An Interpretable Machine Learning Approach to Predict Sensory Processing Sensitivity Trait in Nursing Students.

Sensory processing sensitivity (SPS) is a personality trait that makes certain individuals excessively sensitive to stimuli. People carrying this trait are defined as Highly Sensitive People (HSP). The SPS trait is notably prevalent among nursing students and nurse staff. Although there are HSP diagnostic tools, there is little information about early detection. Therefore, the aim of this work was to develop a prediction model to identify HSP and provide an individualized nursing assessment. A total of 672 nursing students completed all the evaluations. In addition to the HSP diagnosis, emotional intelligence, communication skills, and conflict styles were evaluated. An interpretable machine learning model was trained to predict the SPS trait. We observed a 33% prevalence of HSP, which was higher in women and people with previous health training. HSP were characterized by greater emotional repair (p = 0.033), empathy (p = 0.030), respect (p = 0.038), and global communication skills (p = 0.036). Overall, sex and emotional intelligence dimensions are important to detect this trait, although personal characteristics should be considered. The present individualized prediction model could help to predict the presence of the SPS trait in nursing students, which may be useful in conducting intervention strategies to avoid the negative consequences and reinforce the positive ones of this trait.

Breaking the Stigma in Mental Health Nursing through High-Fidelity Simulation Training.

The social stigma toward individuals with mental health problems is habitual among nursing students, which can lead to poor quality of health care services for patients with mental illnesses. The purpose of the present study was to learn about nursing students' perceptions of providing care to patients with severe mental disorders before and after participating in a simulated student clinical case. A descriptive qualitative study was conducted through 39 interviews. The difficulties expected by the students and their perceptions about patients were explored before the simulation training. Their perceptions about the use of clinical simulation for learning about the adequate management of these patients were analyzed afterwards. Results: Before the simulation training, the students assessed the case as being complicated, expressed their lack of specific training, and felt fear and insecurity, thus reproducing the stigma towards mental health patients. After this training, they positively valued the usefulness of the clinical simulation for gaining confidence and overcoming the stigma. Discussion: The use of high-fidelity simulation offers nursing students the opportunity to approach patients with mental health conditions, overcoming their fears and normalizing mental disorders. Simulation training allows nursing students to analyze the reasoning of clinical judgment and to detect the influence of previous prejudices about mental illness in their clinical decision. This study was not registered.

Sleep analysis of hospital and out-of-hospital emergency professionals.

INTRODUCTION: Sleep deprivation is associated with poorer cognitive functioning and a greater risk of serious diseases. Herein, we analyzed differences in the quality of sleep and excessive daytime sleepiness between hospital emergency services and out-of-hospital emergencies services, and investigated its association with sociodemographic and labor variables. METHOD: This is a cross-sectional observational study carried out between April 2019 and February 2020, including healthcare professionals from different emergency departments, who were evaluated through the following instruments: "Pittsburgh Sleep Quality Index" and "Epworth Sleepiness Scale". RESULTS: Four-hundred and four healthcare professionals were included (mean age 40.4 ± 11.1 years), predominantly women (61.4%) from hospital emergency departments (62.6%). A total of 65.3% of the workers had poor sleep quality and 27.7% had excessive sleepiness. Women had poorer sleep quality (p = 0.022) and higher sleepiness (p = 0.010) than men. Hospital emergency workers presented 2-fold increased risk of poor sleep quality (OR = 1.93, p = 0.003) and sleepiness (OR = 1.93, p = 0.009) than out-of-hospital emergency workers. The more optimistic were less likely to have poor sleep quality (OR = 0.73, p = 0.01) or sleepiness (OR = 0.70, p = 0.002). Nurses, emergency medical technicians and nursing assistants also had a higher risk of poor sleep quality compared to physicians (OR = 1.60; p = 0.043). CONCLUSIONS: Emergency healthcare professionals working in hospital emergency departments had a two-times higher risk of poor sleep quality and sleepiness than out-of-hospital emergency healthcare professionals.

Social and Individual Factors Associated with Eating Disorders in Young Athletes: Effects on Concentration and Fatigue.

Eating disorders are a growing societal problem, especially among young people. This study aims to determine the individual and social factors that support and perpetuate the risk of eating disorders (ED) and their possible consequences on an individual's athletic and academic performances. The sample consisted of 395 athletes between 12 and 16 years of age (M = 14.07; SD = 1.35), of whom 142 (35.9%) were female, and 253 (64.1%) were male. A questionnaire was administered to collect information on sociodemographic data, body image, use of social networks, social relationships, sports practice, risk of developing ED, and academic and sports performance. In the resulting analysis, an initial cross-tabulation was carried out to observe the body distortion of the respondents as a function of BMI, followed by a linear regression to analyze the factors influencing the risk of suffering from ED. In addition, correlations were made to determine the relationship between the risk of manifesting ED and academic and sports performance. The main results show that 77.7% of the young athletes present a risk of ED (M = 13.3; DT = 3.33) due to a high body image distortion, which becomes the determining factor. In addition, relationships with family and friends have a significant influence on this. On the other hand, behaviors related with eating disorders affect concentration (r = -0.122; p = 0.01) and fatigue (r = -0.376; p < 0.01). For all these reasons, generating and promoting prevention and early detection guidelines during adolescence is necessary.

To Clap or Not to Clap: Relevance of "Applause" in Simulation-Based Learning Sessions.

INTRODUCTION: Applause is a common behavior during simulation case learning sessions. Some simulation facilitators believe that this should not be allowed, arguing that it can mislead students when they make mistakes during simulation. This study was conducted to explore the opinions of students about spontaneous applause (initiated by the participants), as a habitual behavior in the simulation sessions, in the undergraduate and postgraduate nursing degrees. METHODS: A qualitative research study was conducted based on the content analysis of 7 focus groups composed of simulation students (N = 101, both undergraduate and graduate students). The participants were asked to conduct a debate about the following question: What is your opinion about the spontaneous applause given to participants by their peers at the completion of the scenario as they go to the debriefing, and why? An inductive method of content analysis was used to interpret the data. RESULTS: The majority considered applause as a sign of support; one student disapproved of the practice. For most participants, receiving spontaneous applause from their peers after finishing the simulation represented a spontaneous example of moral support that reduced the participants' stress. CONCLUSIONS: Applause within the context of clinical simulation is a motivational act, which should not be repressed by the facilitator, as long as it is a spontaneous and genuine act by the participants once the simulation experience ends.

The Effects of a Non-Technical Skills Training Program on Emotional Intelligence and Resilience in Undergraduate Nursing Students.

There is a growing body of research on emotional intelligence and resilience in nursing students. However, there is little evidence of the development of these variables in intervention programs. This study aims to analyze the effects of a non-technical skills training program in emotional intelligence and resilience. Sixty students in the second year of Nursing Education from a Spanish public university completed this psychoeducational course. The pre-experimental design was longitudinal with pre- and post-intervention evaluation. The course consisted of 12 sessions of classroom education, three small-group workshops and a set of individual activities. Results in the emotional intelligence dimensions showed that Clarity (t = 3.10, p = 0.003) and Repair (t = 3.59, p < 0.001) increased significantly after participation in the program. Furthermore, the participants had a higher Resilience index when they had completed the program, with a statistically significant difference from the pre-course mean (t = 2.83, p = 0.006). This non-technical skills training program was an effective method of improving emotional intelligence and resilience in nursing students. Therefore, its use is recommended as a psychoeducational strategy for training undergraduate nursing students, as it improves their personal and professional competencies, resulting in higher-quality care.

Adaptation of the Highly Sensitive Person Scale (HSP) and Psychometric Properties of Reduced Versions of the Highly Sensitive Person Scale (R-HSP Scale) in Spanish Nursing Students.

Sensory processing sensitivity (SPS) can be defined as a personality characteristic that includes the individual characteristics of sensitivity towards endogenous and exogenous stimuli. The differences in environmental sensitivity can play a crucial role in the academic context of health professionals, thus defining it as an area of research that must be addressed. The reduced scale for highly sensitive people (HSP) is a short (16 items) and adapted version of the original scale for highly sensitive people (HSP). This study aims to analyze the psychometric properties of reduced versions of the Highly Sensitive Person Scale (r-HSP Scale) in Spanish nursing students. Once the questionnaire was translated, its psychometric characteristics were analyzed. The Spanish version of the r-HSP scale was administered to 284 university students enrolled in the Nursing Degree. The results from the factorial analysis confirmed the structure of sensitiveness of six factors in our sample. This structure included the following dimensions: (1) Instability, (2) Surroundings, (3) Interaction with others, (4) Sensoperception, (5) Sensitivity, and (6) Insecurity. Additionally, the Cronbach's α values indicated that the Spanish version of the r-HSP scale had an adequate reliability (α = 0.702). The r-HSP scale is defined as a reliable, valid, and agile replica of the original structure of sensitivity in Spanish university students.

Stress in Emergency Healthcare Professionals: The Stress Factors and Manifestations Scale.

Background: Healthcare workers are continuously exposed to a high level of stress, especially emergency department professionals. In the present research, we aimed to determine the internal consistency and validity of the Stress Factors and Manifestations Scale for in-hospital and out-of-hospital emergency workers. Methods: A quantitative, prospective, cross-sectional, and observational study including 269 emergency service professionals. Results: The scale was composed of 21 items, with a Cronbach's α value of 0.908. The hospital workers (38.4 ± 10.8 vs. 35.1 ± 9.9, p = 0.014) and women (39.3 ± 11.4 vs. 34.2 ± 8.6, p < 0.001) had higher levels of stress. The sensitivity, specificity, and predictive values of the scale were adequate. Conclusion: In the present study, including in-hospital and out-of-hospital emergency workers, the Stress Factors and Manifestations Scale presented appropriate usefulness, internal consistency, and validity, with optimal predictive ability. Higher levels of anxiety, female gender, being less optimistic, and working in hospital emergency departments were related to increased stress levels. Further studies are warranted to validate our results and potentially extend the Stress Factors and Manifestations Scale to other contexts.

Romani Women and Health: The Need for a Cultural-Safety Based Approach.

The Romani are the main European ethnic minority. The Romani people's situation of social vulnerability and their difficulties accessing the health system make their health indicators worse than those of the non-Romani population. The present study will delve into health beliefs, and experiences with health services and professionals, through the perspectives of Romani women. In this qualitative study, 16 women of different ages were interviewed in a city located in the South of Spain. Four themes emerged from the analysis of the data: the construction of the identity of Romani women, difficulties in life, health and disease beliefs and barriers to accessing the health system. We conclude that every project for the improvement of the health of the Romani community must take into account the active participation of Romani women and must consider the principles of Cultural Safety, by delving into the intercultural training of health professionals and addressing the social determinants of health which affect the Romani collective.

Satisfaction and Beliefs on Gender-Based Violence: A Training Program of Mexican Nursing Students Based on Simulated Video Consultations during the COVID-19 Pandemic.

The increase in gender-based violence in light of the COVID-19 pandemic is a public health problem that needs to be addressed. Our study aimed to describe the satisfaction with a training program in gender violence victim's attention through simulated nursing video consultations, analyze the beliefs on gender violence in Mexican undergraduate nursing students, and understand the skills that need to be improved. A descriptive cross-sectional study using a mixed-method was carried out with 27 students using a validated satisfaction questionnaire (quantitative data) and conducting scripted interviews (qualitative data) analyzed through the interpretive paradigm. All nursing students expressed a high overall satisfaction with simulated nursing video consultations and positive perceptions about this training program. From the students' perceptions, three first-level categories and their related second-level and specific categories emerged: belief and myths, skills to improve, and learning improvements. A training program in gender violence victim's attention through simulated nursing video consultations, in the middle of a pandemic, was a satisfactory experience for nursing students and beneficial for them, as they gained new knowledge and socioemotional skills. This training program mainly improved the acquisition of communication and emotional management skills for an adequate gender violence victim's attention.

Adaptation to Change Questionnaire for Nurses: Validation and New Needs in the Context of COVID-19.

BACKGROUND: The worldwide pandemic caused by the SARS-CoV-2 coronavirus has challenged healthcare systems and the professionals who work in them. This challenge involves strong changes to which nurses have had to quickly adapt. Emotional and cognitive-behavioral factors influence the capacity for adaptation to change. Based on this model, the objective of this study was to validate the Adaptation to Change Questionnaire (ADAPTA-10) for identifying professionals in a population of nurses who have problems adapting to adverse situations such as those caused by COVID-19. METHODS: This study was performed with a sample of 351 nurses. (3) Results: The ADAPTA-10 questionnaire was found to have good psychometric properties, and to be an effective, useful tool for nurses in research and clinical practice. The two-dimensional structure proposed in the original model was confirmed. Scales are also provided by sex for evaluation of adaptation to change; the highest scores on the emotional component were among nurses who had not personally encountered the virus. CONCLUSIONS: This instrument will be able to detect of the needs for adaptation to the new reality associated with COVID-19, as well as other situations in which nurses are immersed that demand adaptation strategies.

Diagnosis of Subclinical Keratoconus Based on Machine Learning Techniques.

(1) Background: Keratoconus is a non-inflammatory corneal disease characterized by gradual thinning of the stroma, resulting in irreversible visual quality and quantity decline. Early detection of keratoconus and subsequent prevention of possible risks are crucial factors in its progression. Random forest is a machine learning technique for classification based on the construction of thousands of decision trees. The aim of this study was to use the random forest technique in the classification and prediction of subclinical keratoconus, considering the metrics proposed by Pentacam and Corvis. (2) Methods: The design was a retrospective cross-sectional study. A total of 81 eyes of 81 patients were enrolled: sixty-one eyes with healthy corneas and twenty patients with subclinical keratoconus (SCKC): This initial stage includes patients with the following conditions: (1) minor topographic signs of keratoconus and suspicious topographic findings (mild asymmetric bow tie, with or without deviation; (2) average K (mean corneal curvature) < 46, 5 D; (3) minimum corneal thickness (ECM) > 490 µm; (4) no slit lamp found; and (5) contralateral clinical keratoconus of the eye. Pentacam topographic and Corvis biomechanical variables were collected. Decision tree and random forest were used as machine learning techniques for classifications. Random forest performed a ranking of the most critical variables in classification. (3) Results: The essential variable was SP A1 (stiffness parameter A1), followed by A2 time, posterior coma 0°, A2 velocity and peak distance. The model efficiently predicted all patients with subclinical keratoconus (Sp = 93%) and was also a good model for classifying healthy cases (Sen = 86%). The overall accuracy rate of the model was 89%. (4) Conclusions: The random forest model was a good model for classifying subclinical keratoconus. The SP A1 variable was the most critical determinant in classifying and identifying subclinical keratoconus, followed by A2 time.

Diagnosis of Subclinical Keratoconus with a Combined Model of Biomechanical and Topographic Parameters.

This study sought to develop a diagnostic model with aberrometry and biomechanical variables for subclinical keratoconus. The design was a cross-sectional study. The topographic data were obtained with a rotating Scheimpflug camera (Pentacam HR), and biomechanical data were obtained with Corvis ST. The study included 81 eyes distributed in 61 healthy corneas and 20 subclinical keratoconus (SCKC), defined as eyes with suspicious topographic findings, normal slit-lamp examination, and a manifestation of keratoconus. Analyses of the topographic and biomechanical data were performed, and a classifying model of SCKC was elaborated. The model for the diagnosis of SCKC includes posterior coma to 90°, Ambrósio's Relational Thickness in the horizontal profile (ARTh), and velocity when the air pulse is off (A2 velocity). The sensitivity was 89.5%, specificity 96.7%, accuracy 94.9%, and precision 89.5%. The area under the curve (AUC) of the receiver operating characteristic (ROC) curve for the model was 0.951. Diagnosis of subclinical keratoconus depends on the aberrometry variable posterior coma to 90° and the biomechanical variables A2 velocity and ARTh.

Motivation: bringing up the rear in nursing education. Motivational elements in simulation. The participants' perspective.

BACKGROUND: Motivation is a fundamental element of human behavior and learning. We believe that this aspect has not been sufficiently addressed in the field of simulation-based learning in nursing. PURPOSE: The aim of this study was to explore the views and perspectives of students involved in simulation-based learning related to their process of motivation. Also, to identify the motivational elements they perceived, as well as the aspects that could reduce their motivation in the simulation sessions. METHODS: A qualitative study was conducted based on content analysis from 7 focus groups composed of simulation students (n = 101). RESULTS: The study obtained 26 subcategories, 10 categories, and 2 emerging themes (in total, 17 motivational elements and 7 demotivational elements). CONCLUSION: The motivational elements were related with the non-directive/imposing style of the facilitator, the adequate structure and planning of the sessions, the possibility of transferring what was learned to the real world, and especially the atmosphere created in the simulation session. The main demotivational elements were directed simulation, an uncomfortable environment, and the planning and structure of the sessions (with an excessive theoretical content or with stringent evaluations).

Development and Validation of a Social Media Questionnaire for Nursing Training: A Pilot Study.

BACKGROUND: Social media platforms are integrated into the lives of students. Their use in education has been studied, but this research is scarce in nursing. The objective of this study was to develop and validate the questionnaire "Use and views of the social media for nursing education" through a pilot study, to describe the use and attitudes of nursing students to social media. METHODS: Cross-sectional design to validate the modified scale "Students' Use and Views of the Social Media questionnaire." The sample consisted of 107 undergraduate nursing students. RESULTS: The factor analysis extracted three main components to explain social media use for nursing education, with component 1 being the "Need to use media in my professional training," component 2-"To deepen my professional knowledge" and component 3 "Contrast information." High reliability was demonstrated with Chronbach's alpha value (0.84). CONCLUSION: The final tool was proven to have high validity and reliability values, so it is positioned as a viable tool to explore this reality. Students use social media for education in a high proportion and have positive attitudes regarding their education inclusion.

High-Fidelity Virtual Objective Structured Clinical Examinations with Standardized Patients in Nursing Students: An Innovative Proposal during the COVID-19 Pandemic.

In response to the cancellation of in-person objective structured clinical examinations (OSCEs) prompted by confinement due to the COVID-19 pandemic, we designed a solution to adapt our traditional OSCEs to this new reality in nursing education. We implemented an innovative teaching proposal based on high-fidelity virtual OSCEs with standardized patients. The purposes of our study were to describe this innovative teaching proposal and compare nursing competence acquisition in final year nursing students through virtual and in-person OSCE modalities. The study included 234 undergraduate students: 123 students were assessed through high-fidelity virtual OSCEs during May 2020, whereas 111 students were assessed through in-person OSCEs during May 2019. The structure of OSCEs, including its stations, clinical simulated scenarios, and checklists, was the same in both OSCE modalities. The effect size of the differences among the competence categories of checklists, including their total scores, was small. Regarding our virtual OSCEs was similarly successful to in-person OSCEs, this online format was found to be useful, feasible, and cost-saving when in-person OSCE was not possible. Therefore, high-fidelity virtual OSCEs with standardized patients could be considered as another choice of OSCE not only in the current COVID-19 pandemic but could also be extended to normal situations, even post-pandemic.

The repercussions of perceived threat from COVID-19 on the mental health of actively employed nurses.

In the confrontation with the COVID-19 pandemic, threat perceived by the nursing population, and its association with sociodemographic and contextual characteristics, must be measured and evaluated as well as their repercussions on their mental health. Therefore, the purpose of this study was to analyse the repercussion of perceived threat from COVID-19 on the mental health of actively employed nurses, considering a COVID-19 diagnosis, whether their own or of someone close to them. The sample was comprised of 351 nurses. Sociodemographic data were collected, and the Questionnaire on Perception of Threat from COVID-19 and the General Health Questionnaire were administered. The three demographic and contextual variables mentioned were related to mental health, mediated in some symptoms by perceived threat. These results provide important information for implementing measures or psychoeducational programs for nurses, essential in the present pandemic for improving psychological adaptation and reducing the effects on their mental health.

Improving Humanization Skills through Simulation-Based Computers Using Simulated Nursing Video Consultations.

During the COVID-19 confinement, we converted our clinical simulation sessions into simulated video consultations. This study aims to evaluate the effects of virtual simulation-based training on developing and cultivating humanization competencies in undergraduate nursing students. A quasi-experimental study was conducted with 60 undergraduate nursing students. A validated questionnaire was used to evaluate the acquisition of humanization competencies (self-efficacy, sociability, affection, emotional understanding, and optimism). The development of humanization competencies in this group composed of undergraduate nursing students was evaluated using virtual simulation-based training, comparing the levels obtained in these competencies at baseline (pre-test) and after the virtual simulation experience (post-test). After the virtual simulation sessions, students improved their levels in humanization total score and the emotional understanding and self-efficacy competencies, obtaining large effects sizes in all of them (rB = 0.508, rB = 0.713, and rB = 0.505 respectively). This virtual simulation modality enables training in the humanization of care with the collaboration of standardized patients in the form of simulated nursing video consultations and the performance of high-fidelity simulation sessions that comply with the requirements of best practices. Therefore, this methodology could be considered as another choice for virtual simulation. Additionally, this virtual modality could be a way to humanize virtual simulation.

Long Term Follow-Up Safety and Effectiveness of Myopia Refractive Surgery.

(1) Background: Refractive surgery is an increasingly popular procedure for decreasing spectacle or contact lens dependency. The two most common surgical techniques to correct myopia are photorefractive keratectomy (PRK) and femtosecond laser-assisted in situ keratomileusis (FS-LASIK). This study demonstrates the long-term effectiveness, safety, and predictability of both techniques for the refractive surgery of myopia. (2) Methods: A retrospective non-randomized study was performed. We followed 509 PRK eyes and 310 FS-LASIK surgeries for ten years. Patients were followed-up after 3 months and after 1, 2, 5, and 10 years, gathering data on their uncorrected visual acuity (UCVA) and best-corrected visual acuity (BCVA). The safety index of both procedures was defined as the quotient between the postoperative BCVA and the preoperative BCVA. We defined a procedure as safe if this quotient was equal to or greater than 1. The effectiveness index was calculated as the quotient between postoperative UCVA divided by the preoperative BCVA. (3) Results: The safety index was higher than 1 (1.09) and an effectiveness index of 0.82 after ten years of surgery in both groups was found. (4) Conclusion: These data demonstrated excellent safety and effectiveness indices for both techniques, although FS-LASIK is a technique with better safety and effectiveness indices than PRK.