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Nonspecific lower back pain is one of the main health issues experienced by nonprofessional caregivers of dependent individuals. The repetitive movements and efforts made by caregivers to assist dependent individuals are associated with the onset of this lower back pain. The main objective of this study was to assess the effectiveness of an educational intervention for the management of nonspecific lower back pain in nonprofessional caregivers of dependent individuals (TRANSFE program). The secondary objectives were to (i) evaluate the effectiveness of the TRANSFE program on other variables (caregiver burden, perceived social support, and health-related quality of life), (ii) obtain the sociodemographic profile of the sample, and (iii) determine the baseline of the study variables. A quasi-experimental study with post-intervention measurements at 3 months was conducted. Thirty-six nonprofessional caregivers of dependent individuals participated in this study. The presence of lower back pain (back pain index), low back pain (visual analogue scale), disability due to low back pain (Oswestry disability index), perceived social support (Duke-UNK scale), caregiver burden (Zarit burden scale), and health-related quality of life (EuroQol-5D) were assessed. The intervention significantly improved all the studied variables related to lower back pain (p < 0.001). The intervention was effective on other variables related to nonprofessional caregiving such as caregiver burden, perceived social support, and health-related quality of life, albeit with moderate results. An educational intervention for lower back pain experienced by caregivers of dependent individuals was effective in reducing lower back pain and addressing caregiver burden, perceived social support, and health-related quality of life. This study was registered retrospectively on the Open Science Framework platform on 20 June 2024, with the registration number 10.17605/OSF.IO/K7WTE.
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A valid and reliable nursing assessment is essential for identifying required care and ensuring patient safety. The convenience of conducting a comprehensive assessment of the patient has led to a significant increase in assessment tools that may slow down the process. Nevertheless, the possibility of consolidating various instruments that measure common or similar constructs into a meta-instrument is considered an alternative that could enhance assessment efficiency. A meta-instrument can be defined as a measurement tool that consolidates other instruments based on measuring related constructs and sharing dimensions or items, aiming to achieve a more parsimonious measurement. Literature on such assessment tools is scarce, and there are numerous options for their construction and initial validation. Additionally, it is advisable to confirm their psychometric properties and ensure that they maintain, at the very least, the same diagnostic capacity as the original instruments. This article presents a proposal for the phases to follow in constructing meta-instruments, along with various methodological alternatives that can be employed based on the characteristics of the original instruments and the purpose of creating the meta-instrument. Furthermore, special attention is given to the checklists that should be used to study the psychometric properties and diagnostic capacity of the meta-instruments. Finally, future lines of research and challenges in the development of nursing assessment meta-instruments are discussed.
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BACKGROUND: Active aging is considered one of the most effective methods for a healthy aging process. There are numerous clinical practice guidelines that address this model and propose multiple strategies for its achievement through the improvement of motor and cognitive function. Virtual reality is emerging as a potential tool, with various modalities focused on promoting good health maintenance in older adults. The objectives of this review were to map the potential benefits of virtual reality for active aging and delve into adaptability and adherence in older individuals. METHODS: A scoping review was conducted on studies published between 2013 and 2023 in English, Spanish, or Catalan, examining virtual reality interventions in older adults. The search was performed using the Medline, CINAHL, Scopus, and Web of Science databases. The methodological quality was assessed using CASPe and FLC 3.0 critical appraisal guidelines. The graphical data were reported narratively, grouping results based on the study characteristics and the impact of virtual reality. RESULTS: The review process resulted in the inclusion of 22 articles out of the initial 459 following the application of the selection criteria. Most articles were randomized controlled trials (45.4%; n = 10), systematic reviews (40.9%; n = 9), observational studies (9%; n = 2), and pilot studies (4.5%; n = 1). The information was organized based on the virtual reality modality (immersive, non-immersive, and 360) and application area (motor, cognitive, and mental health). CONCLUSIONS: Virtual reality (both immersive and non-immersive) is a valuable tool for promoting physical exercise in older adults, helping to prevent recurrent accidental falls. It also yields positive results for cognitive stimulation in healthy older individuals, improving memory, depression, and mental health in those with cognitive impairment. Virtual reality is generally well-received by older adults, achieving high adherence rates.
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Nomophobia is a phenomenon that describes the fear of not having one's mobile phone accessible. This study aimed to evaluate the presence of nomophobia among nursing students as well as its relationship with procrastination and social anxiety. METHODS: An observational, descriptive, cross-sectional study was conducted in a sample of 308 nursing students. Data were collected using the Nomophobia Questionnaire, Academic Procrastination Scale-Short Form, and Social Anxiety Questionnaire for Adults. Additionally, sociodemographic variables related to academic performance and smartphone use were collected. We performed a descriptive, bivariate, and multivariate analysis of the Nomophobia Questionnaire score. RESULTS: 19.5% (n = 60) of the students presented with or were at high risk of nomophobic behaviour. Moreover, nomophobic behaviour was positively correlated with high levels of social anxiety (p < 0.001), longer daily smartphone usage time (p < 0.001), and a high frequency of smartphone checking in class (p < 0.001). The predictive variables for nomophobic behaviour included age, variables related to smartphone use, social anxiety levels, work, procrastination tendency, sex, and self-reported average grade. CONCLUSION: One out of five students in the sample studied presented with or were at high risk of nomophobic behaviour. Additionally, nomophobic behaviour was associated with social anxiety and variables related to smartphone use. This study was not registered.
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Objetivo: Examinar la validez de constructo del índice de Barthel en unidades de hospitalización de adultos. Métodos: Se realizó un análisis secundario en una muestra de 1.342 pacientes adultos ingresados en unidades de hospitalización. El análisis factorial confirmatorio del índice de Barthel no confirma su estructura unidimensional (CFA-1). Se exploraron dos métodos para encontrar una solución con un mejor ajuste. Se realizó la secuencia de los métodos clásicos de análisis factorial exploratorio y confirmatorio (CFA-2). Se realizó un modelo gráfico gaussiano y un análisis factorial confirmatorio (CFA-3). Se compararon tres modelos sobre una base de varios indicadores de bondad de ajuste. Resultados: Los resultados del CFA-1 (χ2 = 161.616; p < 0,001; RMSEA = 0,183) indicaron un mal ajuste entre el modelo y los datos obtenidos. El análisis factorial exploratorio proporcionó un modelo con dos dimensiones que explicaba 86% de la varianza y mejoró el indicador de bondad de ajuste en CFA-2 (χ2 = 846; p < 0,001; RMSEA = 0,133). El modelo gráfico gaussiano ofreció una solución con tres dimensiones que mejoró la bondad de ajuste con respecto a los modelos anteriores al eliminar el ítem continencia vesical (χ2 = 493; p < 0,001; RMSEA = 0,09). Conclusiones: El índice de Barthel no es una medida unidimensional de la capacidad funcional cuando se aplica en unidades de hospitalización de adultos. El modelo que mejor se ajusta tiene una estructura tridimensional (higiene, alimentación y eliminación, movilidad) que se relaciona con los dominios de los cuidados básicos.(AU)
Objective: Examine the construct validity of the Barthel Index in adult inpatient units. Methods: A secondary analysis was performed on a sample of 1342 adult patients admitted to inpatient units. A confirmatory factor analysis of the Barthel Index did not confirm its unidimensional structure (CFA-1). Therefore, two methods were explored to find a solution with a better fit. The sequence of the classical exploratory and confirmatory factor analysis methods was carried out (CFA-2). In contrast, a Gaussian graphical model and confirmatory factor analysis (CFA-3) were performed. Three models were compared on the basis of several goodness-of-fit indicators. Results: CFA-1 results (χ2 = 161616; P < .001; RMSEA = .183) indicated a poor fit between the model and the data. Exploratory factor analysis provided a model with two dimensions that explained 86% of the variance and improved the goodness-of-fit in CFA-2 (χ2 = 846; P < .001; RMSEA = .133). The Gaussian graphical model, by removing the item Bladder, offered a solution with three dimensions that improved the goodness-of-fit compared to the previous models (χ2 = 492; P < .001; RMSEA = .09). Conclusions: The Barthel Index is not a unidimensional measure of functional capacity when applied to adult inpatient units. The best-fitting model has a three-dimensional structure (Hygiene; Feeding and disposal; Mobility) that relates to the domains of care needs.
Subject(s)
Humans , Male , Female , Adult , Patients , Hospitals , Nursing Care , Nursing Assessment , Repertory, Barthel , Activities of Daily Living , Nursing , Spain , Factor Analysis, StatisticalABSTRACT
The main objective of this study was to analyze the impact of a multifaceted strategy to improve the assessment of functional capacity, risk of pressure injuries, and risk of falls at the time of admission of patients in adult hospitalization units. This was a secondary analysis of the VALENF project databases during two periods (October-December 2020, before the strategy, and October-December 2021, after the strategy). The quantity and quality of nursing assessments performed on patients admitted to adult hospitalization units were evaluated using the Barthel index, Braden index, and Downton scale. The number of assessments completed before the implementation of the new strategy was n = 686 (28.01%), versus n = 1445 (58.73%) in 2021 (p < 0.001). The strategy improved the completion of the evaluations of the three instruments from 63.4% (n = 435) to 71.8% (n = 1038) (p < 0.001). There were significant differences depending on the hospitalization unit and the assessment instrument (p < 0.05). The strategy employed was, therefore, successful. The nursing assessments show a substantial improvement in both quantity and quality, representing a noticeable improvement in nursing practice. This study was not registered.
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OBJECTIVE: Examine the construct validity of the Barthel Index in adult inpatient units. METHOD: A secondary analysis was performed on a sample of 1342 adult patients admitted to inpatient units. A confirmatory factor analysis of the Barthel Index did not confirm its unidimensional structure (CFA-1). Therefore, two methods were explored to find a solution with a better fit. The sequence of the classical exploratory and confirmatory factor analysis methods was carried out (CFA-2). In contrast, a Gaussian graphical model and confirmatory factor analysis (CFA-3) were performed. Three models were compared on the basis of several goodness-of-fit indicators. RESULTS: CFA-1 results (χ2â¯=â¯161,616; Pâ¯<â¯.001; RMSEAâ¯=â¯.183) indicated a poor fit between the model and the data. Exploratory factor analysis provided a model with two dimensions that explained 86% of the variance and improved the goodness-of-fit in CFA-2 (χ2â¯=â¯846; Pâ¯<â¯.001; RMSEAâ¯=â¯.133). The Gaussian graphical model, by removing the item 'Bladder', offered a solution with three dimensions that improved the goodness-of-fit compared to the previous models (χ2â¯=â¯492; Pâ¯<â¯.001; RMSEAâ¯=â¯.09). CONCLUSION: The Barthel Index is not a unidimensional measure of functional capacity when applied to adult inpatient units. The best-fitting model has a three-dimensional structure (Hygiene; Feeding and disposal; Mobility) that relates to the domains of care needs.
Subject(s)
Hospitalization , Adult , Humans , Factor Analysis, StatisticalABSTRACT
The nursing assessment is the first step of the nursing process and fundamental to detecting patients' care needs and at-risk situations. This article presents the psychometric properties of the VALENF Instrument, a recently developed meta-instrument with only seven items that integrates the assessment of functional capacity, risk of pressure injuries and risk of falls with a more parsimonious approach to nursing assessment in adult hospitalization units. A cross-sectional study based on recorded data in a sample of 1352 nursing assessments was conducted. Sociodemographic variables and assessments of the Barthel, Braden and Downton instruments were included at the time of admission through the electronic health history. Thus, the VALENF Instrument obtained high content validity (S-CVI = 0.961), construct validity (RMSEA = 0.072; TLI = 0.968) and internal consistency (Ω = 0.864). However, the inter-observer reliability results were not conclusive, with Kappa values ranging between 0.213 and 0.902 points. The VALENF Instrument has adequate psychometric properties (content validity, construct validity, internal consistency and inter-observer reliability) for assessing the level of functional capacity, risk of pressure injuries and risk of falls. Future studies are necessary to establish its diagnostic accuracy.
Subject(s)
Pressure Ulcer , Humans , Adult , Pressure Ulcer/epidemiology , Accidental Falls , Cross-Sectional Studies , Reproducibility of Results , Hospitalization , Psychometrics/methods , Surveys and QuestionnairesABSTRACT
AIMS: To develop and validate an instrument that integrates functional capacity, risk of pressure ulcers and risk of falling with a more parsimonious approach towards nursing assessments in hospitalization units. DESIGN: Cross-sectional validation multicentre study. METHODS: Socio-demographic variables and assessments of Barthel Index, Braden Index and Downton Scale are included via electronic health records. Instrument's development process will include: (i) conceptual assessments; (ii) content validity; (iii) construct validity; (iv) internal consistency and (v) interobserver reliability. The analysis will consider possible differences in medical and surgical hospitalization units, hospitalization type or being a COVID-19 patient. This study was accepted for funding in November 2020 and approved by the Ethics and Research Committee in January 2021. RESULTS: An integrated instrument that lowers the administrative load of nursing assessments and allows at-risk patients to be detected with at least the same validity and reliability as the original instruments is expected to be obtained.
Subject(s)
COVID-19 , Humans , Adult , Reproducibility of Results , Cross-Sectional Studies , Hospitalization , Nursing Assessment , Multicenter Studies as TopicABSTRACT
Nursing assessment is the basis for performing interventions that match patient needs, but nurses perceive it as an administrative load. This research aims to develop and validate a meta-instrument that integrates the assessment of functional capacity, risk of pressure ulcers and risk of falling with a more parsimonious approach to nursing assessment in adult hospitalization units. Specifically, this manuscript presents the results of the development of this meta-instrument (VALENF instrument). A cross-sectional study based on recorded data was carried out in a sample of 1352 nursing assessments. Socio-demographic variables and assessments of Barthel, Braden and Downton indices at the time of admission were included. The meta-instrument's development process includes: (i) nominal group; (ii) correlation analysis; (iii) multiple linear regressions models; (iv) reliability analysis. A seven-item solution showed a high predictive capacity with Barthel (R2adj = 0.938), Braden (R2adj = 0.926) and Downton (R2adj = 0.921) indices. Likewise, reliability was significant (p < 0.001) for Barthel (ICC = 0.969; τ-b = 0.850), Braden (ICC = 0.943; τ-b = 0.842) and Downton (ICC = 0.905; κ = 7.17) indices. VALENF instrument has an adequate predictive capacity and reliability to assess the level of functional capacity, risk of pressure injuries and risk of falls.
Subject(s)
Nursing Assessment , Pressure Ulcer , Adult , Humans , Reproducibility of Results , Cross-Sectional Studies , Nursing Assessment/methods , Pressure Ulcer/epidemiology , HospitalizationABSTRACT
Objetivos: Determinar el grado de autocuidado y la calidad de vida en una muestra de pacientes con Enfermedad de Parkinson en estadios iniciales y conocer las dimensiones de autocuidado y calidad de vida más afectadas. Estudiar la relación entre los síntomas no motores con estas medidas de resultado.Metodología: Estudio observacional transversal realizado en una muestra de 21 enfermos de Parkinson grado I, II de la escala Hoenh Yarh. Se estudió el nivel de autocuidados, calidad de vida, síntomas no motores y nivel de salud percibido. Se realizó análisis descriptivo, inferencial y de correlación con el paquete estadístico SPSS v.20.Resultados: La edad media de la muestra fue de 71,86 (dt+/-8,93) años, el 52,4% eran hombres. El nivel medio de autocuidados fue de 1,14 (dt+/-0,35) siendo la dimensión más afectada el uso de medicamentos con una autonomía completa del 61,9% y 17,28 (dt+/-7,75) para la calidad de vida siendo la dimensión más afectada el disconfort corporal (m=35,03; dt+/-19,61).Se observó correlación baja entre los síntomas no motores y la calidad de vida (r=0,246;p=0,022), pero no entre los síntomas no motores y el autocuidado (r=0,010;p=0,662).Conclusiones: El nivel de autocuidados y calidad de vida de la muestra estudiada es adecuado. Las dimensiones de calidad de vida más afectadas son el disconfort corporal seguida por el deterioro cognitivo y los síntomas no motores están relacionados con el nivel de calidad de vida. Es relevante considerar estos aspectos en el desarrollo de intervenciones de educación terapéutica dirigidas a pacientes con Parkinson
Objectives: To determine the level of self-care and quality of life in a sample of patients in the early stages of Parkinson's disease and identify the most highly affected dimensions of self-care and quality of life. To study the relationship between non-motor symptoms and these outcome measures.Method: A cross-sectional study was conducted in a sample of 21 patients with stage I or II Parkinson's disease as defined by the Hoenh Yarh Scale. We studied the level of self-care, quality of life, non-motor symptoms and perceived health status. Descriptive, inferential and correlation analyses were performed using SPSS v.20.Results: Mean sample age was 71.86 (SD+/-8.93) years old, and 52.4% were males. The mean score for self-care was 1.14 (SD+/-0.35), and the most highly affected dimension was medication use, with 61.9% of the sample presenting complete autonomy, while for quality of life it was 17.28 (SD+/-7.75), and the most highly affected dimension was bodily discomfort (m=35.03; SD+/-19.61). We observed a correlation between non-motor symptoms and quality of life (r=0.246; p=0.022), but not between non-motor symptoms and self-care (r=0.010; p=0.662).Conclusions: Our sample presented an acceptable level of self-care and quality of life. The most highly affected quality of life dimensions were bodily discomfort followed by cognitive impairment, and non-motor symptoms were related to the level of quality of life. It is important to consider these aspects when designing therapeutic education interventions targeting patients with Parkinson's disease