datos se analizaron utilizando el método de Brawn y Clare. RESULTADOS: Los principales hallazgos de los resultados se relacionaron con cuatro temas. El impacto emocional de asumir un rol profesional con altas autoexigencias y responsabilidades; Factores que influyen en el desarrollo de emociones negativas como la crueldad de la pandemia, la impotencia en relación con la gestión y la política sanitaria, el papel cambiante del profesional y la relación con la sociedad; Protección personal a través de estrategias de afrontamiento para gestionar las emociones negativas como el apoyo de los compañeros y la familia; Buenas prácticas para el futuro buscando diferentes estrategias de gestión que puedan influir en los individuos y en sus relaciones personales, profesionales y sociales. CONCLUSIóN: El fuerte impacto de las circunstancias vividas apunta a la necesidad de desarrollar programas de apoyo psicológico que puedan proteger la salud mental de las personas durante una crisis y mejorar la relación entre los trabajadores y sus jefes.

Exploring Disparities in Self-Reported Mental Health Symptoms Across Professional Categories in Spain's Emergency Medical Services: A Nationwide Cross-Sectional Study.

OBJECTIVE: This study aimed to analyze stress, anxiety, depression, and self-efficacy levels among Spanish out-of-hospital emergency medical professionals from February 1, 2021, to April 30, 2021. METHODS: A nationwide survey was completed by 1666 Emergency Medical Services (EMS) workers. The Depression, Anxiety, and Stress Scale (DASS-21) and the General Self-Efficacy Scale (GSE) were used. Data analysis used chi-squared, análisis of variance (ANOVA), and logistic regressions. RESULTS: The sample comprised 833 (50%) men, with an average age of 44.3 ± 9.9 y (range: 19-67 y). Occupational distribution included 453 (27.2%) physicians, 474 (28.4%) nurses, and 739 (44.4%) emergency medical technicians (EMTs). EMTs exhibited higher odds of severe or extremely severe depression compared with physicians (odds ratio [OR]: 1.569; 95% confidenceinterval [95% CI]: 1.213-2.030) and nurses (OR: 1.561; 95% CI: 1.211-2.012). EMTs also displayed higher probabilities of severe or extremely severe anxiety compared with nurses (OR: 1.944; 95% CI: 1.529-2.701). Furthermore, EMTs demonstrated elevated probabilities of severe or extremely severe stress compared with physicians (OR: 1.387; 95% CI: 1.088-1.770). However, no significant differences were found in self-efficacy, with a median value of 73 [20]. CONCLUSIONS: Out-of-hospital EMS workers experienced mental health challenges, showing varying levels of depression, stress, and anxiety across different occupational groups. EMTs were particularly affected.

Influence of Previous Mental State on Psychological Outcomes of Spanish Out-of-Hospital Professionals during the COVID-19 Pandemic.

This study aimed to describe factors relating to the psychological distress of healthcare workers (HCWs) in Spanish out-of-hospital emergency medical services (EMS), according to the previous or non-use of psychotropic drugs or psychotherapy. A multicentre, cross-sectional descriptive study was designed. The study population were all physicians, nurses, and emergency medical technicians (EMTs) working in any Spanish out-of-hospital EMS between February and April 2021. The main outcomes were the levels of stress, anxiety, depression, and self-efficacy, assessed by DASS-21 and G-SES. Differences in levels of stress, anxiety, depression, and self-efficacy, according to sex, age, previous use of psychotropic drug or psychotherapy, work experience, professional category, type of work, and modification of working conditions were measured using the Student's t-test for independent samples, one-way ANOVA, Pearson's correlation, or 2-factor analysis of covariance. A total of 1636 HCWs were included, of whom one in three had severe mental disorders because of the pandemic. The interaction of the previous or non-use of psychotropic drugs or psychotherapy with the rest of the factors considered did not modify the levels of stress, anxiety, depression, and self-efficacy. However, HCWs with a history of psychotropic drug or psychotherapy use had a more intense negative emotional response and lower self-efficacy, regardless of their sex, professional category, type of work, or change in the working conditions. These HCWs are considered particularly vulnerable to the development or recurrence of new disorders or other comorbidities; therefore, the implementation of monitoring and follow-up strategies should be a priority.

Influence of the Cumulative Incidence of COVID-19 Cases on the Mental Health of the Spanish Out-of-Hospital Professionals.

This study aimed to analyze the psychological affectation of health professionals (HPs) of Spanish Emergency Medical Services (EMSs) according to the cumulative incidence (CI) of COVID-19 cases in the regions in which they worked. A cross-sectional descriptive study was designed, including all HPs working in any EMS of the Spanish geography between 1 February 2021 and 30 April 2021. Their level of stress, anxiety and depression (DASS-21) and the perception of self-efficacy (G-SES) were the study's main results. A 2-factor analysis of covariance was used to determine if the CI regions of COVID-19 cases determined the psychological impact on each of the studied variables. A total of 1710 HPs were included. A third presented psychological impairment classified as severe. The interaction of CI regions with the studied variables did not influence their levels of stress, anxiety, depression or self-efficacy. Women, younger HPs or those with less EMS work experience, emergency medical technicians (EMT), workers who had to modify their working conditions or those who lived with minors or dependents suffered a greater impact from the COVID-19 pandemic in certain regions. These HPs have shown high levels of stress, anxiety, depression and medium levels of self-efficacy, with similar data in the different geographical areas. Psychological support is essential to mitigate their suffering and teach them to react to adverse events.

Psychological Impact of the COVID-19 Pandemic on Out-of-Hospital Health Professionals: A Living Systematic Review.

Health professionals (HPs), especially those working in the front line, have been one of the groups most affected by the COVID-19 pandemic. The objective of this study is to identify the best available scientific evidence on the impact of the COVID-19 pandemic on the mental health of out-of-hospital HPs in terms of stress, anxiety, depression, and self-efficacy. A living systematic review of the literature was designed, consulting the electronic online versions of the CINHAL, Cochrane Library, Cuiden, IBECS, JBI, LILACS, Medline PyscoDoc, PsycoINFO, Scopus, and Web of Science databases in November 2021. Original research was selected, published in either English, Spanish, French, Italian, or Portuguese. In total, 2082 publications were identified, of which 16 were included in this review. The mental health of out-of-hospital HPs was affected. Being a woman or having direct contact with patients showing suspicious signs of COVID-19 or confirmed cases were the factors related to a greater risk of developing high levels of stress and anxiety; in the case of depressive symptoms, it was having a clinical history of illnesses that could weaken their defenses against infection. Stopping unpleasant emotions and thoughts was the coping strategy most frequently used by these HPs.

Experience of emergency healthcare professionals in cardiopulmonary resuscitation and its relationship with self-efficacy: A qualitative approach. / La experiencia de los profesionales sanitarios en la reanimación cardiopulmonar y su relación con su autoeficacia: una aproximación cualitativa.

AIM: To gain a deeper knowledge of the phenomenon of cardiopulmonary resuscitation by capturing the meanings that professionals attach to the behaviour of reanimation and its relationship with Social Cognitive Theory. METHOD: Qualitative research from a phenomenological approach focussing on field work with a focus group of professionals from Madrid (doctors, nurses and technicians), as well as a previous study. After the transcription of the data, it was coded, categories were formed and it was grouped into dimensions, interpreting the data according to the Social Cognitive Theory. Data was collected from other sources, experience of professionals and family members who had witnessed a cardiopulmonary resuscitation, until the saturation of the data. RESULTS: The phenomena that affect the people involved in a cardiopulmonary resuscitation were explored holistically. The relevant aspects to feel able to perform cardiopulmonary resuscitation, as well as those that may hinder the behaviour were identified. Two dimensions were found, personal and situational factors, as well as several categories in each dimension related to Bandura's theory of self-efficacy. CONCLUSIONS: Professionals' self-efficacy in a cardiopulmonary resuscitation does not always depend on the technical skills acquired. Personal and situational factors influence the professional being able to vary their behaviour cognitively and emotionally. This knowledge enables cardiopulmonary resuscitation competencies in a clinical situation to be improved and individualized training programmes to be designed in teaching practice.

Impacto de la pandemia COVID-19 en la salud mental de profesionales sanitarios de los servicios de emergencias médicas extrahospitalarios españoles / The impact of the COVID-19 pandemic on the mental health of healthcare professionals from the Spanish outpatient medical emergency services

Objetivo: analizar el nivel de afectación psicológica de los profesionales sanitarios (PS) de servicios de emergencias extrahospitalarias (SEM) españoles en función de la incidencia acumulada de COVID-19 de las comunidades autónomas (CC.AA.) en las que trabajaban, identificando posibles factores predictores de una mayor severidad.Método: estudio descriptivo transversal multicéntrico en el que se incluyeron a todos los PS que se encontrasen trabajando en algún SEM de la geografía española entre el 01/02/2021 y el 30/04/2021. Las variables principales fueron: nivel de estrés, ansiedad y depresión, evaluados mediante la escala DASS-21, recogiéndose también información sociodemográfica, clínica y laboral. Se llevó a cabo un análisis univariante y multivariante de regresión logística.Resultados: la muestra estuvo formada por 1.710 PS. El 37,39%, el 39,36% y el 30,46% de las personas participantes presentaron niveles graves de estrés, ansiedad y depresión, respectivamente. Las mujeres, quienes eran más jóvenes o con menos experiencia laboral en SEM, el personal técnico en emergencias sanitarias, quienes declararon consumo previo de psicoterapia y/o psicofármacos, o quienes modificaron sus condiciones laborales, tuvieron más probabilidades de desarrollar niveles más graves de estrés, ansiedad o depresión, variando estos factores en función del área geográfica (clasificada según la IA de COVID-19) de trabajo.Conclusiones: la IA de casos COVID-19 en las diferentes CC.AA. no ha condicionado la aparición de niveles psicopatológicos de estrés, ansiedad y depresión en los PS del ámbito extrahospitalario español; si bien, en cada una de ellas, se han identificado factores sociodemográficos, clínicos o laborales que predisponen a una mayor afectación psicológica.(AU)

Objective: to analyse the level of psychological impact on healthcare professionals from Spanish outpatient emergency services (OES) based on the cumulative incidence of COVID-19 in the autonomous communities (AA.CC.) where they were working, identifying potential factors to predict higher severity.Method: a multi-center cross-sectional descriptive study, including all healthcare professionals who were working in any OES within the Spanish geography between 02/01/2021 and 04/30/2021. The main variables were: level of stress, anxiety and depression, assessed through the DASS-21 scale. Sociodemographic, clinical and occupational information was also collected. Univariate and multivariate analysis of logistical regression was conducted.Results: the sample included 1,710 healthcare professionals; 37.39%, 39.36% and 30.46% of the participants presented severe levels of stress, anxiety, and depression, respectively. Women, those younger or with less experience of work at OES, the technical staff in healthcare emergencies, those who declared previous use of psychotherapy and/or psychotropic drugs, or those who modified their working conditions, presented higher likelihood of developing more severe levels of stress, anxiety or depression; these factors varied according to the geographical area (classified by the cumulative incidence of COVID-19) where they worked.Conclusions: the cumulative incidence of COVID-19 cases in the different autonomous communities has not determined the development of psychopathological levels of stress, anxiety and depression in healthcare professionals from the outpatient setting; however, sociodemographic, clinical or occupational factors have been detected in each one which predisposed them to a higher psychological impact.(AU)

Diseño y validación de escalas de antecedentes de autoeficacia en reanimación cardiopulmonar para profesionales: Logros de Ejecución, Activación Emocional y Fisiológica / Design and validation of sources scales of self-efficacy in cardiopulmonary resuscitation for professionals: Mastery Experiences scale; Emotional and Physiological States scale

Material y método: estudio observacional descriptivo transversal. Se diseñaron dos escalas de antecedentes de autoeficacia, previo estudio cualitativo con consenso de expertos y piloto en 29 profesionales, compuestas por 14 ítems la escala de Logros de Ejecución (LE) y 17 ítems la escala de activación emocional y fisiológica (AEF). Se obtuvo na respuesta on line (programa Gandía BarbWin) en una muestra de 1400 profesionales con experiencia en RCP (441 médicos, 769 enfermeros y 190 Técnicos Emergencias Sanitarias) de 17 comunidades españolas. Se realizaron diferentes análisis psicométricos.Resultados: La fiabilidad de la escala LE en RCP, medida por el coeficiente Alpha de Cronbach (α), tiene una adecuada consistencia interna (α > 0,80) siendo más elevada en médicos (α > 0,93), seguidos de enfermeros (α > 0,90) y TES (α > 0,81). La estructura interna y validez factorial en los médicos es unifactorial (Varianza explicada 67,52%), siendo bifactorial para la muestra total (73,02%) y submuestras (enfermeros 71,59%, TES 62,90%).La fiabilidad para la escala de AEF en RCP es más modesta (α= 0,71-0,81) y contempla una estructura interna bifactorial para todos los casos (51,99%).Conclusión: los resultados psicométricos permiten afirmar la disponibilidad de dos medidas de antecedentes de la autoeficacia en RCP, escala de LE y escala de AEF, con suficientes garantías de fiabilidad y validez para ser utilizadas en evaluación, formación y/o práctica clínica.(AU)

Aim: to design and validate two technically appropriate measures of the two main sources of self-efficacy in CPR: Mastery Experience (ME); and Emotional and Physiological States (EPS).Design: cross-sectional descriptive observational study. Two self-efficacy antecedent scales were designed, after a qualitative study with expert consensus and a pilot study in 29 professionals, composed of 14 items on the Mastery Experience scale (ME) and 17 items on the Emotional and Physiological States scale (EPS). An online response (Gandía BarbWin program) was obtained in a sample of 1,400 professionals with experience in CPR (441 doctors, 769 nurses, and 190 Health Emergency Technicians) from 17 Spanish communities. Different psychometric analyzes were carried out.Results: the reliability of the ME scale in CPR, measured by Cronbach's Alpha coefficient (α), has adequate internal consistency (α> 0.80) being higher in physicians (α> 0.93), followed by nurses (α > 0.90) and paramedics (α> 0.81). The internal structure and factorial validity in physicians is univariate (Variance explained 67.52%), being bifactorial for the total sample (73.02%) and subsamples (nurses 71.59%, paramedics 62.90%).The reliability for the EPS scale in CPR is more modest (α = 0.71-0.81) and contemplates a bifactorial internal structure for all cases (51.99%).Conclusion: the psychometric results allow us to affirm the availability of two antecedent measures of self-efficacy in CPR: the ME scale and the EPS scale, with sufficient guarantees of reliability and validity to be used in assessment, training and / or clinical practice.(AU)

Autoeficacia en reanimación cardiopulmonar (RCP) básica y avanzada: diseño y validación de una escala / Self-efficacy in basic and advanced cardiopulmonary resuscitation (CPR): design and validation of a scale

INTRODUCCIÓN: La autoeficacia es una variable de relevancia reconocida en la práctica clínica y en la formación en reanimación cardiopulmonar (RCP). El objetivo de este estudio fue diseñar y validar una escala de autoeficacia general en RCP básica y avanzada para profesionales españoles con experiencia. MATERIALES Y MÉTODO: Se diseñó una escala con 29 ítems mediante procedimientos cualitativos y haciendo uso del juicio de expertos. La escala se aplicó mediante encuesta electrónica a una muestra de 1.400 profesionales de la salud con experiencia en RCP: médicos (31,5%), enfermeros (54,9%) y técnicos sanitarios (13,6%). RESULTADOS: La escala presentó una alta fiabilidad (α>0,92) al considerar la autoeficacia en RCP tanto básica como avanzada, en su análisis conjunto y por separado. En el análisis de componentes principales se obtuvieron soluciones conceptual y teóricamente consistentes, con una varianza explicada que oscila entre el 55% y el 70% y una estructura de uno o 2 factores, según las subescalas y los diferentes colectivos profesionales. Se obtuvo una correlación sustancial entre subescalas (r=0,80). DISCUSIÓN: Se dispone de una escala de autoeficacia general en RCP, con especificaciones para RCP básica y RCP avanzada, con suficientes garantías de fiabilidad y validez factorial, susceptibles de ser utilizadas de forma conjunta o por separado con profesionales españoles. La escala se propone como una herramienta útil para la docencia, tanto en formación inicial como continuada, que puede ser usada para diseñar, desarrollar y evaluar programas de aprendizaje específicos sobre competencias profesionales para realizar una RCP eficaz

INTRODUCTION: Self-efficacy is a relevant variable recognised in clinical practice and CPR training. The aim of this study was to develop and validate a scale of general self-efficacy in basic and advanced CPR for Spanish professionals with experience. MATERIALS AND METHODS: A scale with 29 items was designed using qualitative procedures and expert judgment. The scale was sent via e-mail to a sample of 1400 health professionals with experience in CPR: doctors (31.5%), nurses (54.9%), and health technicians (13.6%). RESULTS: A high internal consistency (Alpha above 0.92) was found in basic CPR self-efficacy as well as in advanced CPR, when analysed together and separately. In the Principal Component Analysis, conceptual and theoretically consistent solutions were obtained, with an explained variance ranging between 55% and 70%, and a structure of one or two factors, according to the subscales and the different professional groups. A substantial correlation was obtained between sub-scales (r=.80). DISCUSSION: A scale of general self-efficacy in CPR is available, with specifications for basic CPR and advanced CPR, with sufficient guarantees of reliability and with evidence of factorial validity to be used jointly or separately with Spanish professionals. The scale is proposed as a useful tool for teaching, both in initial and continuing training, which can be used to design, develop and evaluate specific learning programs on professional skills to perform effective CPR

Elaboración y validación de una escala de autoeficacia en reanimación cardiopulmonar para estudiantes en Ciencias de la Salud / Preparation and validation of a self-efficacy scale in cardiopulmonary resuscitation for Health Sciences students

Objetivo: elaborar un instrumento fiable capaz de medir la autoeficacia del alumno en reanimación cardiopulmonar (RCP) tras un aprendizaje previo. Método: estudio de elaboración y validación de un instrumento: desarrollo del instrumento, validez de aspecto y contenido, validez de constructo. La primera fuente de extracción de los ítems que compondrían la escala de autoeficacia consistió en un cuestionario que contenía 14 preguntas semiestructuradas y cinco casos clínicos sobre la RCP y la parada cardiaca, que tuvieron que cumplimentar profesionales formados en RCP. Los ítems estaban integrados en tres escalas y fueron validados en aspecto y contenido por parte de expertos. Para la validez de constructo se contó con dos muestras de sujetos distintas (85 alumnos en la primera fase y 101 en la segunda). Se llevaron a cabo análisis descriptivos, análisis de fiabilidad mediante coeficiente alfa de Cronbach, y se realizó análisis factorial exploratorio. Se usó el programa estadístico SPSS versión 19.0. Resultados: en la primera fase, la escala A de autoeficacia obtuvo un coeficiente alfa de Cronbach de 0,91. En la segunda fase se obtuvo un alfa de Cronbach para la escala A de 0,93. El valor obtenido con la población total (n= 186), valor muy similar al encontrado con la muestra total (n= 186), fue de 0,92. La escala de autoeficacia en RCP básica tuvo una estructura unidimensional y contenía 20 ítems. Se encontraron relaciones estadísticamente significativas de los constructos cognitivo-emocionales y el valor de autoeficacia. Conclusión: se obtuvo una escala unidimensional de autoeficacia en RCP básica. Existen variables emocionales y cognitivas que intervienen como mediadoras en la conducta de reanimación (AU)

Objective: to prepare a reliable tool in order to measure the self-efficacy of Cardiopulmonary Resuscitation (CPR) students after previous training. Method: a study for preparation and validation of a tool: development, aspect and contents validity, construct validity. The first source for collecting the items which would form the self-efficacy scale consisted in a questionnaire including 14 semi-structured questions and five clinical cases on CPR and cardiac arrest, which had to be completed by professionals with CPR training. These items were classified into three scales, and were validated by experts in terms of aspect and contents. Two different samples were used for construct validity (85 students in the first stage and 101 in the second stage). Descriptive analysis was conducted, as well as reliability analysis through Cronbach’s alpha coefficient; an exploratory factor analysis was also conducted. The SPSS statistical program, version 19.0, was used for analysis. Results: in the first stage, the Self-efficacy Scale A obtained a 0.91 Cronbach’s alpha coefficient; in the second stage, Scale A achieved a 0.93 Cronbach’s alpha. The value obtained with the total population (n= 186) was 0.92, very similar to the one obtained with the total sample. The Self-efficacy Scale for basic CPR had one-dimensional structure and included 20 items. Statistically significant associations were found between cognitive-emotional constructs and the self-efficacy value. Conclusion: a one-dimensional scale was obtained for self-efficacy in basic CPR. There are emotional and cognitive variables involved as mediators in the resuscitation behavior (AU)

La experiencia de los profesionales sanitarios en la reanimación cardiopulmonar y su relación con su autoeficacia: una aproximación cualitativa / Experience of emergency healthcare professionals in cardiopulmonary resuscitation and its relationship with self-efficacy: A qualitative approach

Objetivo: Conocer el fenómeno de la reanimación cardiopulmonar captando los significados que los profesionales le dan a la conducta de reanimar y su relación con la teoría social cognitiva. Método: Investigación cualitativa de enfoque fenomenológico, centrada en el trabajo de campo con un grupo focal de profesionales de Madrid (médicos, enfermeras y técnicos), así como los resultados de un estudio anterior. Tras la transcripción de los datos, se codificaron, se formaron categorías y se agruparon en dimensiones, interpretándolos de acuerdo con la teoría social cognitiva. Se contó con datos de otras fuentes, experiencia de profesionales y familiares que han presenciado una reanimación cardiopulmonar, hasta llegar a la saturación de los datos. Resultados: Se exploraron de forma holística los fenómenos que afectan a las personas implicadas en una reanimación cardiopulmonar. Se identificaron los aspectos relevantes para sentirse capaces de realizar una reanimación cardiopulmonar, así como aquellos que pueden obstaculizar la conducta. Se encontraron 2dimensiones, factores personales y situacionales, así como varias categorías en cada dimensión que están en relación con la teoría de la autoeficacia de Bandura. Conclusiones: La autoeficacia del profesional en una reanimación cardiopulmonar no depende solo de las competencias técnicas adquiridas. Los factores personales y situacionales influyen cognitiva y emocionalmente en el profesional, pudiendo variar su conducta. En la práctica clínica y docente, permite mejorar las competencias de reanimación cardiopulmonar y diseñar programas de formación individualizados

Aim: To gain a deeper knowledge of the phenomenon of cardiopulmonary resuscitation by capturing the meanings that professionals attach to the behaviour of reanimation and its relationship with Social Cognitive Theory. Method: Qualitative research from a phenomenological approach focussing on field work with a focus group of professionals from Madrid (doctors, nurses and technicians), as well as a previous study. After the transcription of the data, it was coded, categories were formed and it was grouped into dimensions, interpreting the data according to the Social Cognitive Theory. Data was collected from other sources, experience of professionals and family members who had witnessed a cardiopulmonary resuscitation, until the saturation of the data. Results: The phenomena that affect the people involved in a cardiopulmonary resuscitation were explored holistically. The relevant aspects to feel able to perform cardiopulmonary resuscitation, as well as those that may hinder the behaviour were identified. Two dimensions were found, personal and situational factors, as well as several categories in each dimension related to Bandura's theory of self-efficacy. Conclusions: Professionals' self-efficacy in a cardiopulmonary resuscitation does not always depend on the technical skills acquired. Personal and situational factors influence the professional being able to vary their behaviour cognitively and emotionally. This knowledge enables cardiopulmonary resuscitation competencies in a clinical situation to be improved and individualized training programmes to be designed in teaching practice

[Competencies in nursing care research. Proposal of the nursing research coordination and development unit (Investén-isciii)]. / Competencias en investigación: propuesta de la Unidad de coordinación y desarrollo de la Investigación en Enfermería (Investén-isciii).

OBJECTIVE: To determine and prioritize the research competencies that should be acquired by nurses in distinct educational (graduate, masters, doctorate) and clinical practice settings (basic, intermediate and advanced) and in specialized training. METHOD: An observational, descriptive, cross sectional study was performed in 2006. The generic and specific competencies for each of the 7 above-mentioned settings were established and sent by electronic mail to a group of experts who were asked to evaluate each competency on a scale from 1 to 5 (1 = not important, 5 = very important). RESULTS: Evaluations were received from 34 (74%) of the 46 experts contacted. Of the general competencies, those receiving the highest scores, with a median of 5 points, were "ethical commitment" and "ability to work in a team". Among the specific competencies, those most highly scored were "awareness of the need to base nursing practice on the results of scientific research", "ability to critically read the scientific literature" and "ability to base nursing practice on the results of scientific research and the best available evidence". For doctorates and advanced-level nursing, most of the competencies, both general and specific, obtained a median score of 5 points. CONCLUSIONS: The most highly scored competencies were those relating to critical thinking, ethics and information analysis at each of the three levels of nursing training. Knowledge of English and interpersonal skills were less highly valued.

Farmacología práctica en la Urgencia Extrahospitalaria La Tabla RaNa. ¿Qué hemos aprendido? / No disponible

No disponible

Índice de impacto o traslación a la práctica clínica: una difícil decisión / Impact index or translation into clinical practice: a difficult decision

No disponible

Farmacología práctica en la Urgencia Extrahospitalaria / Practical pharmacology in Out-of-hospital Emergencies

El papel de los profesionales de la Enfermería en los proyectos de seguridad clínica, así como el hecho de la prescripción enfermera, han determinado que las enfermeras y enfermeros sean conscientes de la necesidad de una mayor formación, actualización y manejo en el área de la farmacología. En la siguiente serie de artículos se llevará a cabo un recorrido por la farmacología de emergencias, centrándose en la de uso más habitual y tomando como referencia aquellos medicamentos que son dispensados y utilizados por el SUMMMA 112, Servicio de Urgencias Médicas de laComunidad de Madrid, donde se desarrolla la actividad profesional de las autoras desde hace dos décadas. La metodología ha consistido en realizar una revisión general de bibliografía, consensuar dosis y forma de administración y finalmente hacer una síntesis en una tabla, la “Tabla RaNa”, que pretende ser una útil herramienta de consulta rápida para la administración de fármacos en la emergencia extrahospitalaria (AU)

The role of Nursing professionals in clinical safety projects, as well as nursing prescription, have been essential in making nurses aware of the need of more extensive training, updating and management in the field of pharmacology. The following series of articles will present an overview of Emergency pharmacology, focusing on the most commonly used and using as a reference drugs that are prescribed and used by the SUMMA112, Medical Emergency Service of the Community of Madrid, where the authors have been conducting their professional activity for the past two decades. The methodology has consisted in performing a general review of the bibliography, reaching consensus on dosage and administration route, and finally in creating a summarising table, the “RaNaTable”, which aims to be a useful tool for fast consultation on the administration of drugs in out-of-hospital medical emergencies (AU)