Self-management in heart failure using mHealth: A content validation.

AIM: To describe the development of a mobile health application -mICardiApp- designed by a multidisciplinary professional team and patients with heart failure and to evaluate its content validity. METHODS: Critical reviews of the literature, semi-structured interviews with patients, and user stories guided the development of the content of the mobile application. These contents were refined and validated through a modified Delphi process. An expert panel of healthcare and social care professionals together with patients and academics evaluated the content through two content validity indicators, relevance, and adequacy, and provided narrative feedback. The content validity of the app and each screen was determined by calculating the Content Validity Index (CVI). Similarly, the Adequacy Index (AI) was analyzed. RESULTS: The developed app is composed by 8 topics: (1) available resources, (2) cardiac rehabilitation, (3) control of signs and symptoms, (4) emotional support, (5) learning and having fun, (6) medication, (7) nutrition, and (8) physical activity. The results demonstrated high CVI of the screens and the full app. 57 of the 59 screens in the app reached an excellent CVI ≥ 0.70 for both relevance and adequacy, except for 2 screens. The CVI Average Method of the app was 0.851. CONCLUSIONS: mICardiApp is presented as an application to improve health literacy and self-management of patients with multimorbidity and heart failure, with proven validation.

Design of a nursing objective structured clinical examination of a first-year clinical practice program.

OBJECTIVE: The aim of the present study was to design a content-valid nursing objective structured clinical examination attending a first-year clinical nursing practice program. METHOD: The examination was designed following a procedure based on the consensus of experts which was comprised of three phases: selection of the activities in which students should be competent according to the learning outcomes of the course, clinical case design, and integration of the clinical cases designed into the stations of the test. RESULTS: Of the 44 surveys submitted for the design of the stations, 37 were answered, of which 31 respondents met the inclusion criteria of the panel of experts. The activities on which the experts reached the highest degrees of consensus were: basic physical assessment and monitoring of vital signs, assessment of hygiene and skin status, ability to develop care plans, management of safety principles in administration of medication and administration of oral medication. Based on the selected activities, the experts developed 20 clinical cases, from which a four-station nursing objective structured clinical examination was designed. CONCLUSION: The structured methodology based on the design of experts enabled the design of a content-valid objective structured clinical examination appropriate for the evaluation of the learning outcomes achieved by the students attending a clinical practice program.

Design of a nursing objective structured clinical examination of a first-year clinical practice program / Projeto de um exame clínico estruturado objetivo de enfermagem de um programa de prática clínica do primeiro ano / Diseño de una prueba de evaluación clínica objetiva estructurada de cuidados de enfermería del primer curso de prácticas clínicas

ABSTRACT Objective: The aim of the present study was to design a content-valid nursing objective structured clinical examination attending a first-year clinical nursing practice program. Method: The examination was designed following a procedure based on the consensus of experts which was comprised of three phases: selection of the activities in which students should be competent according to the learning outcomes of the course, clinical case design, and integration of the clinical cases designed into the stations of the test. Results: Of the 44 surveys submitted for the design of the stations, 37 were answered, of which 31 respondents met the inclusion criteria of the panel of experts. The activities on which the experts reached the highest degrees of consensus were: basic physical assessment and monitoring of vital signs, assessment of hygiene and skin status, ability to develop care plans, management of safety principles in administration of medication and administration of oral medication. Based on the selected activities, the experts developed 20 clinical cases, from which a four-station nursing objective structured clinical examination was designed. Conclusion: The structured methodology based on the design of experts enabled the design of a content-valid objective structured clinical examination appropriate for the evaluation of the learning outcomes achieved by the students attending a clinical practice program.

RESUMO Objetivo: O objetivo do presente estudo foi elaborar um exame clínico estruturado de objetivos de enfermagem com conteúdo válido, participando de um programa de prática clínica de enfermagem do primeiro ano. Método: O exame foi elaborado seguindo um procedimento baseado no consenso de especialistas que compreendeu três fases: seleção das atividades nas quais os alunos deveriam ser competentes de acordo com os resultados de aprendizagem do curso, desenho do caso clínico e integração do quadro clínico casos projetados para as estações do teste. Resultados: Das 44 pesquisas submetidas para a concepção das estações, 37 foram respondidas, das quais 31 respondentes atenderam aos critérios de inclusão do painel de especialistas. As atividades nas quais os especialistas alcançaram maior grau de consenso foram: avaliação física básica e monitoramento dos sinais vitais, avaliação da higiene e do estado da pele, capacidade de desenvolver planos de cuidados, gestão dos princípios de segurança na administração de medicamentos e administração de medicamentos orais. Com base nas atividades selecionadas, os especialistas desenvolveram 20 casos clínicos, a partir dos quais foi elaborado um exame clínico estruturado objetivo de enfermagem em quatro estações. Conclusão: A metodologia estruturada baseada na concepção de especialistas permitiu a concepção de um exame clínico estruturado objetivo válido e de conteúdo adequado para a avaliação dos resultados de aprendizagem alcançados pelos alunos que frequentam um programa de prática clínica.

RESUMEN Objetivo: El objetivo de este estudio fue diseñar una Evaluación Clínica Objetiva Estructurada con validez de contenido para evaluar el nivel de competencias de estudiantes de primer curso de formación practico-clínica enfermera. Método: Se diseñó la prueba siguiendo un procedimiento basado en consenso de expertos con tres fases: selección de las actividades en la que los alumnos debían ser competentes en base a los resultados de aprendizaje de la asignatura, diseño de casos clínicos, e integración de los casos clínicos diseñados en las estaciones de la prueba. Resultados: Las actividades que alcanzaron mayor consenso por parte de los expertos fueron: valoración física básica y monitorización de signos vitales, valoración de la higiene y estado de la piel, capacidad para elaborar planes de cuidados, manejo de los principios de seguridad en la administración de medicación y administración de medicación oral. En base a las actividades seleccionadas, los expertos elaboraron 20 casos clínicos, a partir de los cuales se diseñó una evaluación clínica objetiva estructurada de cuidados de enfermería formada por cuatro estaciones. Conclusión: La metodología estructurada basada en el diseño de expertos permitió el diseño de una evaluación clínica objetiva estructurada adecuada para evaluar los resultados de aprendizaje alcanzados por los estudiantes de primer curso de formación práctico-clínica.

A Student Assessment Tool for Standardized Patient Simulations (SAT-SPS): Psychometric analysis.

BACKGROUND: The evaluation of the level of clinical competence acquired by the student is a complex process that must meet various requirements to ensure its quality. The psychometric analysis of the data collected by the assessment tools used is a fundamental aspect to guarantee the student's competence level. AIM: To conduct a psychometric analysis of an instrument which assesses clinical competence in nursing students at simulation stations with standardized patients in OSCE-format tests. METHOD: The construct of clinical competence was operationalized as a set of observable and measurable behaviors, measured by the newly-created Student Assessment Tool for Standardized Patient Simulations (SAT-SPS), which was comprised of 27 items. The categories assigned to the items were 'incorrect or not performed' (0), 'acceptable' (1), and 'correct' (2). PARTICIPANTS: 499 nursing students. Data were collected by two independent observers during the assessment of the students' performance at a four-station OSCE with standardized patients. Descriptive statistics were used to summarize the variables. The difficulty levels and floor and ceiling effects were determined for each item. Reliability was analyzed using internal consistency and inter-observer reliability. The validity analysis was performed considering face validity, content and construct validity (through exploratory factor analysis), and criterion validity. RESULTS: Internal reliability and inter-observer reliability were higher than 0.80. The construct validity analysis suggested a three-factor model accounting for 37.1% of the variance. These three factors were named 'Nursing process', 'Communication skills', and 'Safe practice'. A significant correlation was found between the scores obtained and the students' grades in general, as well as with the grades obtained in subjects with clinical content. CONCLUSIONS: The assessment tool has proven to be sufficiently reliable and valid for the assessment of the clinical competence of nursing students using standardized patients. This tool has three main components: the nursing process, communication skills, and safety management.

Nursing diagnosis of grieving: content validity in perinatal loss situations.

PURPOSE: To validate the content of the NANDA-I nursing diagnosis of grieving in situations of perinatal loss. METHODS: Using the Fehring's model, 208 Spanish experts were asked to assess the adequacy of the defining characteristics and other manifestations identified in the literature for cases of perinatal loss. FINDINGS: The content validity index was 0.867. Twelve of the 18 defining characteristics were validated, seven as major and five as minor. From the manifestations proposed, "empty inside" was considered as major. CONCLUSION: The nursing diagnosis of grieving fits in content to the cases of perinatal loss according to experts. IMPLICATIONS FOR NURSING PRACTICE: The results have provided evidence to support the use of the diagnosis in care plans for said clinical situation.

Desarrollo y evaluacion psicometrica de una forma abreviada de la escala de posicionamiento ante el diagnostico enfermero / A forma abreviada da escala posições frente ao diagnostico de enfermagem: desenvolvimento e avaliação psicométrica / A short form of the positions on nursing diagnosis scale: development and psychometric testing

El Position on Nursing Diagnosis (PND) es una escala que utiliza la técnica del diferencial semántico para medir las actitudes hacia el concepto diagnóstico enfermero. El estudio objetivó desarrollar una forma abreviada de la versión española de esta escala, evaluar sus propiedades psicométricas y eficiencia. Se utilizó un doble enfoque empírico-teórico para obtener una forma reducida del PND, el PND-7-SV, que fuera equivalente a la original. Mediante un diseño transversal a través de encuesta, se evaluó la fiabilidad (consistencia interna y fiabilidad test-retest), validez de constructo (análisis factorial exploratorio, técnica de grupos conocidos y validez discriminante) y de criterio (validez concurrente), sensibilidad al cambio y eficiencia del PND-7-SV en una muestra de 476 estudiantes de enfermería españoles. Los resultados avalaron la utilidad del PND-7-SV para medir las actitudes hacia el diagnóstico enfermero de manera equivalente a la forma completa de la escala y en un tiempo más reducido.

O Position on Nursing Diagnosis (PND) é uma escala que utiliza a técnica do diferencial semântico para medir atitudes em relação ao conceito diagnóstico de enfermagem. O objetivo deste estudo foi desenvolver uma forma abreviada da versão em espanhol desta escala e avaliar suas propriedades psicométricas e eficiência. Foi utilizada uma dupla abordagem teórico-empírica para obter uma forma curta do PND, o PND-7-SV, que era equivalente à original. Usando um desenho transversal através de pesquisa, foi avaliada a confiabilidade (consistência interna e confiabilidade teste-reteste), validade de constructo (análise fatorial exploratória, técnica de grupos conhecidos e validade discriminante) e de critério (validade concorrente), sensibilidade à mudança e eficiência da PND-7-SV em uma amostra de 476 estudantes de enfermagem espanholas. Os resultados endossaram a utilidade do PND-7-SV para medir atitudes em relação ao diagnóstico de enfermagem de maneira equivalente à forma completa da escala e em um curto tempo.

The Positions on Nursing Diagnosis (PND) is a scale that uses the semantic differential technique to measure nurses' attitudes towards the nursing diagnosis concept. The aim of this study was to develop a shortened form of the Spanish version of this scale and evaluate its psychometric properties and efficiency. A double theoretical-empirical approach was used to obtain a short form of the PND, the PND-7-SV, which would be equivalent to the original. Using a cross-sectional survey design, the reliability (internal consistency and test-retest reliability), construct (exploratory factor analysis, known-groups technique and discriminant validity) and criterion-related validity (concurrent validity), sensitivity to change and efficiency of the PND-7-SV were assessed in a sample of 476 Spanish nursing students. The results endorsed the utility of the PND-7-SV to measure attitudes toward nursing diagnosis in an equivalent manner to the complete form of the scale and in a shorter time.

The Spanish version of the Position on Nursing Diagnosis scale: cross-cultural adaptation and psychometric assessment.

AIM: To report the adaptation into Spanish and psychometric testing of the Position on Nursing Diagnosis scale. BACKGROUND: The Position on Nursing Diagnosis is a scale that uses the semantic differential technique to measure nurses' attitudes towards the nursing diagnosis concept. DESIGN: Methodological design. METHOD: The scale was cross-culturally adapted through a process including translation, comparison with versions in other languages, back-translation, review, and pre-testing. An opportunistic sample of 621 Spanish registered nurses was recruited from August-December 2011. Reliability was evaluated through internal consistency and test-retest reliability. Construct validity, using both exploratory factor analysis and the known-group technique, and concurrent validity were assessed. FINDINGS: The Position on Nursing Diagnosis-Spanish Version was obtained from the cross-cultural adaptation process. High internal consistency and satisfactory test-retest reliability over a two week period (n = 240) were found. In the principal component analysis, all items loaded strongly on a single-factor which accounted for adequate variance, supporting the unidimensionality of the scale. A statistically significant difference was found comparing the scores of nurses who were members of the Spanish Association of Nomenclature, Taxonomy and Nursing Diagnosis and those who were not. Concurrent validity was supported by the significant correlation found between the scores and the degree of nursing diagnosis utilization and attendance to training sessions. CONCLUSION: The findings support the validity and reliability of the Position on Nursing Diagnosis-Spanish Version for its use among Spanish registered nurses as a measurement of their attitude towards the nursing diagnosis concept.

[A short form of the positions on nursing diagnosis scale: development and psychometric testing]. / Desarrollo y evaluación psicométrica de una forma abreviada de la escala de posicionamiento ante el diagnóstico enfermero.

The Positions on Nursing Diagnosis (PND) is a scale that uses the semantic differential technique to measure nurses' attitudes towards the nursing diagnosis concept. The aim of this study was to develop a shortened form of the Spanish version of this scale and evaluate its psychometric properties and efficiency. A double theoretical-empirical approach was used to obtain a short form of the PND, the PND-7-SV, which would be equivalent to the original. Using a cross-sectional survey design, the reliability (internal consistency and test-retest reliability), construct (exploratory factor analysis, known-groups technique and discriminant validity) and criterion-related validity (concurrent validity), sensitivity to change and efficiency of the PND-7-SV were assessed in a sample of 476 Spanish nursing students. The results endorsed the utility of the PND-7-SV to measure attitudes toward nursing diagnosis in an equivalent manner to the complete form of the scale and in a shorter time.

Tackling perinatal loss, a participatory action research approach: research protocol.

AIM: The aim of this study was to promote changes to improve the care provided to parents who have experienced a perinatal loss through participatory action research. BACKGROUND: The birth of a child is a joyful event for most families, however, unfortunately some pregnancies end in loss. Perinatal loss creates a heavy emotional impact not only on parents but also on health professionals, where in most cases there is an evident lack of skills, strategies and resources to cope with these kinds of situations. DESIGN: Participatory action research is the methodology proposed to achieve the purpose of this study. METHODS: Participatory action research consists of five stages: outreach and awareness, induction, interaction, implementation and systematization. The working group will include professionals from the Mother and Child Unit for patients at a tertiary level public hospital in Spain. The duration of the study will be 3 years since the approval of the protocol in January 2011. The qualitative techniques used will include group dynamics such as the SWOT analysis the nominal group technique, focus groups and brainstorming, among others that will be recorded and transcribed, generating reports throughout the evolution of the group sessions and about the consensus reached. Content analysis will be conducted on the field diaries kept by the participants and researchers. This project has been funded by the Andalusian Regional Ministry of Health. DISCUSSION: Participatory action research is a methodological strategy that allows changes in clinical practice to conduct a comprehensive transformative action in the care process for perinatal loss.