Development and validation of the questionnaire to analyze the communication of nurses in nurse-patient therapeutic communication.

OBJECTIVE: The purpose of this study was to develop and analyze the psychometric properties of an instrument that could analyze the communication of nursing professionals in nurse-patient therapeutic communication. METHODS: A literature review and a panel of experts were used (N = 10) to develop the questionnaire to analyze the communication of nurses in nurse-patient therapeutic communication. The final version of the questionnaire was composed of 49 items and applied to a convenience sample of 370 nurses. RESULTS: The construct validity was assessed by an exploratory factor analysis (EFA) and the reliability using Cronbach's Alpha. Three dimensions were identified that determine therapeutic communication: professional, contextual and/or situational and patient. The Cronbach's α total coefficient was 0.90, ranging from 0.71 to 0.81 for the dimensions. CONCLUSION: The questionnaire to analyze the communication of nurses in nurse-patient therapeutic communication represents a valid and reliable questionnaire to measure nurses' communication with patients in the clinical setting. IMPLICATIONS FOR PRACTICE: The use of the questionnaire enables the analysis of elements that interfere with effective communication. This can assist in developing interventions to improve nurses' therapeutic communication with patients.

Intervention for Alleviating Clinical Inertia in the Management of Urinary Incontinence.

PURPOSE: The purpose of this study was to determine whether clinical inertia exists in the care of patients with urinary incontinence and to test the effects of an educational intervention designed to alleviate inertia related to care of urinary incontinence. DESIGN: Single-group, pretest/posttest design. SUBJECTS AND SETTING: The sample comprised 132 participants practicing in 6 medical-surgical inpatient care units at an urban hospital in Almería, Spain; 66 (50%) were RNs, and all other participants were unlicensed assistive personnel. Most participants (87.9%) were female; their average age was 43.99 years (SD = 7.85 years). METHODS: An educational intervention (online course) was provided. The main objective of the course was application of evidence-based knowledge for prevention and management of urinary incontinence in hospitalized patients. The course program comprised 3 didactic units: (1) introduction and evaluation of the patient with urinary incontinence, (2) care plans, and (3) instructions and rational use of absorbent products. Data collection included demographic and professional characteristics of respondents, desired results when caring for patients with incontinence, a medical record checklist, an occupational environment and satisfaction scale, and an assessment record of knowledge/skills and training activity satisfaction. RESULTS: After comparing the pre- and posttest scores of knowledge on urinary incontinence, significant differences were found before and after the intervention (z = -14.113, P = .000). Specifically, analysis revealed differences in caring actions related to urinary incontinence (z = -14.248, P = .000) and differences in direct observation of urinary incontinence practice following the intervention (z = -14.326, P = .000). CONCLUSIONS: Our findings indicate existence of inertia in nursing care for hospitalized patients with urinary incontinence. The educational intervention improved knowledge, observable nursing care activities related to incontinence management, and improved documentation of care.

Guess it (SVUAL): An app designed to help nursing students acquire and retain knowledge about basic and advanced life support techniques.

To design an app that helps nursing students to acquire and retain knowledge of Basic and Advanced Life Support techniques, as well as analyze the students' gamification experience. The study had two phases: 1) App design and development and 2) experimental study. A total of 184 students participated, with 92 in the experimental group and 92 in the control group. The instruments used were the Guess it (SVUAL) app, a test on knowledge and the Gameful Experience Scale. The app was deemed to have a suitable level of content and user-friendliness of 97%. The experimental group obtained a higher average score on the knowledge test than the control group (U = 2835.500; Z = -3.968; p < 0.05). On the re-test, the experimental group also obtained a higher average score than the control group. As for the experience within the game, all the dimensions scored higher than average, except the absence of negative effects dimension, which indicates that the app had very few negative consequences on the participants. The developed app has proven to have a good level of content and to be user-friendly, improving knowledge levels and retention of information in nursing students.

The connection of the clinical learning environment and supervision of nursing students with student satisfaction and future intention to work in clinical placement hospitals.

AIMS AND OBJECTIVES: To analyse nursing students' perceptions of the clinical learning environment and supervision and the connection between their satisfaction and intention of staying in their placement hospitals. BACKGROUND: Global nursing shortage necessitates strategies for the recruitment and retention of nurses. It is believed that nursing students' clinical placement experiences can affect their learning outcomes, as well as influence their choice of future workplace. DESIGN: Cross-sectional, correlational study. METHODS: One hundred and eighty nursing students participated in the study. The data were collected in person using The Clinical Learning Environment, Supervision and Nurse Teacher scale tool. Students' satisfaction with the clinical learning environment and learning process was measured using a 4-point Likert scale developed by the researchers. The STROBE checklist was used in this paper. RESULTS: Nursing students perceived a favourable clinical learning environment and supervision in the hospitals where they undertook clinical placements, recording high levels of satisfaction and high levels of intention to stay and work there. The clinical learning environment and supervision established positive correlations with student satisfaction. CONCLUSIONS: This study promotes the development of knowledge and understanding of how student satisfaction and intention to stay and work in their placement hospitals relates to the quality of the clinical learning environment and supervision, which could be helpful to the management of healthcare facilities and faculties in improving nursing education and retention/recruitment strategies. RELEVANCE TO CLINICAL PRACTICE: Nursing students represent the future of the nursing workforce, so managers of healthcare facilities and faculties should move towards promoting a clinical learning and supervisory environment where supervisors, tutors and staff are aware of their commitment to student education and promote optimal learning and positive experiences in order for students to feel satisfied and motivated to work in their placement hospitals.

Undergraduate nurses' perception of the nursing practice environment in university hospitals: A cross-sectional survey.

OBJECTIVE: To describe the psychometric properties of the Practice Environment Scale of the Nursing Work Index (PES-NW) among undergraduate nurses and to compare their perceptions of the nursing practice environment by academic year and unit type. BACKGROUND: Despite the fact that nursing students develop most of their undergraduate learning and training in the nursing practice environment, their perception about it has not been considered to date. METHODS: The psychometric properties were analysed on a sample of 180 undergraduate nurses. Data collection was carried out in 2018. Data were analysed using percentages, frequencies, mean, standard deviation and Mann-Whitney U test. Factor structure was evaluated with exploratory factor analysis, and reliability was evaluated with Cronbach's alpha. RESULTS: Psychometric analysis showed an adequate construct validity and reliability for the PES-NWI. Cronbach's Alpha was 0.884. Undergraduate nurses perceived most hospitals as favourable, scoring the 'Nurse-physician relationships' factor highest and 'Staffing and resource adequacy' factor lowest. CONCLUSION: The PES-NWI is a valid and reliable instrument that could be applied in future research to explore nursing students' perceptions of the nursing practice environment. IMPLICATIONS FOR NURSING MANAGEMENT: Nurse managers are responsible for supervising and ensuring that the nursing practice environment at university hospitals meets the necessary criteria to support the workplace learning of undergraduate nurses.

Magnet hospital attributes in nursing work environment and its relationship to nursing students' clinical learning environment and satisfaction.

AIMS: To analyse nursing students' perception of the Magnet hospital attributes of the work environment at the hospitals where they perform their clinical placement and the relationship of this factor to their clinical learning environment and supervision, satisfaction and intention to stay in those hospitals once graduated. DESIGN: This study had a cross-sectional, correlational, design. METHODS: Data were collected using self-reported questionnaires from 180 nursing students at a university in southeast Spain between September-October 2018. Nursing work environment and clinical learning environment were measured using the Practice Environment Scale of the Nursing Work Index and Clinical Learning Environment, Supervision and Nurse Teacher scale, respectively. Students' satisfaction with the work environment and with the clinical learning process were measured using a four-point Likert scale developed by the researchers. Percentages, frequencies, mean, standard deviation, χ2 test, Mann-Whitney U test, Spearman and phi correlation were used to analyse the data. RESULTS: Nursing students' perception of greater Magnet-like features at work environment was associated with better clinical learning environment (Spearman rs = |0.22-0.54|; p < .01) and satisfaction with the work environment (Spearman rs = 0.18; p = .01) and with their learning process (Spearman rs = 0.21; p < .01). Greater intention to stay working in the hospital after graduation was significantly associated with greater satisfaction with the learning process (phi = 0.31; p < .01) and the work environment (phi = 0.23; p = .02). CONCLUSION: Magnet-like features at the work environment lead to superior clinical learning environment and higher students' satisfaction, two factors that play a decisive role in their decision to stay at hospitals where they performed clinicals after graduation. IMPACT: In the face of a global nurse shortage, nursing managers and faculty leaders should consider the improvement of nursing workplaces as a strategic alliance to promote satisfactory clinical learning experience and aid recruitment of nurses.

Systematic review of measurement properties of self-reported instruments for evaluating therapeutic communication.

A systematic review was carried out to examine measurement tools of therapeutic relational communication, using an electronic search of the following databases: PubMed, LILACS, CINAHL, CiberIndex, Scielo and Scopus. The project followed the guidelines of Preferred Reporting Items for Systematic Reviews and Meta-Analysis and the protocol recommended by the Consensus-based Standards for the selection of health Measurement Instruments (COSMIN) panel. Thirteen instruments were included in the review. and their measurement properties were tested. The most common communication elements found in the measuring instruments were: empathy, respect, listening, contact, communicative competence, communication quality, and communication skills. Studies that used a theoretical foundation were based on patient-centered humanistic models. Empathy, respect, controlled contact, and other basic elements of interpersonal communication were most commonly found among the measuring regents. In conclusion, this review analyzed the theoretical foundations of the components of instruments used to measure therapeutic relational communication in the nursing field.

Problematic mobile phone use, nomophobia and decision-making in nursing students mobile and decision-making in nursing students.

The objective of this study was to determine the influence of nomophobia and/or problematic mobile phone use on decision-making in nursing students. A cross-sectional study was carried out. The sample consisted of 124 nursing students. The Nomophobia Questionnaire, Mobile Phone Problematic Use Scale and Melbourne Decision Making Questionnaire were used for data collection. Regarding the results, the average total score of the Nomophobia Questionnaire was 69.50 ± 21.08, and the average total score of the Mobile Phone Problematic Use Scale was 83.60 ± 19.90 points. Positive correlations were found between the dimensions of nomophobia and the Mobile Phone Problematic Use Scale. Additionally, positive correlations were found between nomophobia and the dimensions of "buck-passing" (rs = 0.263; p = 0.017), procrastination (rs = 0.307; p = 0.011) and hypervigilance (rs = 0.284; p = 0.002) in regards to decision-making. As for the Mobile Phone Problematic Use Scale, a positive correlation was found between this scale and the procrastination dimension (rs = 0.128; p = 0.015). Problematic mobile phone use and/or nomophobia may have an influence on decision-making in nursing students. Levels of procrastination, hypervigilance and "buck-passing" in nursing students are affected by mobile phone use throughout their training. These factors may affect their academic performance, as well as their relationships with patients and other colleagues.

Interpersonal communication, empathy, and stress perceived by nursing students who use social networks.

AIM: The objective of this study was to explore interpersonal communication, empathy, and stress perceived by nursing students who use social networks. DESIGN: A cross-sectional study was performed. METHODS: A convenience sample of 135 nursing students. For data collection, the following instruments were used: The WhatsApp Negative Impact Scale, The Perceived Stress Scale, The Interpersonal Communication Competence Inventory, and the Jefferson Scale of Empathy. Data collection took place in February 2020. RESULTS: A negative correlation was found between the WhatsApp Negative Impact and the Jefferson Scale of Empathy (rs = -0.204; p = .019). Conversely, a positive correlation was also observed between the Interpersonal Communication Competence Inventory and the Jefferson Scale of Empathy (rs = 0.212; p = .014). CONCLUSION: Nursing students' use of new technology could be problematic and interfere with their therapeutic communication skills. IMPACT: This study addresses the problem of social network use in the clinical setting and how this can influence nursing students' therapeutic communication skills with patients. The results of this study have showed that, among nursing students, social network use has a negative impact, showing decreased empathy. Likewise, students who show a greater level of empathy have better interpersonal communication skills. However, significant results were not found between psychological distress and problematic social network use. Therefore, it is necessary to perform additional studies that would further explore this aspect. This study allows us to explore the negative impact of social networks on therapeutic communication, with the aim of developing prevention strategies at university institutions.

Original Research: How Magnet Hospital Status Affects Nurses, Patients, and Organizations: A Systematic Review.

OBJECTIVE: As the number of Magnet hospitals continues to rise in the United States and abroad, the body of literature regarding various outcomes at Magnet hospitals is increasing also. A systematic review examining and compiling the most recent evidence would be invaluable to those seeking to pursue Magnet recognition for their facility. We conducted this systematic review to investigate how Magnet hospital status affects outcomes for nursing professionals, patients, and health care organizations. METHODS: In January 2018, the databases CINAHL, ProQuest, PubMed, and La Biblioteca Cochrane Plus were searched for relevant studies. The reference lists of selected articles were also examined to identify additional studies. The PRISMA statement was followed, and established methods for systematic review were used to produce a narrative summary. The quality of the reviewed studies was assessed according to the 22-item Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist for observational studies. RESULTS: Of the 163 studies identified, 21 met the eligibility criteria and are included in this review. On the whole, lower rates of nursing shortages, burnout, job dissatisfaction, and turnover were observed at Magnet hospitals compared with non-Magnet hospitals. The rates of patient mortality, falls, hospital-acquired infections, and pressure ulcers were also lower. Nursing work environments were found to be safer and were associated with a higher quality of care in Magnet hospitals than in non-Magnet hospitals, and Magnet hospitals were found to provide more cost-effective care. CONCLUSION: This review provides nursing managers and administrators with the most recent evidence demonstrating that Magnet hospitals have better nursing work environments and are associated with better outcomes for nurses, patients, and organizations than non-Magnet hospitals. This evidence should inform future decision-making with regard to pursuing Magnet designation.

Using a Mobile Phone Application Versus Telephone Assistance During Cardiopulmonary Resuscitation: A Randomized Comparative Study.

INTRODUCTION: In recent years, the way CPR instructions are given has changed because of the development of new technology that allows bystanders who witness a cardiac arrest to be guided in performing CPR. This study aimed to compare the effectiveness of using a mobile phone application (app) versus telephone operator assistance in performing cardiopulmonary resuscitation (CPR) techniques in simulated settings. METHODS: A comparative study was performed with 2 intervention groups: (1) mobile phone app and (2) telephone assistance. A total of 128 students participated and were distributed randomly into each intervention group. A CPR observation checklist and standard CPR quality parameter measurements were used for data collection. RESULTS: The group that used the app obtained better results than the group that had telephone assistance on 5 items during CPR observation: checking if the area is secure (X2(1) = 26.81; P < 0.05), asking for help (X2(1) = 66.07; P < 0.05), opening of airways (X2(1) = 12.03; P < 0.05), checking for breathing (X2(1) = 6.10; P < 0.05), and contacting emergency services (X2(1) = 12.41; P < 0.05). Regarding the skill level of CPR, no statistically significant differences were found when comparing the 2 intervention groups (X2(1) = 0.91; P = 0.33). As for the parameters measured, there were only statistically significant differences found in the item compression fraction (U = 1,593.00; Z = -2.16; P < 0.05), with the group that used the app obtaining better results. DISCUSSION: Better outcomes were observed in recognizing if the area was safe, asking for help, opening up the airways, checking for breathing, and calling emergency services in the mobile phone app group. However, the results indicated that there were no differences in the CPR parameters, except compression fraction, when the app was used as opposed to being guided by telephone.

Work environment factors in coping with patient death among Spanish nurses: a cross-sectional survey.

OBJECTIVE: to explore self-perception competence among Spanish nurses dealing with patient death and its relationship with work environment, evidence-based practice, and occupational stress. METHOD: a cross-sectional web-based survey collected information from a convenience sample of 534 nurses from professional Spanish Colleges who answered four validated questionnaires: Coping with Death Scale, Practice Environment Scale of the Nursing Work Index, Perception of Evidence-Based Practice (EBP) and Nursing Stress Scale. RESULTS: a total of 79% of the participants were women, the average age was 40 years old, 38% had a postgraduate degree and 77% worked in public health settings. Many nurses evaluated their work environment as unfavorable (66%), reported high occupational stress (83.5±14.9), and had high scores on knowledge/skills in EBP (47.9±11.3). However, 61.2% of them perceived an optimal coping (>157 score). The multivariate logistic model indicated positive associations with work environment and EBP characteristics (OR: 1.30, p=0.054; OR: 1.04, p=0.007; OR: 1.13, p<0.001, respectively) but negative associations with occupational stress and short work experience (OR: 0.98, p=0.0043; OR: 0.74, p<0.002, respectively). These factors explained 23.1% of the coping variance (p<0.001). CONCLUSION: although most nurses perceived optimal coping, the situation could be enhanced by modifying several contextual factors. The identification of these factors would improve the quality of end-of-life care by facilitating nursing management.

The Effect of Cell Phones on Attention and Learning in Nursing Students.

The use of cell phones can have a negative effect on nursing students' academic performance. The purpose of this study was to identify the effects that problematic cell phone use and nomophobia have on learning in nursing students. A quasi-experimental study was carried out among nursing students, with a control group (n = 61, 49.2%) and an experimental group (n = 63, 50.8%). The experimental group left their cell phones, in sound or vibration mode, as they normally kept them, on a table located in the corner of the classroom. Both groups showed higher-than-average levels of nomophobia at the beginning of the class. As for problematic cell phone use and attention, it was found that there were statistically significant differences in both cases (U = 1355.500, Z = -2.830, P = .005; U = 1449.000, Z = -2.363, P = .018, respectively), and the experimental group had higher average scores, as well as in those related to knowledge. A relationship has been found between nomophobia and problematic cell phone use. Students who do not have access to their cell phones during class perceive more problematic cell phone usage, in addition to paying closer attention during class. Because of this, it is important to create policies and norms restricting cell phone use during all types of academic training among nursing students.

Educational Interventions for Nursing Students to Develop Communication Skills with Patients: A Systematic Review.

INTRODUCTION: Nursing students establish therapeutic relationships with their patients and as future nursing professionals, they should be trained to be effective communicators. The objective of this systematic review was to know the impact of educational interventions on nursing students to develop their communication skills with patients. METHODS: A systematic review of literature was carried out. The following databases were consulted: CINAHL, PubMed (Ovid Medline), SCOPUS and Web of Science. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guided this review. As for inclusion criteria, published articles in English from 2000 to 2020 were included. The methodological rigor of the included articles was evaluated with the JBI Critical Appraisal Checklist for Randomized Controlled Trial or Quasi-Experimental Studies. Changes in communication skills with the patient after the implementation of an intervention were analyzed. RESULTS: Of the included studies in this systematic review (N = 19), two studies were randomized controlled trials, others were single group quasi-experimental studies (N = 11) and two group quasi-experimental studies (n = 6). The majority of the studies were carried out in the USA (n = 7). The most frequent educational intervention was simulation (n = 11). As for the improvement of communication skills, 13 of the 19 articles found statistically significant differences in patient-centered communication skills of nursing students. CONCLUSIONS: This systematic review provides preliminary evidence of the effectiveness of interventions used to train nursing students in patient-centered communication. Although all the interventions obtained significant results in communication skills, it has not yet been determined which methodology is more effective.

Online sexual activities among university students: relationship with sexual satisfaction / Actividades sexuales online en estudiantes universitarios: relación con la satisfacción sexual

This study explores online sexual activities and analyzes the relationship between these activities and sexual satisfaction. A total of 236 university students completed self-reported scales. The results indicated that the most frequent online sexual activities were: searching for sexual issues, flirting via chat rooms and viewing erotic or pornographic videos. With regards to the relationship between online sexual activities and sexual satisfaction, it was found that participants who reported not seeking sexual information as well as not using chatrooms for sexual conversations, obtained a higher score in sexual satisfaction. In conclusion, although engaging in activities online for sexual purposes has a high prevalence, its influence on obtaining greater sexual satisfaction is not sufficiently proven

Este estudio explora las actividades sexuales a través de internet y analiza la relación entre estas actividades y la satisfacción sexual. Un total de 236 estudiantes universitarios completaron los cuestionarios administrados. Los resultados indicaron que las actividades sexuales online más realizadas fue la búsqueda de temas sexuales, ligar a través de chats y consultar videos eróticos o pornográficos. Con respecto a la relación entre las actividades sexuales online y la satisfacción sexual, se encontró que los participantes que manifestaron no buscar información sexual así como no utilizar chats para conversaciones sexuales, obtuvieron una mayor puntuación en satisfacción sexual. En conclusión, aunque la realización de actividades a través de internet con fines sexuales tiene una alta prevalencia, no queda acreditada de manera suficiente su influencia en la obtención de una mayor satisfacción sexual

Development and Validation of Breadcrumbing in Affective-Sexual Relationships (BREAD-ASR) Questionnaire: Introducing a New Online Dating Perpetration.

New technologies are changing people's lifestyles and in turn, their way of relating to and interacting with others. Breadcrumbing is one of the new 2.0 concepts linked to the virtual relationship paradigm. This study aimed to design and psychometrically test the Breadcrumbing in Affective-Sexual Relationships (BREAD-ASR) Questionnaire to explore breadcrumbing perpetration in adolescent relationships online. A total of 247 adolescents participated in a paper-and-pencil survey carried out from March to June 2019 in a high school in southeastern Spain. Psychometric analysis showed a satisfactory content and construct validity for the instrument. The ordinal alpha coefficient was 0.83, indicating the BREAD-ASR questionnaire had good internal consistency. The BREAD-ASR questionnaire constitutes a valid and reliable instrument which can be used by health professionals in screenings for breadcrumbing perpetration and to design effective prevention and intervention programs in the community, which may help and support adolescents and families to deal with new forms of online relationships and perpetration successfully.

Work environment factors in coping with patient death among Spanish nurses: a cross-sectional survey / Fatores do ambiente de trabalho no enfrentamento da morte de pacientes entre enfermeiros espanhóis: uma pesquisa transversal / Factores del entorno laboral de los profesionales de enfermería relacionados con el afrontamiento del cuidado al final de la vida: encuesta transversal

Objective: to explore self-perception competence among Spanish nurses dealing with patient death and its relationship with work environment, evidence-based practice, and occupational stress. Method: a cross-sectional web-based survey collected information from a convenience sample of 534 nurses from professional Spanish Colleges who answered four validated questionnaires: Coping with Death Scale, Practice Environment Scale of the Nursing Work Index, Perception of Evidence-Based Practice (EBP) and Nursing Stress Scale. Results: a total of 79% of the participants were women, the average age was 40 years old, 38% had a postgraduate degree and 77% worked in public health settings. Many nurses evaluated their work environment as unfavorable (66%), reported high occupational stress (83.5±14.9), and had high scores on knowledge/skills in EBP (47.9±11.3). However, 61.2% of them perceived an optimal coping (>157 score). The multivariate logistic model indicated positive associations with work environment and EBP characteristics (OR: 1.30, p=0.054; OR: 1.04, p=0.007; OR: 1.13, p<0.001, respectively) but negative associations with occupational stress and short work experience (OR: 0.98, p=0.0043; OR: 0.74, p<0.002, respectively). These factors explained 23.1% of the coping variance (p<0.001). Conclusion: although most nurses perceived optimal coping, the situation could be enhanced by modifying several contextual factors. The identification of these factors would improve the quality of end-of-life care by facilitating nursing management.

Objetivo: explorar a capacidade de autopercepção entre enfermeiros espanhóis que lidam com a morte do paciente e sua relação com o ambiente de trabalho, a prática baseada em evidências e o estresse ocupacional. Método: pesquisa transversal pela internet coletou informações de uma amostra de conveniência de 534 enfermeiros das Faculdades Profissionais Espanholas que responderam a quatro questionários: Escala de Enfrentamento da Morte, Escala Ambiente de Trabalho da Prática de Enfermagem, Percepção da Prática Baseada em Evidências (EBP, acrônimo em inglês) e Escala de Estresse em Enfermagem. Resultados: 79% das participantes eram mulheres com média de 40 anos, 38% tinham pós-graduação e 77% trabalhavam em ambiente de saúde pública. Muitos enfermeiros avaliaram seu ambiente de trabalho como desfavorável (66%), relataram alto estresse ocupacional (83,5 ± 14,9) e altas pontuações em conhecimento/habilidades em EBP (47,9 ± 11,3). No entanto, 61,2% deles consideraram um enfrentamento ótimo (pontuação >157). O modelo logístico multivariado indicou associações positivas com o ambiente de trabalho e as características da EBP (OR: 1,30, p = 0,054; OR: 1,04, p = 0,007; OR: 1,13, p < 0,001, respectivamente), mas negativas com estresse ocupacional e curta experiência de trabalho (OR: 0,98, p = 0,0043; OR: 0,74, p < 0,002, respectivamente). Esses fatores explicaram 23,1% da variância de enfrentamento (p < 0,001). Conclusão: embora a maioria dos enfermeiros considerasse um enfrentamento ótimo, a situação poderia ser melhorada pela modificação de vários fatores contextuais. A identificação desses fatores melhoraria a qualidade da assistência no final da vida, facilitando a gestão da enfermagem.

Objetivo: explorar el afrontamiento autopercibido por los profesionales españoles de enfermería para trabajar con pacientes moribundos y su relación con el entorno laboral, la práctica clínica y el estrés ocupacional. Método: estudio observacional transversal vía internet de una muestra de conveniencia con 534 enfermeros reclutados a través de colegios profesionales españoles que respondieron a cuatro cuestionarios validados: Escala de Afrontamiento de la Muerte, Entorno de la Práctica Enfermera, Práctica Basada en la Evidencia en Enfermería (PBE) y Escala de Estrés para Enfermería. Resultados: la mayoría de los participantes fueron mujeres (79%), de 40 años de media, con estudios de posgrado (38%) y trabajando en el sistema público (77%). Gran parte evaluó su ambiente de trabajo como desfavorable (66%), mostrando estrés ocupacional (83,5 ± 14,9) y altas puntuaciones en conocimiento/habilidades-PBE (47,9 ± 11,3). Sin embargo, el 61,2% autopercibía un afrontamiento óptimo (> 157 puntos). El análisis de regresión logística multivariante mostró que el afrontamiento se asociaba positivamente con el entorno laboral y dos subescalas-PBE (OR: 1,30, p= 0,054; OR: 1,04, p= 0,007; OR: 1,13, p <0,001, respectivamente), pero negativamente con el estrés ocupacional y la poca experiencia laboral (OR: 0,98, p= 0,0043; OR: 0,74, p <0,002, respectivamente). Estos factores explicaban el 23,1% de la varianza (p <0.001). Conclusión: aunque la mayoría de los enfermeros percibían un afrontamiento óptimo, la situación podría mejorarse modificando algunos factores. La identificación de estos factores mejoraría la calidad de la atención de los pacientes al final de la vida, facilitando la gestión de enfermería.

The Influence of Gamification on Decision Making in Nursing Students.

BACKGROUND: Gamification provides nursing students with a setting in which they can practice clinical reasoning and decision making in a realistic and secure way. The purpose of this study was to determine the influence of gamification on decision making in nursing students. METHOD: A quasi-experimental study was performed with a control group and an experimental group. A convenience sample was used to select the participants. A total of 191 nursing students participated. Participants were randomly assigned to one of the groups. RESULTS: On comparing the control group and experimental group, statistically significant differences were found in the following patterns: vigilance, buck passing, and procrastination. CONCLUSION: Using gamification as part of nursing education increases satisfaction, creative thinking, and control, among other aspects, with little to no negative effects throughout the experience, which has a significant impact on decision making. [J Nurs Educ. 2019;58(12):718-722.].

How to measure gamification experiences in nursing? Adaptation and validation of the Gameful Experience Scale [GAMEX].

BACKGROUND: There has been an increasing amount of research in the last few years on the use of gamification in nursing. However, there is not yet a suitable measuring instrument that fully captures the emotional qualities that arise with the use of gamification. OBJECTIVES: To culturally adapt and validate the Gameful Experience Scale used among nursing students as well as understand their game experience. DESIGN: The study was divided into two phases 1) cross-cultural adaptation and 2) validation of the scale and cross-sectional descriptive study. SETTINGS: Faculty of Health Sciences at the University of Almeria, Spain. PARTICIPANTS: 226 students studying an undergraduate nursing degree. METHODS: In the first phase, a cross-cultural adaptation was carried out using a forward-back translation, with the collaboration of a panel of experts. In the second phase, the corresponding analyses were performed, to measure the reliability and the validity of the instrument. RESULTS: The Kaiser-Meyer-Olkin test that measures the appropriateness of the sample had a result of 0.875. Bartlett's sphericity test was significant (X2(351) = 3755.142, p < 0.05). A structure of 6 factors was confirmed. The total Chronbach α value was 0.855. In the analysis of the test-retest reliability, a correlation level of 0.89 was obtained (p < 0.05). The participants showed high scores in all the dimensions, except that of absence of negative effects. CONCLUSIONS: The adapted version of the scale showed good results in regards to reliability and validity, which indicates that it is an effective tool to be used to measure the game experience in nursing students' training.

Comparative study of nomophobia among Spanish and Portuguese nursing students.

Nomophobia is the fear of leaving the house without a mobile and being out of mobile phone contact and affects different areas of a person's life, especially in terms of social, work and academic relationships due to a dependence on the use of smartphones. Discovering the prevalence of nomophobia among nursing students is very important, as the misuse of smartphones in clinical practice may cause distractions, affecting the quality of care and putting patient safety at risk. Furthermore, it can lead to poorer academic performance during class. The aim of this study was to compare the levels of nomophobia experienced by nursing students at the University of Almeria, Spain and the Polytechnic Institute of Braganza, Portugal. A comparative descriptive observational study was carried out. A nomophobia questionnaire adapted to the Spanish and Portuguese sociolinguistic context was employed; 258 participants comprised the subjects of study. The main results showed both Spanish and Portuguese nursing students scored higher than average regarding levels of nomophobia. However, the scores gathered from items on the questionnaire were generally higher among the Portuguese population than the Spanish one. The Portuguese students (54.7%) felt more anxious than the Spanish students (35.4%) if their battery ran out. Similarly, the Portuguese population showed a greater need for instant communication with their family and friends. In conclusion, the dimensions explored indicate significant levels of nomophobia among both nursing student populations, with higher levels among the Portuguese population than the Spanish.