The therapeutic relationship from the perspective of patients and nurses in the first days of admission: A cross-sectional study in acute mental health units.

The therapeutic relationship (TR) is essential in mental health nursing care and plays a fundamental role in the understanding and treatment of the patient's health status. Despite being a bidirectional construct, limited evidence is available to shed light on this issue in mental health units and even less so in the first days of admission. This study aimed to examine the association and differences between nurses' and patients' perspectives on the establishment of the therapeutic relationship in acute mental health units during the first days of hospitalization. A cross-sectional study was carried out in 12 Spanish mental health units. Data were collected from patients and nurses using the Working Alliance Inventory-Short (WAI-S) questionnaire. A total of 234 cases were analysed, including 234 patients and 58 nurses. The results showed a positive association between nurses' and patients' perspectives on the therapeutic relationship, but also revealed significant differences on each WAI-S dimension. Nurses assigned higher scores compared to patients on the perception of the quality of the therapeutic relationship. The dimensions with the greatest weight from the patients' perspective regarding the quality of the therapeutic relationship were the perception of greater agreement on goals and tasks among nurses. This study demonstrates the importance of establishing shared goals and tasks with nurses from the first days of hospitalization to improve the quality of the therapeutic relationship as perceived by patients. These findings underline the need to consider the different perspectives of both parties to promote a high-quality therapeutic relationship.

Estrategias para incrementar la motivación de las enfermeras asistenciales hacia la investigación / Strategies to increase motivation for research among practice nurses

OBJETIVO: identificar estrategias de intervención que sean de utilidad para potenciar la motivación de las enfermeras hacia la investigación. MÉTODO: el estudio se desarrolló en el contexto del máster universitario de Liderazgo y Gestión de Enfermería 2018/2019 de la Universidad de Barcelona. Se aplicó un diseño cualitativo mediante análisis interpretativo de contenido. Los datos se obtuvieron a través de la elaboración de un plan de acción donde cada participante, a partir de unos objetivos, planteó unas estrategias de intervención para incrementar su motivación hacia la investigación. Para el análisis se agruparon las diferentes estrategias por dimensiones, estableciendo dos subcategorías: intervenciones autoaplicadas dirigidas hacia uno mismo, e intervenciones institucionales dirigidas a la institución. RESULTADOS: prevalecieron las intervenciones dirigidas a la organización de la vida personal. Las propuestas más habituales de intervenciones autoaplicadas se relacionaron con aumentar el tiempo de dedicación a la investigación intentando optimizar el tiempo personal, incrementar la formación específica en investigación, el conocimiento de lengua inglesa y medidas destinadas a aumentar la motivación intrínseca. Mientras que las propuestas de intervenciones institucionales estuvieron enfocadas a disponer de tiempo para investigar dentro de la jornada laboral y tener acceso a los recursos necesarios. CONCLUSIONES: los resultados obtenidos pueden ayudar a generar planes estratégicos de intervención en los que se potencie la investigación enfermera a partir de un modelo de implantación, elaborado por las propias enfermeras, tanto de intervenciones autoaplicadas como a desarrollar por la institución

OBJECTIVE: to identify intervention strategies that will be useful in order to boost motivation for research among nurses. METHOD: the study was conducted in the setting of the University Master Degree for Nursing Leadership and Management 2018/2019 in the University of Barcelona. A qualitative design was applied through interpretive content analysis. Data were collected through the preparation of a plan of action where each participant, based on some objectives, presented intervention strategies in order to increase their motivation towards research. The different strategies were grouped by dimensions for their analysis, determining two subcategories: self-applied interventions targeted to oneself, and institutional interventions targeted to the institution. RESULTS: there was a prevalence of interventions targeted to personal life management. The most usual proposals for self-applied interventions were associated with increasing the time devoted to research, trying to optimize personal time, to increase the specific training on research, knowledge of English, and measures targeted to increase intrinsic motivation. On the other hand, the proposals for institutional interventions were focused on having time for research within the working day, and having access to the resources required. CONCLUSIONS: the results obtained can help to generate strategic plans of intervention that will boost nursing research based on a model of implementation, prepared by nurses, both for self-applied interventions and for those to be conducted by the institution

Critical thinking: A comparative analysis between nurse managers and registered nurses.

AIM: To analyse the levels of critical thinking among nurse managers and registered nurses and to explore the association between these levels and socio-demographic and occupational factors. BACKGROUND: Critical thinking is an essential skill in advanced clinical nursing. However, few studies to date have explored critical thinking levels in nurse managers or compared them with those recorded in registered nurses. METHODS: A randomized sample of 44 nurse managers and 295 registered nurses from a tertiary hospital in Barcelona participated in this study. The Nursing Critical Thinking in Clinical Practice Questionnaire was used to measure the level of critical thinking. The data were analysed using multivariate analysis by logistic regression. RESULTS: Levels of critical thinking were higher in nurse managers than in registered nurses. Age, work shift schedule and educational level were associated with a higher level of critical thinking in nurse managers and were predictor factors. CONCLUSIONS: This study identified age, work shift schedule and educational level as factors that impact on the acquisition of critical thinking skills among nurse managers. IMPLICATIONS FOR NURSING MANAGEMENT: This study provides substantive evidence of the levels of critical thinking among nurse managers. When introducing strategies to enhance these skills, the associated occupational factors should be taken into account.

Impacto de la enfermedad oncológica infantil. PErcepción de las familias y de las enfermeras. Proyecto de investigación / Research project. The impact of pediatric oncologic disease: families' and nurses' perception

Introducción. Vivir la experiencia de tener un hijoa con cáncer es una situación que genera una crisis en la familia que afecta no solo a nivel estructural, sino también emocional. Las enfermeras son las profesionales miembros del equipo multidisciplinar que se relacionan más tiempo con estas familias, por lo que es interesante saber cómo evidencian esta experiencia para poder mejorar la práctica asistencial, que debe contemplar una orientación holística dentro de los cuidados de alta complejidad que precisa un niño oncológico. Objetivos. Analizar el impacto en las familias producido por el debut de una enfermedad oncológica infantil; describir la percepción de las enfermeras sobre el impacto y la vivencia de las familias en el inicio de una enfermedad oncológica infantil y comparar la percepción que tienen las familias con la percepción de las enfermeras con respecto al debut de la enfermedad oncológica infantil. Ámbito de estudio. Unidad de Oncología y Hospital de Día del Hospital Sant Joan de Déu de Barcelona. Metodología. Estudio cualitativo siguiendo un enfoque basado en la fenomenología hermenéutica de Heidegger. Los participantes serán las familias de niños con cáncer y las enfermeras dedicadas a su cuidado. Para la recogida de datos se utilizará la entrevista en profundidad y, si se considerara pertinente, el grupo de discusión. El tipo de análisis utilizado será el de la temática bajo el método de análisis del contenido, siguiendo el método de análisis Guía QUAGOL (Qualitative Analysis Guide of Leuven) (AU)

Introduction. Going through the experience of having a child with cancer often results in a structural and emotional crisis for the family. Nurses, as professional members of a multidisciplinary team, interrelate the most with the families of oncologic pediatric patients. It is of great interest to provide evidence of nurses’ experience, in order to improve the care practice for children with cancer. Due to these patients’ highly complex needs in terms of care, a holistic approach is required. Objectives. To design a study which will determine the impact that the debut of an oncologic disease on a child has on families, by comparing nurses’ perception on the impact and experience of families going through this process to those of the actual family. Field of study. Oncology Unit and Day Hospital Sant Joan de Déu, Barcelona. Methodology. A qualitative study based on Heidegger’s hermeneutic phenomenology. The subjects of study will be parents of children with cancer and nurses involved in their care. For data collection, interviews and group discussions (if considered relevant) will be collected. The type of analysis used will be content analysis, following the QUAGOL Guide (Qualitative Analysis Guide of Leuven) (AU)

Levels of exposure to ethical conflict in the ICU: Correlation between sociodemographic variables and the clinical environment.

OBJECTIVES: To analyse the level of exposure of nurses to ethical conflict and determine the relationship between this exposure, sociodemographic variables and perceptions of the clinical environment. DESIGN AND SETTING: Prospective and descriptive correlational study conducted at 10 intensive care units in two tertiary hospitals affiliated to the University of Barcelona. Sociodemographic and professional data were recorded from a questionnaire and then the previously validated Ethical Conflict in Nursing Questionnaire-Critical Care Version was administered to obtain data regarding experiences of ethical conflict. RESULTS: Two hundred and three nurses (68.6%) participated in the study, of whom only 11.8% had training in bioethics. Exposure to ethical conflict was moderate with a x¯=182.35 (SD=71.304; [0-389]). The realisation that analgesia is ineffective and the administration of treatment without having participated in the decision-making process were the most frequently reported ethical conflicts. Professionals who perceived their environment as supportive for dealing with ethical conflicts reported lower levels of these events (p=0.001). CONCLUSIONS: Ethical conflict is an internal problem but it is strongly influenced by certain variables and environmental conditions. The involvement of nurses in the decision-making processes regarding the care of critically ill patients emerges as a factor that protects against ethical conflicts.

Impacto de una intervención informativa sobre el programa de cribado de cáncer colorrectal en profesionales de atención primaria / Impact of an informative intervention on the colorectal cancer screening program in primary care professionals

OBJETIVO: Evaluar el impacto de una intervención informativa a profesionales de atención primaria sobre sus conocimientos de cribado de cáncer colorrectal, recomendaciones de vigilancia posterior y estrategias de derivación. Método DISEÑO: Ensayo clínico controlado y aleatorizado por conglomerados. Emplazamiento: centros de atención primaria de L'Hospitalet de Llobregat (Barcelona). PARTICIPANTES: médicos y enfermeras de atención primaria. Intervención: sesión informativa y envío de píldoras informativas en 6 de 12 centros (seleccionados aleatoriamente) sobre el programa de cribado cáncer colorrectal. MEDICIONES PRINCIPALES: cuestionario ad hoc que recoge las características de los profesionales, los centros y 2 variables contextuales; implicación de los profesionales en el programa de cribado; conocimientos sobre el cáncer colorrectal, los factores de riesgo, los procedimientos de cribado, las recomendaciones de seguimiento posterior a la exploración diagnóstica y las estrategias de derivación. RESULTADOS: La media de la puntuación total en el primer cuestionario fue 8,07(1,38) sobre 11 y la del segundo 8,31(1,39). No se encontraron diferencias estadísticamente significativas entre el grupo intervención y control, sin embargo, en 9 preguntas se aumentó el porcentaje de respuestas correctas en el grupo intervención, mayoritariamente relacionadas con el seguimiento posterior a la exploración diagnóstica. CONCLUSIONES: La intervención mejora el porcentaje de respuestas correctas, sobre todo en aquellas en las que se obtuvo peor puntuación en el primer cuestionario. Este estudio muestra que los profesionales están familiarizados con el cribado de cáncer colorrectal, pero es importante tener una comunicación frecuente con ellos para mantener actualizada la información relacionada con el cribado y fomentar su implicación con el mismo

OBJECTIVE: To evaluate the impact of an intervention in primary care professionals on their current knowledge about colorectal cancer screening, subsequent surveillance recommendations and referral strategies. Methods DESIGN: Cluster randomized controlled trial. LOCATION: Primary Care Centers in L'Hospitalet de Llobregat (Barcelona). PARTICIPANTS: Primary Care Professionals (doctors and nurses). Intervention: Training session in six of the 12 centers (randomly selected) about the colorrectal cancer screening program, and three emails with key messages. MAIN MEASUREMENTS: Professionals and centers characteristics and two contextual variables; involvement of professionals in the screening program; information about colorectal cancer knowledge, risk factors, screening procedures, surveillance recommendations and referral strategies. RESULTS: The total score mean on the first questionnaire was 8.07 (1.38) and the second 8.31 (1.39). No statistically significant differences between the intervention and control groups were found, however, in 9 out of 11 questions the percentage of correct responses was increased in the intervention group, mostly related to the surveillance after the diagnostic examination. CONCLUSIONS: The intervention improves the percentage of correct answers, especially in those in which worst score obtained in the first questionnaire. This study shows that professionals are familiar with colorectal cancer screening, but there's a need to maintain frequent communication in order to keep up to date the information related to the colorectal cancer screening

[Impact of an informative intervention on the colorectal cancer screening program in primary care professionals]. / Impacto de una intervención informativa sobre el programa de cribado de cáncer colorrectal en profesionales de atención primaria.

OBJECTIVE: To evaluate the impact of an intervention in primary care professionals on their current knowledge about colorectal cancer screening, subsequent surveillance recommendations and referral strategies. METHODS DESIGN: Cluster randomized controlled trial. LOCATION: Primary Care Centers in L'Hospitalet de Llobregat (Barcelona). PARTICIPANTS: Primary Care Professionals (doctors and nurses). INTERVENTION: Training session in six of the 12 centers (randomly selected) about the colorrectal cancer screening program, and three emails with key messages. MAIN MEASUREMENTS: Professionals and centers characteristics and two contextual variables; involvement of professionals in the screening program; information about colorectal cancer knowledge, risk factors, screening procedures, surveillance recommendations and referral strategies. RESULTS: The total score mean on the first questionnaire was 8.07 (1.38) and the second 8.31 (1.39). No statistically significant differences between the intervention and control groups were found, however, in 9 out of 11 questions the percentage of correct responses was increased in the intervention group, mostly related to the surveillance after the diagnostic examination. CONCLUSIONS: The intervention improves the percentage of correct answers, especially in those in which worst score obtained in the first questionnaire. This study shows that professionals are familiar with colorectal cancer screening, but there's a need to maintain frequent communication in order to keep up to date the information related to the colorectal cancer screening.

Burnout en la profesión enfermera: una aproximación bibliométrica inicial / Burnout in the nursing profession: an initial bibliometric approach

Objetivo: obtener datos del estado de la investigación sobre burnout en profesionales de la Enfermería desde 1952 hasta el año 2011.Método: búsqueda bibliográfica electrónica de la literatura relevante publicada sobre el burnout de las enfermeras hasta diciembre del 2011. Las bases de datos consultadas fueron: PubMed (Medline), BVSalud Biblioteca Virtual en Salud, Biblioteca Complutense de Madrid, Trip Database, DOAJ (Directory of Open Acces Journals), ENFISPO, BioMed, Cochrane, Dialnet, Gopubmed, Psyke: catálogo de artículos sobre psicología en español, Highwire Standford University, Science Direct, SciELO, Cinahl, Cuiden, Cuidatge y Wylley-Blackwell. Resultados y conclusiones: se obtuvieron 4.506 artículos. La media de producción anual durante los 60 años analizados fue de 75,1, presentó unos niveles bajos durante los primeros años y no fue hasta 1981 cuando la producción aumentó de manera importante. El análisis de la productividad por autores revela que la mayor parte de los mismos solamente han publicado un artículo durante este periodo, y solo un 2,2% del total han producido más de diez artículos durante este periodo. El grupo de las diez revistas más productivas representa el 21,4% de la producción total de artículos incluidos en el estudio. El 68,1% proceden de revistas de Enfermería (AU)

Objective: to obtain data about the situation of research on burnout innursing professionals since 1952 and until 2011.Methodology: electronic bibliography search for relevant literature published on nurse burnout until December, 2011. The following databases were searched: PubMed (Medline), BVSalud (Virtual Library on Health), Complutense University Library, Madrid; Trip Database, DOAJ(Directory of Open Access Journals), ENFISPO, BioMed, Cochrane, Dialnet, Gopubmed; Psyke: catalog of Psychology articles in Spanish; Highwire Standford University, Science Direct, SciELO, Cinahl, Cuiden, Cuidatge and Wylley-Blackwell. Results and Conclusions: 4,506 articles were obtained. The median annual production during those 60 years analyzed was 75.1; there werelow levels during the first years, and the production did not show a major increase until 1981. The analysis of productivity by authors shows that the majority of them have only published one article during this period,and only 2.2% of them have published over ten articles during said period. The group of the ten most productive journals represents 21.4% of the total production of articles included in the study. 68.1% of these articles have appeared in Nursing Journals (AU)

Efectividad de la atención domiciliaria de enfermería administrada a pacientes con trastorno mental severo: ensayo clínico controlado / Effectiveness of a home care nursing program for patients with severe mental disorder: a controlled clinical trial

Objetivo. Conocer la efectividad de un programa de atención domiciliaria de enfermería (PADE) administrado a pacientes con trastorno mental severo. Método. Se aplicó un ensayo clínico controlado, con grupo experimental y grupo control, y mediciones pre y postintervención. La muestra estuvo compuesta por 52 pacientes afectados por un trastorno mental severo, residentes en la ciudad de Badalona (Barcelona). El PADE (intervención) se llevo a cabo durante 1 año y para evaluar su efectividad se utilizaron los siguientes instrumentos: DAI (Drug Attitude Inventory); juicio clínico global; GAF (Global Assessment of Functioning); QLS (Quality of Life Satisfaction); cuestionario de grados de insight en pacientes esquizofrénicos I-II. Los datos se analizaron mediante pruebas estadísticas no paramétricas. Resultados. Se estudiaron 30 pacientes en el grupo experimental y 22 en el grupo control. En el grupo experimental se consiguió: a) aumentar la adherencia al tratamiento (p = 0,001); b) incrementar el grado de vinculación a los centros de salud mental (p < 0,001); c) reducir el número de reingresos y los días de reingreso (media de 14 días por año en el grupo experimental frente a 74 días por año en el grupo control); d) aumentar el nivel de calidad de vida de los pacientes, en los aspectos intrapsíquicos (p = 0,02), relacionales (p = 0,02) y de actividades cotidianas (p = 0,021), y e) incrementar ligeramente su capacidad funcional. Conclusiones. Los resultados permiten concluir que el PADE incide favorablemente en el nivel general de salud de los pacientes afectados de un trastorno mental severo

Objective. To assess the effectiveness of a home care nursing program in patients with a severe mental disorder. Method. In a year-long controlled clinical trial, 52 patients with severe mental disorder resident in the city of Badalona (Barcelona) were examined pre- and post- intervention. The following instruments were used to assess the program's effectiveness: the Drug Attitude Inventory (DAI), Global Clinical Impression (GCI), Global Assessment of Functioning (GAF), Quality of Life Satisfaction (QLS), and the Degrees of Insight Questionnaire in Schizophrenic Patients I-II. The data were analyzed using non-parametric statistical tests. Results. There were 30 patients in the experimental group and 22 in the control group. In the experimental group, the trial: a) increased patients' adherence to treatment (p = 0.001); b) enhanced the links with the mental health community center (p < 0.001); c) reduced the number of readmissions and length of hospital stay (a mean of 14 days per year in the experimental group versus a mean of 74 days per year in the control group); d) increased patients' quality of life: intrapsychic (p = 0.02), relational (p = 0.02) and everyday activities (p = 0.021); and e) achieved a slight increase in their functional capacity. Conclusions. The results suggest that the home care nursing program has a positive impact on the general health of patients with severe mental disorder

Construcción y análisis psicométrico de un cuestionario para evaluar la salud mental positiva / Development and psychometric analysis of a positive mental health questionnaire

Los objetivos del presente trabajo son: a) construir un cuestionario para evaluar la salud mental positiva siguiendo el modelo conceptual planteado por Jahoda (1958) y b) analizar las propiedades psicométricas del instrumento y valorar el modelo hipotético planteado. La muestra fue de 387 estudiantes de la Escuela de Enfermería de la Universidad de Barcelona. Los resultados generales apuntan un modelo de salud mental positiva distinto al planteado por Jahoda. Los análisis psicométricos son favorables: índice de homogeneidad de los ítems superior a 0,25; coeficiente alfa de la escala global 0,91 y fiabilidad test-retest de 0,85; correlación entre el Cuestionario de Salud Mental Positiva y el Cuestionario de Salud General de Goldberg (1972) de -0,41; los seis factores extraídos a través del análisis factorial exploratorio explican el 46,8 por ciento de la varianza total. Sin embargo, serán necesarias nuevas investigaciones para asentar la generalizabilidad de los resultados psicometricos del cuestionario y confirmar el nuevo modelo de salud mental positiva (AU)