Nursing students faced with organ donation: Multicenter stratified national study.

AIM: To analyze the attitude of university nursing students at Spanish universities toward organ donation and transplantation and the factors affecting to their attitude. BACKGROUND: The opinion of future nurses toward organ transplant donation could have an important influence on the population. Knowing that opinion and what factors influence it is important to improve the attitude towards organ donation and transplantation. DESIGN: A multicenter, sociological, interdisciplinary and observational study including university nursing diploma students in a complete academic year. METHODS: Selected and randomized sample was taken of students from 52 of the 111 faculties and nursing schools and faculties in Spain with teaching activity PARTICIPANTS: A sample of 10,566 students was selected stratified by geographical area and year. MEASUREMENT INSTRUMENT: The instrument used was a validated questionnaire of attitude toward organ donation and transplantation, self-administered and completed anonymously. RESULTS: Completion rate: 85 % (n = 9001). Of the students surveyed, 78 % (n = 7040) would donate their organs after dying. Variables related to a favourable attitude: (1) Interest in listening to a talk about organ donation and transplantation [Odds ratio 1.66, 95 % confidence interval 2.05-1.35]; (2) Family discussion [Odds ratio 2.30, 95 % confidence interval 2.79-1.90] or discussion with friends about organ donation and transplantation [Odds ratio 1.56, 95 % confidence interval 1.86-1.31]; (3) Knowing that one's father [Odds ratio 1.54, 95 % confidence interval 1.94-1.22], mother's [Odds ratio 1.44, 95 % confidence interval 1.82-1.13] or partner [Odds ratio 1.28, 95 % confidence interval 1.60-1.03] has a favourable opinion; (4) Having a good self-assessment of information about organ donation and transplantation [Odds ratio 2.94, 95 % confidence interval 4.90-1.78]; (5) Not being worried about possible mutilation of the body after donation [Odds ratio 2.73, 95 % confidence interval 3.36-1.72]. CONCLUSIONS: Nursing students in Spain tend to have a favourable attitude toward organ donation and transplantation although more than 20 % of those surveyed are not in favour. TWEETABLE ABSTRACT: To maintain a high rate of organ donation for organ transplantation, it is necessary to improve the social awareness of future generations of nurses towards organ donation.

Exploring Health Science Students' Notions on Organ Donation and Transplantation: A Multicenter Study.

The knowledge acquired during university education about organ donation and transplantation (ODT) decisively influences the information future health professionals transmit. This is important in ODT where the participation of the general public is essential to obtain organs. OBJECTIVE: To determine notions of Spanish medicine and nursing students on ODT and its relationship with attitude toward ODT. METHODS AND DESIGN: and design. We conducted a sociologic, multicenter, and observational study. The population for our study consisted of medical and nursing students in Spanish universities. Our database was the Collaborative International Donor Project, stratified by geographic area and academic course. A validated questionnaire (PCID-DTO-RIOS) was self-administered and completed anonymously. Our sample consisted of 9598 medical and 10,566 nursing students (99% confidence interval; precision of ±1%), stratified by geographic area and year of study. RESULTS: The completion rate for our study was 90%. Only 20% (n=3640) of students thought their notions on ODT were good; 41% (n=7531) thought their notions were normal; 36% (n=6550) thought their notions were scarce. Comparing groups, there were differences between those who believed that their notions on ODT were good (44% nursing vs 56% medical students; P < .000), and those who believed it scarce (54% nursing vs 46% medical students; P < .000). Notions on ODT were related with attitude toward the donation of one's own organs: those who considered their notions were good were more in favor then those who considered it scarce (88% vs 72%; P < .000). CONCLUSION: Only 20% of Spanish medical and nursing students thought their notions on ODT were good. Having good knowledge is related to a favorable attitude towards ODT. Receiving specific information on the subject could improve their knowledge about ODT during their training.

Organ Donation Related With Attitude Toward the Law of Presumed Consent: Spanish University Medical and Nursing Students Study.

INTRODUCTION: Information provided by health care professionals is crucial to create a climate of social opinion. This is important in organ donation and transplantation (ODT), where the participation of the general public is essential to obtain organs. OBJECTIVE: To determine the attitude toward the Law of Presumed Consent (LPC) among Spanish university students and to analyze their relation with attitude toward ODT. METHODS: and design. The type of study was a sociologic, multicenter, observational study. The population included medical and nursing students in Spanish universities. Database of Collaborative International Donor Project was used stratified by geographic area and academic course. A validated questionnaire (Collaborative International Donor Project, organ donation and transplantation questionnaire in Spanish [PCID-DTO-RIOS]) was self-administered and completed anonymously. A sample of 9598 medical and 10,566 nursing students was analyzed (99% confidence and precision of ±1%) and stratified by geographic area and year of study. RESULTS: Completion rate was 90%. Regarding attitude toward LPC, 66% of the students were against the law, whereas 34% accepted it. Of the students surveyed, 9% considered the law as a gesture of solidarity, 25% as an effective way of not wasting organs, 48% as an abuse of power, and 18% as offenses against the family. Those students who were in favor of LPC also had a more favorable attitude toward ODT (86% vs 76%; P < .001). Comparing groups, nursing students were less in favor of LPC than medical students (32% vs 36%; P < .000). CONCLUSION: Sixty-six percent of Spanish university medical and nursing students were against the LPC. The favorable attitude toward ODT is associated with considering the law as a gesture of solidarity or as an effective way of not wasting organs.

Confident Perception of Primary Care Physicians Correlates to the Attitude Toward Donation and Organ Transplantation: A Multicenter Study of Medical And Nursing Spanish Students.

A primary care physician (PCP) not only accompanies the patient in the process of an illness, but throughout his or her life. The confidence we have in these health professionals is fundamental, and their favorable attitude toward organ donation and transplantation (ODT) has a significant influence on the population. OBJECTIVE: To analyze trust in PCPs among Spanish medical and nursing students, the relationship with their attitude toward ODT, and the factors that condition it. METHODS AND DESIGN: A sociologic, multicenter, and observational study. POPULATION: medical and nursing students in Spanish universities. DATABASE: Collaborative International Donor Project, stratified by geographic area and academic course. A validated questionnaire (PCID-DTO-RIOS) was self-administered and completed anonymously. A sample of 9598 medical and 10,566 nursing students (99% confidence and precision of ±1%), stratified by geographic area and year of study. RESULTS: Completion rate: 90%. With respect to students' trust in their physician, 18% (n = 3267) of them totally trust (completely), 45% (n = 8101) trust enough, 30% (n = 5478) of them have not enough trust, and 7% not at all. Comparing groups, medical students totally trust more in PCPs than nursing students (55% vs 45%; P < .000), however, nursing students have less than enough trust in their PCP than medical students (53% vs 47%; P < .000). Students that totally trust in their PCP were more in favor toward ODT than students with not enough trust (83% vs 77%; P < .000). CONCLUSION: Only 18% of Spanish medical and nursing students totally trust in their PCP. Attitude toward ODT is related to a higher level of trust in PCPs among these students.

Nursing Students' Knowledge About Organ Donation and Transplantation: A Spanish Multicenter Study.

Health care professionals and the information that they provide to the public on organ donation and transplantation (ODT) influence attitudes toward this option. OBJECTIVE: The objective was to analyze the knowledge of university nursing students at Spanish universities toward ODT and the factors affecting it. METHODS AND DESIGN: The methods and design included a multicenter, sociologic, and observational study including university nursing diploma students in a complete academic year. PARTICIPANTS: A sample of 10,566 students was selected stratified by geographic area and year. INSTRUMENT: A validated questionnaire of knowledge toward ODT (PCID-DTO RIOS), self-administered and completed anonymously. RESULTS: Questionnaire completion rate: 85% (n = 9001). Only 18% (n = 1580) believed that their knowledge about ODT was good, 40% (n = 3578) believed that the information they had was normal, and 39% believed that their knowledge was sparse. Of the students, 96% believed that organ needs are not covered and 79% that they might need a transplant in the future. Only 39% (n = 3493) had attended a talk about ODT. Furthermore, 83% (n = 7435) believed that attending a talk would be interesting. The following variables were associated with having a more adequate knowledge: gender (62% men vs 57% women; P < .001); academic year (P < .001); knowing a donor (P < .001); knowing a transplant patient (P < .001); believing the possibility of needing a transplant oneself in the future (P < .001); attitude toward deceased donation (P < .001); and interest in receiving an informative talk about ODT (P < .001). CONCLUSION: Only 18% of nursing students in Spain believed that their knowledge about ODT was adequate. These results must be considered for possible training plans for these future professionals.

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.

Información recibida por las mujeres diagnosticadas de cáncer de mama / Information received from women diagnosed with breast cancer

Objetivo: analizar la información que reciben las mujeres que adolecen de cáncer de mama. Ilustrar qué entienden de dichas explicaciones. Analizar qué dificultades tienen los profesionales para transmitir la información del proceso.Metodología: cualitativa fenomenológica. Se realizaron 34 entrevistas en profundidad (a 29 mujeres, 1 hombre y 4 médicos) en los servicios específicos del Hospital Vall d’Hebron y en ginecología del Centro de Atención Primaria de Salud La Mina de Barcelona, entre 2004 y 2006. El rango de edad era entre 20 y 69 años. Resultados: de acuerdo con el nivel de instrucción se distribuyen las mujeres en 5 grupos: que explican errores médicos; profesionales sanitarios enfermos; amas de casa, con estudios primarios incompletos; con estudios de enseñanza secundaria; con estudios universitarios y diversidad de profesiones. Mujeres y profesionales explican la dificultad de dar y recibir información.Discusión: se coincide con otros autores que decir la verdad debería ser un proceso individualizado, siempre difícil, en el que el enfermo lleva la iniciativa, pone límites y gradúa las preguntas y los silencios. La información profesional debe conseguir el mayor bien posible para el enfermo.Conclusiones: las mujeres tienen miedo a recidivas; este aumenta cuando no confían en la información que reciben del equipo que las está tratando. Las universitarias desean recibir la información sin paternalismos. Las mujeres con instrucción primaria desean que verifiquen que esta fue entendida.

Purpose: To analyze information received by women with breast cancer. To explain what they understand from said explanations. To analyze difficulties experienced by professionals to convey process information.Methods: qualitative phenomenological. 34 interviews were carried out in depth (to 29 women, 1 man and 4 physicians) in the specific services of Vall d’Hebron Hospital, and in the gynecology service of the Primary Health Care Center La Mina in Barcelona, between 2004 and 2006. Age range was between 20 and 69 years. Results: Women were grouped as per instruction level. There were 5 groups of women: who explain medical errors; sick health professionals; housewives, with incomplete primary education; with high school education; with university education and different professions. Women and professionals explain the difficulty of giving and receiving information.Discussion: we agreed with other authors who say that telling the truth should be an individualized process, always difficult, in which the sick person has the initiative, sets limits and graduates questions and silences. Professional information should obtain the best for the sick person.Conclusions: women are afraid of relapses; it increases when they do not trust information received from the team treating them. University graduated women want to receive information without paternalism. Women with primary education want verification that it has been understood.

Objetivo: Analisar a informação que é recebida pelas mulheres afetadas pelo câncer de mama. Indicar o que é que elas entendem dessas explicações. Analisar quais são as dificuldades que afrontam os profissionais para transmitir a informação sobre o processo.Metodologia: qualitativa fenomenológica. 34 entrevistas foram feitas de forma particularizada (a 29 mulheres, um homem e quatro médicos) na unidade de Serviços Específicos do Hospital Vall d’Hebron, e na unidade de ginecologia do “Centro de Atención Primaria de Salud La Mina de Barcelona”, de 2004 a 2006. A faixa etária é de 20 a 69 anos.Resultados: As mulheres são agrupadas segundo seu nível de instrução, reunidas em cinco grupos: mulheres capazes de explicar os erros médicos; profissionais da saúde doentes; donas de casa com um ensino primário incompleto; mulheres com ensino médio; mulheres com estudos universitários e com diversas profissões. Mulheres e profissionais explicam a dificuldade de dar e receber informação.Discussão: A conclusão atingida foi a mesma de outros autores: dizer a verdade é um processo individualizado e sempre difícil; no qual o doente tem a iniciativa, põe limites e faz as perguntas e controla o fluxo da conversação. A informação profissional tem que fornecer a maior quantidade de benefícios ao doente.Conclusões: As mulheres têm medo às recidivas. Este medo aumenta quando desconfiam da informação que recebem da equipe que as trata. As universidades desejam receber a informação sem nenhum paternalismo. As mulheres que cursaram o ensino primário desejam verificar a compreensão da informação.

Vivencias de las mujeres mastectomizadas. Un estudio fenomenológico / Experiences of mastectomised women. A phenomenological study

Objetivo. Comprender las vivencias de las mujeres tras la mastectomía, analizando qué lleva a unas a reconstruirse la mama y a otras a no hacerlo. Identificar las situaciones de la mujer mastectomizada con linfedema, alopecia u otros problemas. Método. Utilizamos la metodología de investigación cualitativa de trayectoria fenomenológica. Se realizaron 29 entrevistas en profundidad a mujeres con las que contactamos a través de informantes específicos: Hospital Vall d’Hebron; Centro de Atención Primaria de Salud La Mina de Barcelona. El rango de edad era entre 20 y 69 años. Resultados. Fue posible desvelar el fenómeno de estudio a través del análisis de los discursos recolectados. Aparecen: mujeres con las mamas reconstruidas y no reconstruidas. Imagen corporal mutilada por la pérdida de una o ambas mamas. Participación de la mujer en acontecimientos sociales, estilo de vida y vestido. El cáncer se visibiliza: linfedema, pérdida del pelo con afectación de su imagen pública. Conclusiones. De las mujeres participantes, las jóvenes, universitarias, de clase social media y las mayores de 40 años con estudios primarios, se reconstruyen la mama. Las universitarias de clase social media-alta y alta no se la reconstruyen. Negocian de otras maneras su relación de pareja

Objective. To understand the life experience of women with mastectomy in relation to their disease, analysing what leads some women to have breast reconstruction and others not to do so. Identify the situation of mastectomised women with lymphoedemas, alopecia and other problems. Method. Phenomenological qualitative research. Twenty-nine in-depth interviews were conducted on the women through specific informants in the oncology services of the Hospital Vall d’Hebron; and the gynaecology unit at the Salud La Mina Primary Care Centre in Barcelona. The age range was between 20 and 69 years. Results. Through the analysis of the interviews it was possible to reveal the phenomenon in research. The following subjects were those of most relevance: there women with reconstructed and non-reconstructed breasts, and a mutilated body image through the loss of one or both breasts. Participation of women in social occasions, use of clothing and lifestyle. The cancer is visualised: lymphoedemas, loss of hair with an affect on the public image. Conclusions. Younger women, graduates and middle class ladies and those over 40 with a primary education are those that have a breast reconstruction. Middle-high and high class graduates do not have a breast reconstruction. They negotiate their relationship with their partner in other ways (AU)

[Experiences of mastectomised women. A phenomenological study]. / Vivencias de las mujeres mastectomizadas. Un estudio fenomenológico.

OBJECTIVE: To understand the life experience of women with mastectomy in relation to their disease, analysing what leads some women to have breast reconstruction and others not to do so. Identify the situation of mastectomised women with lymphoedemas, alopecia and other problems. METHOD: Phenomenological qualitative research. Twenty-nine in-depth interviews were conducted on the women through specific informants in the oncology services of the Hospital Vall d'Hebron; and the gynaecology unit at the Salud La Mina Primary Care Centre in Barcelona. The age range was between 20 and 69 years. RESULTS: Through the analysis of the interviews it was possible to reveal the phenomenon in research. The following subjects were those of most relevance: there women with reconstructed and non-reconstructed breasts, and a mutilated body image through the loss of one or both breasts. Participation of women in social occasions, use of clothing and lifestyle. The cancer is visualised: lymphoedemas, loss of hair with an affect on the public image. CONCLUSIONS: Younger women, graduates and middle class ladies and those over 40 with a primary education are those that have a breast reconstruction. Middle-high and high class graduates do not have a breast reconstruction. They negotiate their relationship with their partner in other ways.

Imagen corporal femenina y sexualidad en mujeres con cáncer de mama / Feminine body image and sexuality in women with breast cancer

Objetivo: Analizar las vivencias de las mujeres mastectomizadas relacionadas con su sexualidad, los factores que influyen en que abandonen total o parcialmente sus pautas sexuales anteriores y la repercusión que esto puede tener en la desestructuración familiar. Metodología. Cualitativa Fenomenológica. Se llevaron a cabo 30 entrevistas en profundidad en los servicios de rehabilitación, oncología y radioterapia del Hospital Vall d'Hebron; y ginecología del Centro de Atención Primaria de Salud La Mina de Barcelona. El rango de edad era entre 20 y 69 años. Resultados: Fue posible desvelar el fenómeno de estudio a través del análisis de los discursos recolectados, los temas de mayor relevancia fueron: mujeres con problemas de pareja. Las vivencias de la imagen corporal mutilada. Renuncia o disminución de relaciones sexuales. Pérdida de la pareja. Rechazo de algunos hombres a tocar la cicatriz de la mastectomía. Evitar el desnudo integral. Mujeres para las cuáles el marido o pareja se convierte en lo fundamental. Recuperación de la sexualidad. Preocupación por preservar la vida. Mujeres que no se han reconstruido la mama y no desean hacerlo. Conclusiones: Padecer un cáncer de mama puede llevar al rompimiento de algunas mujeres con sus parejas y ser vivido por ellas como un problema, por otra parte esto no afectará a la mayoría de mujeres que se verán acompañadas en todo momento por sus parejas; aunque no todas las mujeres afirman tener pareja, ni desear tener relaciones (AU)

The aim was to analyse the experiences of women who had undergone a mastectomy with respect to their sexuality, the factors that contribute to any changes in their sexual behaviour, and the repercussions that could lead to family destructuralisation. The methodology used was based on Qualitative Phenomenological Investigation. Thirty extensive interviews were carried out at the rehabilitation, oncology and radiotherapy centres of the Vall d'Hebron Hospital, and at the gynaecological centre at the Primary Health Care Centre of La Mina (Barcelona). Participants' ages ranged from 20 to 69 years. Analysis of the collective comments from the participants revealed that the most relevant themes were: women with problems with their partners; living with the image of a mutilated body; lack of or diminished interest in sexual relations; loss of a partner; refusal on the part of some men to touch the mastectomy scar; avoidance of total nudity; women for whom their partner had become overly important in their lives; recuperation of sexuality; concern for their survival; women who had not had breast reconstruction and did not wish to do so. Conclusions: In some women breast cancer may cause a breakdown of their relationship with their partners and could be experienced as a problem. On the other hand, in the majority of those women who have been seen to be accompanied at all times by their partners, it is not perceived as such. Nevertheless, not all the women interviewed claimed to either have a partner or want to maintain relationships (AU)

Innovación docente y convergencia europea: formar en competencias / Teaching innovation and european convergence: training in competences

En el año 1996, en el marco del programa europeo Sócrates/Erasmus, en la Escuela de Enfermería Vall d'Hebron se inicia el intercambio de profesores, alumnos y programas. Este programa ofrece a los estudiantes la posibilidad de realizar parte de sus estudios, o de participar en otras actividades académicas, en otras universidades de la Unión Europea. Dicho intercambio ha favorecido el hecho de tener una actitud positiva hacia la metodología docente Problem Based Learning (PBL), Aprendizaje Basado en Problemas (ABP), predominante en las universidades del Norte de Europa, destacando el nuevo paradigma para los estudios de Enfermería y adaptados a las necesidades de la sociedad, basados en competencias y con una orientación hacia un aprendizaje basado en problemas. • La incorporación del Aprendizaje Basado en Problemas tuvo como objetivo su aplicación a la totalidad de estudiantes (300) de las promociones 2001-2004, 2002-2005 y 2003-2006. Para ello, se llevó a cabo un pilotaje mediante la integración de la Práctica de Aula en los cursos académicos 2001-02; 2002-03; 2003-04. Dicha metodología está implantada en primer curso, integrando todas las materias, curso académico 2002-03, segundo curso 2003-2004, quedando pendiente la implantación de 3º. • La Convergencia Europea plantea el nuevo paradigma para la enseñanza universitaria y nuestro modelo se sitúa a la cabeza del cambio: la enseñanza por competencias, énfasis aprender a aprender, protagonismo y responsabilidad del estudiante, valor del tiempo de estudio y el papel del tutor

In 1996, within the framework of the European Socrates/Erasmus Programme, the School of Nursing of Vall d’Hebron started an exchange of teachers, students and programmes. This programme offers students the possibility to carry out part of their studies in other Universities in the European Union, or to participate in other activities. Such exchange fostered a positive attitude towards Problem Based Learning (PBL), as teaching methodology. This methodology is largely implemented in Northern European Universities with special emphasis placed on nursing studies in order to make them more based on competences, thus meeting present society needs and with a problem based learning approach. • The aim of including Problem Based Learning methods was to apply such methods to the whole student population (300) in the years 2001-205, 2002-2005 and 2003-2006. For such purpose, a pilot study was carried out by means of integrating Classroom Practice in the years 2001-02; 2002-03; 2003-04. This methodology is implemented in the first year of studies to all subject matters, academic year 2002-2003, and in the second year, 2003-2004. Implementing of methodology is still pending for the third year. • European convergence raises the issue of a new paradigm in University teaching and our model purports to be ahead of changes: competence based teaching, emphasis on learning to learn, patient’s protagonism and responsibility, value of the time of study and the role of tutor