Developing Evidence-Based Practice questionnaire for community health nurses: reliability and validity of a Spanish adaptation.

AIMS AND OBJECTIVES: This study aimed to translate the community nursing version of the Developing Evidence-Based Practice questionnaire, adapt the Spanish translation to the primary care context in Spain, and evaluate its reliability and validity. BACKGROUND: Instruments available in Spanish to date are not designed to rigorously evaluate barriers and incentives associated with evidence-based practice implementation in community health nursing. DESIGN: Classical Test Theory approach. METHODS: The 49-item Developing Evidence-Based Practice questionnaire was translated, back-translated and pilot-tested. Two items were added to assess respondents' ability to read and understand the English language. During the first six months of 2010, 513 nurses from 255 primary health care centres in Catalunya (Spain) voluntarily participated in the study. Internal consistency and test-retest reliability were evaluated. Internal structure was analysed by principal component analysis. A randomized, controlled, parallel-design study was carried out to test scores' sensitivity to change with two groups, intervention and control. The intervention consisted of eight hours of in-person training, provided by experts in evidence-based practice. RESULTS: Of 513 nurses, 445 (86·7%) nurses responded to all 51 items. Factor analysis showed six components that explained 51% of the total variance. Internal consistency and test-retest reliability were satisfactory (Cronbach α and intraclass correlation coefficients >0·70). A total of 93 nurses participated in the sensitivity-to-change tests (42 in the intervention group, 51 controls). After the training session, overall score and the 'skills for evidence-based practice' component score showed a medium (Cohen d = 0·69) and large effect (Cohen d = 0·86), respectively. CONCLUSIONS: The Developing Evidence-Based Practice questionnaire adapted to community health nursing in the primary care setting in Spain has satisfactory psychometric properties. RELEVANCE TO CLINICAL PRACTICE: The Developing Evidence-Based Practice questionnaire is a useful tool for planning and evaluating the implementation of evidence-based practice in community health nursing.

Diagnósticos enfermeros estandarizados: guía para la práctica clínica en Atención Primaria / Standardised nursing diagnoses: clinical practice guidelines in Primary Care

En 1994 un grupo de enfermeras asistenciales de Atención Primaria de Salud (APS) de Barcelona iniciamos un trabajo orientado a desarrollar la especificidad de la atención enfermera adoptando el modelo de Virginia Henderson y utilizando la metodología del proceso de cuidados. Nuestro objetivo era aportar un instrumento de trabajo útil que ayudase, en todas las etapas del proceso, a salvar la distancia que separa la teoría de los modelos enfermeros de la práctica clínica y que, posteriormente, su utilización permitiera validar el contenido de los distintos diagnósticos enfermeros (DxE) elaborados. Metodología: los DxE más frecuentes en la práctica asistencial fueron seleccionados utilizando la técnica de grupo nominal. Cada uno de los diagnósticos elaborados se revisó por primera vez en el año 2000 para incorporar aportaciones de la literatura científica respecto a los objetivos, así como a las intervenciones utilizando la “Nursing Intervention Classifications (NIC)”. La segunda revisión fue en el 2005 para incorporarla codificación de los objetivos ya formulados según “Nursing Outcome Classification (NOC)”.Resultados: identificación de 36 diagnósticos enfermeros y elaboración de la guía de actuación correspondiente en cada uno de ellos. Conclusiones: las guías de cuidados estandarizados sirven como pauta de trabajo, siendo imprescindible personalizar la valoración para individualizarlos cuidados y permiten la identificación del rol autónomo de la enfermera. Su informatización ha facilitado el registro del proceso enfermero. Sería interesante recoger posibles variaciones de las guías propuestas para analizar y modificarlas si está indicado (AU)

In 1994 a group of healthcare nurses serving at Primary Care Health units in Barcelona started a project aimed at developing the specificity of nursing care by adopting the Virginia Henderson’s model and by utilising care process methodology. Our objective was to contribute with a useful working tool that helped in all the stages of the process to shorten the distance between theory and the nursing models used in clinical practice so that these could be subsequently used to validate the contents of the elaborated nursing diagnoses. Methodology: the nursing diagnoses most frequently used in healthcare practice were selected using the nominal group technique. Each of the elaborated diagnoses was revised for the first time in 2000 to include the contribution of the scientific literature regarding objectives and the interventions using the “Nursing Intervention Classifications (NIC)”. The second revision was performed in 2005 to incorporate the codification of already existing objectives according to the “Nursing Outcome Classification(NOC)”.Results: identification of 36 nursing diagnosis and elaboration of a clinical practice guideline for each of these diagnoses. Conclusions: standardised clinical care guidelines serve as a work guideline and are essential to personalise the assessment in order to individualise the care given, which also permits to identify the autonomous role of the nurse. Automation of standardised guides has facilitated the nursing process. It would be interesting to compile possible variations from the proposed guidelines for their analysis and amendment if necessary (AU)

[Health indicators: the health status of the population attended to by a at home care program]. / Indicadores de salud. Estado de salud de ia población atendida en un Programa de Atención Domiciliaria.

The authors describe health indicators in their functional, social, mental and cognitive dimensions for patients included in an at home care program by means of an observational study of prevalences; these patients are part of the 12,000 patients included in the "Health at Home" Program run by the Primary Health Care Teams of the Catalonian Health Institute in the city of Barcelona. Information was obtained on 517 subjects. In spite of the fact that half of these patients have poor results recorded in their files under health indicators, only one fourth of these patients had a complete geriatric evaluation.

Indicadores de salud. Estado de salud de la población atendida en un Programa de Atención Domiciliaria / Health indicators: the health status of the population attended to by a at home care program

Se describen los indicadores de salud en las dimensiones funcional, social, mental y cognitiva, de pacientes incluidos en un programa de Atención Domiciliaria, mediante un estudio observacional de prevalencias: los 12.000 pacientes incluidos en el Programa «Salut a Casa» de los Equipos de Atención Primaria (EAP) del «Institut Català de la Salut» en la ciudad de Barcelona. Se obtuvo información de 517 sujetos. A pesar de que la mitad de ellos presenta unos malos resultados en los indicadores de salud, sólo una cuarta parte tenía una valoración geriátrica global

The authors desribe health indicators in their functional, social, mental and cognitive dimensions for patients included in an at home care program by means of an observacional sudy of prevalences; these patients are part of the 12,000 patients included in the "Health at Home" Program run by the Primary Health Care Teams of the Catalonian Health Institute in the city of Barcelona. Information was obtained on 517 subjects. In spite of the fact that half of these patients have poor results recorded in their files under health indicators, only one fourth of these patients had a complete gereiatric evaluation