Effectiveness of gamification in nursing degree education.

Background: Previous research in nursing has found favorable results from the use of teaching methodologies alternative to lectures. One of the complementary methodologies used for university teaching is gamification, or the inclusion of game elements, creating a dynamic learning environment that allows the acquisition of knowledge and the development of other skills necessary for nursing students. The purpose of this study was to evaluate the effect of a gamification session on student satisfaction and knowledge scores in nursing students in simulated laboratory practice. Methods: A pre-post quasi-experimental study was conducted with 122 students from the nursing degree program who participated in the research. The evaluation consisted of four sessions of three hours each. In two sessions, participants were trained through a vertical methodology, by means of theoretical training provided by teaching staff, and two hours of clinical simulation, where the students were able to practice the techniques on professional simulators. At the other two sessions, participants received an explanation of the theoretical aspects of the session, one hour of clinical simulation, and one hour of gamification, in which they had to pass tests based on the performance of practical activities on the subject of the session. At the end of the gamification session, all the participants received a certificate as winners of the "nursing game". Results: There was an improvement in the satisfaction and the knowledge level in the gamification sessions. Both were statistically significant (P < 0.001). There was an improvement in the items related to the development of critical thinking and the mobilizing concepts from theory to practice in the gamification sessions. Conclusion: The intervention was effective in improving the satisfaction of the sessions received and in knowledge development.

Variables predictoras del uso de los métodos anticonceptivos en jóvenes: una revisión sistemática / Predictor variables of contraceptive method use in young people: A systematic review

Diseño: Revisión sistemática. Fuentes de datos: Se consultaron las bases de datos PubMed, CINAHL, Scopus, Cuiden Plus, LILACS e IME. Selección de estudios: Se realizó una evaluación de la calidad de los estudios que fue revisada por dos investigadores en paralelo. Como resultado, se seleccionaron un total de cinco investigaciones primarias. Extracción de datos: Se extrajo información sobre la población seleccionada en el estudio, método anticonceptivo estudiado y las variables predictoras identificadas. Resultados: Se identificaron siete variables predictoras que explican específicamente el uso del preservativo masculino, píldora anticonceptiva o píldora anticonceptiva de emergencia. Las variables más relevantes fueron el nivel de conocimiento y las actitudes hacia el empleo de los métodos anticonceptivos, de manera que un mayor conocimiento y unas actitudes positivas incrementan la probabilidad de uso de métodos anticonceptivos. Otro resultado destacado fue la presencia de un sesgo formativo con un mayor conocimiento de las mujeres sobre las opciones anticonceptivas hormonales y actitudes más positivas. Conclusión: Los futuros programas formativos deben orientarse hacia la evaluación de cambios en el comportamiento, mediante el desarrollo de actitudes positivas hacia el uso de los métodos anticonceptivos a través de la adquisición de un conocimiento de calidad sobre las opciones contraceptivas.(AU)

Objective: To analyse predictor variables of contraceptive method use in young people. Design: Systematic review. Data sources: PubMed, CINAHL, Scopus, Cuiden Plus, LILACS and IME databases were consulted. Study selection: An assessment of the quality of studies was carried out by two researchers in parallel. As a result, a total of 5 primary research studies were selected. Data extraction: Information was extracted on the selected study population, contraceptive method studied and predictor variables identified. Results: Seven predictor variables were identified that specifically explain the use of the male condom, contraceptive pill or emergency contraceptive pill. The most relevant variables were the level of knowledge and attitudes towards contraceptive use, therefore high knowledge and positive attitudes increase the likelihood of contraceptive use. Another notable finding was the presence of a formative bias with womenhaving higher knowledge of hormonal contraceptive options and more positive attitudes. Conclusion: Future training programs should be oriented towards assessing behavioral changes through the development of positive attitudes towards contraceptive use by gaining knowledge of contraceptive options.(AU)

[Predictor variables of contraceptive method use in young people: A systematic review]. / Variables predictoras del uso de los métodos anticonceptivos en jóvenes: una revisión sistemática.

OBJECTIVE: To analyse predictor variables of contraceptive method use in young people. DESIGN: Systematic review. DATA SOURCES: PubMed, CINAHL, Scopus, Cuiden Plus, LILACS and IME databases were consulted. STUDY SELECTION: An assessment of the quality of studies was carried out by two researchers in parallel. As a result, a total of 5 primary research studies were selected. DATA EXTRACTION: Information was extracted on the selected study population, contraceptive method studied and predictor variables identified. RESULTS: Seven predictor variables were identified that specifically explain the use of the male condom, contraceptive pill or emergency contraceptive pill. The most relevant variables were the level of knowledge and attitudes towards contraceptive use, therefore high knowledge and positive attitudes increase the likelihood of contraceptive use. Another notable finding was the presence of a formative bias with women having higher knowledge of hormonal contraceptive options and more positive attitudes. CONCLUSION: Future training programs should be oriented towards assessing behavioral changes through the development of positive attitudes towards contraceptive use by gaining knowledge of contraceptive options.

Satisfaction of Online University Education during the COVID-19 Pandemic.

The rapid global spread of the coronavirus disease affected the education sector, which had to adapt its teaching methodology to an online scenario to curb the increase in infections. This study aimed to determine the satisfaction level of university students regarding the online education they received during the COVID-19 pandemic. A descriptive cross-sectional study was carried out with nursing degree students. Convenience sampling was used because of the accessibility of the sample, estimating 168 as the minimum sample size needed. The satisfaction level was measured using the "Questionnaire on Satisfaction of University Students with Online Training" (CUSAUF). The sample consisted of 215 participants. The overall level of satisfaction was high. Subject content and teaching methodology were the most highly rated aspects, while aspects related to lecturer-student communication and communication among students were rated the worst. The Cronbach's α for the satisfaction scale was 0.94, showing high internal consistency and reliability of the sample. Online education could be considered an alternative methodology for teaching learning modules or complementing face-to-face training in future training programs.

Young nursing and medical students' knowledge and attitudes towards sexuality and contraception in two spanish universities: an inferential study.

BACKGROUND: Living safely sexuality and without risk to one's health is an international priority. The youth age group has specific characteristics that make it a particularly vulnerable group for adverse consequences such as unwanted pregnancies or sexually transmitted infections. Health professionals are an important group to address this issue; however, to achieve a good result, sufficient knowledge is required to solve all the issues. This study aimed to assess the level of knowledge of young university students studying a nursing or a medical degree. METHODS: A descriptive cross-sectional study of young medical and nursing students was conducted. The selection of participants was made by convenience. The Sexuality and Contraceptive Knowledge Instrument scale was used to measure knowledge level. A bivariate analysis was conducted using the Mann-Whitney U test or the Kruskal-Wallis H test, depending on the number of categories of the independent variable. Finally, a multivariate analysis was conducted using a multiple linear regression model, establishing the level of knowledge as the dependent variable and all variables that obtained statistical significance in the bivariate analysis as predictors. Data collection was carried out from October 2020 to March 2021. RESULTS: The sample comprised 657 health university students. Participants had a good level of knowledge, with 77.9% answering 50% of the questions correctly. Before training, 34.15% of the participants did not pass 50% of the questions asked. This percentage decreased to 12.87% after receiving sexuality training during their university degrees. The main training gaps were found for the items on hormonal contraceptive methods. The bivariate analysis showed that female participants had significantly higher knowledge scores, as did those who had used a hormonal contraceptive method during the most recent intercourse or were aware of family planning centers. These variables maintained their significant effect at the multivariate level, obtaining two models with good explanatory power for participants of both university degrees. CONCLUSION: The general level of knowledge of the healthcare students was high and sufficient after receiving training during the university degree (87.13% of the participants obtain more than 50% of items correct). The main training gap was found for items on hormonal contraceptive methods, which should be emphasized in future training programs.

Perceptions and concerns about sustainable healthcare of nursing students trained in sustainability and health: A cohort study.

AIM: To describe nursing students' perceptions of sustainable health education in the nursing curriculum and their concerns about sustainable healthcare and the impact of climate change on nursing. BACKGROUND: Sustainable health education involves education on the impact of climate change on health and the impact of healthcare on the environment. The effectiveness of sustainable health education in improving attitudes, knowledge and skills in sustainable healthcare has been demonstrated. However, there is a need to study students' perceptions of this and their concerns about achieving sustainable healthcare from the use and disposal of healthcare resources. DESIGN: A cohort study with an inductive content analysis of open-ended questions included in a survey. METHODS: The study was carried out with undergraduate nursing students throughout their four-year undergraduate academic program using scenario-based learning and augmented reality related to sustainability, climate change and health. As students were exposed to three educational interventions, they completed a survey of open-ended questions about their perceptions of their environmental sustainability training in the nursing curriculum, their concerns about the resources' used in healthcare and their perceptions of the impact of climate change on the nursing profession. RESULTS: Students identified content in the nursing degree program on climate change and health and hospital waste segregation. They also demanded more content on 'low environmental impact nursing care' when their clinical practice training increased. Students were concerned about the excessive and unnecessary use of materials in healthcare, especially in the post-pandemic period, the lack of environmental awareness of healthcare professionals and the lack of power to change the situation. They recognised the lack of proper waste segregation in healthcare settings, no recycling bins and little reuse of materials. They were also concerned about the polluting disposal of material. They perceived important impacts of climate change on nursing, such as patient care due to increased pollution-related diseases, including foetal malformations and new health care needs arising from weather conditions. Finally, students were concerned about the impact this will have on nursing care work and require 'nursing leadership in environmental awareness'. CONCLUSIONS: Students demand more training in low environmental impact healthcare and innovative educational practices are effective in this regard. Appropriate Sustainable Healthcare Education can make future health professionals more environmentally aware and enable them to lead the shift towards climate-smart care. TWEETABLE ABSTRACT: Students demand more training in low environmental impact healthcare and perceive significant impacts of climate change on nursing.

Knowledge of Sexuality and Contraception in Students at a Spanish University: A Descriptive Study.

Youth is a period characterized by impulsiveness and risk-taking. This population often feels invulnerable and has a strong motivation to seek out their identity. These characteristics make it a risky age period for an unwanted pregnancy. This study aimed to investigate the level of knowledge about sexuality and contraception among nursing students at the University of Jaen. The students completed a 16-item questionnaire assessing their knowledge level about sexuality and contraception. A bivariate analysis was performed using the Kruskal-Wallis H and Mann-Whitney U tests. Later, an ordinal logistic regression model was generated. The sample consisted of 130 participants, with an average age of 20.36 years. The level of knowledge about sexuality and contraception was moderately high, 10.38 points out of 16. The factors associated with the probability of accordingly presenting a high level of knowledge were being a woman, having studied in a public institution, not having used any contraceptive method in the first sexual experience, and wishing to use a contraceptive pill in future sexual relations. In conclusion, the knowledge level about sexuality and contraception is high, although it is necessary to assess whether this level of high knowledge translates to the use of contraceptive methods in future sexual experiences.

Effectiveness of scenario-based learning and augmented reality for nursing students' attitudes and awareness toward climate change and sustainability.

BACKGROUND: Mainstreaming sustainable healthcare into the curricula of health professions is a key action to raise awareness and change attitudes. Therefore, the present study aimed to assess the contribution of scenario-based learning and augmented reality to the environmental awareness and attitudes toward climate change and sustainability among undergraduate nursing students. METHODS: This study was designed as a time-series analysis. Undergraduate nursing students in their 3 years were introduced to sustainability and climate change in the context of healthcare through scenario-based learning sessions. Questionnaires were used to collect data on participants' attitudes towards sustainability and climate change, the usefulness of the educational sessions and the extent to which students changed their clinical practice. A data summary, related sample Friedman and Wilcoxon signed-rank tests were used to test for differences in survey scores. RESULTS: Attitudes and environmental awareness toward climate change and sustainability increased significantly as students received the learning sessions over the 3 years. After their first clinical training period, students already showed a high awareness of unsustainable practices in their working environment; however, they still struggled to apply sustainability and address unsustainable practices in healthcare settings. Most students felt that the scenarios helped them to make links between climate change, resources, and health. CONCLUSIONS: The scenario-based learning and augmented reality increase environmental awareness and attitudes toward climate change and sustainability among nursing students. Students are very aware of unsustainable practices in their work environment, but more work needs to be done on the application of sustainability principles to nursing practice.

Nursing students' attitudes towards climate change and sustainability: A cross-sectional multisite study.

BACKGROUND: Education is a social tipping intervention necessary for stabilising the earth's climate by 2050. Integrating sustainable healthcare into healthcare professions curricula is a key action to raise awareness. OBJECTIVES: This study aimed to: i) investigate nursing students' attitudes towards and awareness of climate change and sustainability issues and its inclusion in nurse education, ii) explore differences across a range of countries, and iii) compare attitudes in 2019 with those of a similar sample in 2014. DESIGN: A cross-sectional multicentre study. Data were collected through the Sustainability Attitudes in Nursing Survey (SANS_2) questionnaire. SETTINGS: Seven different universities and schools of nursing in five countries (UK, Spain, Germany, Sweden, and Australia). PARTICIPANTS: A convenience sample of first-year undergraduate nursing students. METHODS: The SANS_2 questionnaire was self-administered by nursing students at the seven participating universities at the start of their undergraduate degree, between September 2019 and February 2020. RESULTS: Participants from all seven universities (N = 846) consistently showed awareness and held positive attitudes towards the inclusion of climate change and sustainability issues in the nursing curriculum (M = 5.472; SD: 1.05; min-max 1-6). The relevance of climate change and sustainability to nursing were the highest scored items. Esslingen-Tübingen students scored the highest in the 'inclusion of climate change and sustainability in the nursing curricula'. Students at all universities applied the principles of sustainability to a significant extent at home. Nursing students' attitudes towards climate change and sustainability showed significantly higher values in 2019 (Universities of Plymouth, Brighton, Esslingen-Tübingen, Jaen, Murcia, Dalarna, and Queensland) than in 2014 (universities of Plymouth, Jaen, Esslingen, and Switzerland). CONCLUSIONS: Nursing students have increasingly positive attitudes towards the inclusion of sustainability and climate change in their nursing curriculum. They also recognise the importance of education regarding sustainability and the impact of climate change on health, supporting formal preparation for environmental literacy. It is time to act on this positive trend in nursing students' attitudes by integrating these competencies into nursing curricula.

Nurses and ward managers' perceptions of leadership in the evidence-based practice: A qualitative study.

AIM: To describe nurses and ward managers' experiences with nursing leadership in the implementation of evidence-based practice. BACKGROUND: The implementation of evidence-based practice requires to identify the most suitable styles of nursing leadership for the successful application. DESIGN: A qualitative descriptive study. METHODS: The study was carried out with 57 nurses (clinical nurses and ward managers) in eight focus groups from five public hospitals. Template analysis, using the Promoting Action on Research Implementation in Health Services framework, was used. The Consolidated Criteria for Reporting Qualitative Research guide was followed in planning and reporting this research. RESULTS: Three types of nursing leadership were identified: traditional leadership, medium leadership and transformational leadership. Traditional leadership was the most frequent, with a predominance of bureaucratic tasks for ward managers, so implementation of evidence-based practice is difficult. CONCLUSION: Nurses do not feel empowered and they perceive the changes as an imposition. In the absence of strong leadership for evidence-based practice, a natural leader emerges. IMPLICATIONS FOR NURSING MANAGEMENT: Clinical nurses demand more empowerment for decision-making, and ward managers need clarity of roles. To create an environment favourable to evidence-based practice, it is necessary consider the role of the transformational leader.

Educational program on sexuality and contraceptive methods in nursing degree students.

BACKGROUND: Previous educational programs about sexuality and contraceptive methods are delivered through vertical teaching methodology and use an increase in knowledge level as an indicator of effectiveness; however, attitudes towards contraceptive use are not addressed. OBJECTIVES: This study aimed to evaluate the effect of a peer-educational intervention to improve knowledge level and attitudes regarding contraceptive methods in university students. DESIGN: A pre-post quasi-experimental study. SETTINGS: Young university students from a Spanish university. PARTICIPANTS: 131 students in their second year of the Nursing degree program. METHODS: An intervention consisting of two 3-hour sessions was conducted. The first session introduced the main aspects of contraceptive methods and was conducted by the teacher. The second session began with student presentations about contraceptive methods, followed by clinical simulations of a family planning service that the students had to implement and solve. RESULTS: There was a 71.43% improvement in the knowledge level scale score and a 2.17% improvement in the attitudes towards the use of contraceptive methods; both were statistically significant (p < 0.001). For 11 of the 15 items in the knowledge scale, a significantly higher proportion of success was found after the intervention. CONCLUSION: Peer-educational intervention was effective in improving knowledge level and attitudes about contraceptive methods.

Hospitalised patients with palliative care needs: Spain and Sweden compared.

OBJECTIVES: This study aimed to describe and compare symptoms, care needs and types of diagnoses in hospitalised patients with palliative care needs in Spain and Sweden. METHODS: A cross-sectional, population-based study was carried out at two hospitals in both Spain and Sweden. Using a questionnaire, we performed 154 one-day inventories (n=4213) in Spain and 139 in Sweden (n=3356) to register symptoms, care needs and diagnoses. Descriptive analyses were used. RESULTS: The proportion of patients with care needs in the two countries differed (Spain 7.7% vs Sweden 12.4%, p<0.001); however, the percentage of patients with cancer and non-cancer patients was similar. The most prevalent symptoms in cancer and non-cancer patients in both countries were deterioration, pain, fatigue and infection. The most common cancer diagnosis in both countries was lung cancer, although it was more common in Spain (p<0.01), whereas prostate cancer was more common among Swedish men (p<0.001). Congestive heart failure (p<0.001) was a predominant non-cancer diagnosis in Sweden, whereas in Spain, the most frequent diagnosis was dementia (p<0.001). Chronic obstructive pulmonary disease was common in both countries, although its frequency was higher in Spain (p<0.05). In total, patients with cancer had higher frequencies of pain (p<0.001) and nausea (p<0.001), whereas non-cancer patients had higher frequencies of deterioration (p<0.001) and infections (p<0.01). CONCLUSIONS: The similarities in symptoms among the patients indicate that the main focus in care should be on patient care needs rather than diagnoses. Integrating palliative care in hospitals and increasing healthcare professional competency can result in providing optimal palliative care.

Context as a Facilitator of the Implementation of Evidence-based Nursing: A Meta-synthesis.

Nurses have numerous difficulties in implementing science due to obstacles related to the work context. The aim is to explore the work-context-related facilitators of the application of evidence in clinical practice by nursing professionals. Qualitative meta-synthesis of primary studies on nurses' experiences of work-context-related facilitators, as defined by the Promoting Action on Research Implementation in Health Services model. Using the Qualitative Appraisal and Review Instrument of the Joanna Briggs Institute. Of the total 57 primary research articles included, an explanatory model of the facilitating factors related to the work context was generated on the basis of four general categories: institutional support (leadership), multidisciplinary support (teamwork and communication), culture of improving quality of care (nursing professionals' attitudes towards change) and use of research (valuing research). Action can be taken on the facilitating factors of the evidence-based practice application in nursing clinical environments, providing resources and motivation from the organization.

Effectiveness of the e-NurSus Children Intervention in the Training of Nursing Students.

The paediatric population is the most vulnerable to exposure to environmental risk factors. Institutions of higher education have to equip nursing students with the attitudes, knowledge, and skills to respond to this using blended learning. The aim of this study was to evaluate the effect of e-NurSus Children intervention on student nurses' attitudes, knowledge, and skills. A quasi-experimental study of time series was designed using pre and post educational intervention evaluation in 2018. The participants were nursing students (N = 267) from Spain (n = 110) and the United Kingdom (n = 157). Three instruments were used: the Sustainability Attitudes in Nursing Survey, the Children's Environmental Health Knowledge Questionnaire, and the Children's Environmental Health Skills Questionnaire. The attitudes (15.81%), knowledge (39.02%), and skills (29.98%) of nursing students improved following the e-NurSus Children intervention. It is necessary to include topics on children's environmental health in nurse education as students are aware of this issue but do not have the knowledge or skills required to manage problems or illness caused by the environment. The e-NurSus Children intervention is an effective tool to address this educational gap.

Efectividad de las intervenciones educativas para la prevención del embarazo en la adolescencia / Effectiveness of educational interventions for the prevention of pregnancy in adolescents

Objetivo: Evaluar la efectividad de las intervenciones educativas dirigidas a prevenir el embarazo en la adolescencia. Diseño: Revisión sistemática. Fuentes de datos: Se consultaron las bases de datos PubMed, CINAHL, Scopus, Cuiden Plus, LILACS e IME para buscar estudios sobre intervenciones educativas para la prevención del embarazo en la adolescencia. Selección de estudios: Se seleccionaron un total de 24 investigaciones primarias, donde se evaluaba el efecto de un programa educativo para la prevención del embarazo en la adolescencia. La calidad de los estudios seleccionados se evaluó usando la escala CASPe. Resultados: Los programas educativos que midieron una modificación de la tasa de embarazo en la adolescencia muestran resultados poco concluyentes, ya que 2 investigaciones obtienen una reducción y otros 2 no hallan cambios significativos. Sin embargo, los programas educativos se muestran efectivos para aumentar el nivel de conocimiento sobre sexualidad y métodos anticonceptivos, y para modificar las actitudes sobre el riesgo de embarazo en la adolescencia o las actitudes hacia el uso de los métodos anticonceptivos. No se encuentran diferencias estadísticamente significativas entre los estudios que muestran un resultado positivo y los estudios con resultado negativo (p > 0,05) para ninguno de los resultados analizados en la revisión. Conclusión: No existe una modalidad de intervención que sea la más efectiva para la prevención de un embarazo en la adolescencia. Se necesita un mayor número de investigaciones con un abordaje longitudinal que valoren no solo resultados intermedios, sino una modificación en la tasa de embarazo

Objective: To assess the effectiveness of the interventions to prevent a pregnancy in adolescence. Design: Systematic review. Data sources: The following databases were consulted: PubMed, CINAHL, Scopus, Cuiden Plus, LILACS, and IME, in order to identify interventions aimed at preventing a pregnancy in adolescence. Study selection: A total of 24 primary investigations, in which an educational program to prevent a pregnancy in the adolescence was evaluated, were selected. The quality of the selected studies was assessed according to the CASPe scale. Results: Educational programs for the modification of the teenage pregnancy rate show inconclusive results, as there are 2 studies that find a reduction, and 2 that find that there are no significant changes. For secondary outcomes, it was found that educational programs are effective for increasing the knowledge level about sexuality and contraceptive methods and changing attitudes about the risk of a teenage pregnancy or the use of contraceptive methods. There are no statistically significant differences between the studies with a positive and negative outcome (P > .05) for any of the results analysed in this review. Conclusion: There is no a single intervention modality that is the most effective for prevention of a teenage pregnancy. More research is needed with a longitudinal approach that assess not only intermediate results, but also a modification in the pregnancy rate

Sexuality and contraceptive knowledge in university students: instrument development and psychometric analysis using item response theory.

BACKGROUND: As a consequence of biological, psychological and social changes during puberty, youth is a period characterized by impulsiveness and risk-taking. Members of this population often feel invulnerable and have a strong motivation to explore their identity. A good level of knowledge is necessary to allow young people to experience their sexuality in a healthy way, without associated risks. In our environment there is currently no valid Spanish-language tool to measure the level of knowledge about sexuality and contraception. This study sought to develop and test the psychometric properties of a new sexuality and contraception knowledge instrument. METHODS: This is a cross-sectional study to validate the sexuality and contraception knowledge instrument. The validation process followed four phases: (1) development of the instrument, (2) content validation by an expert panel, (3) pilot test and (4) psychometric analysis of the instrument using item response theory according to the Rasch model. The validation process took place from September 2017 to February 2018. RESULTS: The sample included 387 students enrolled at the Nursing and Law degrees from the University of Jaen. The final instrument was made up of 15 items. All of the items presented good adaptation values with respect to the model. The scale showed good fit and reliability: 0.99 for items and 0.74 for people. The temporal stability of the scale was calculated using test-retest, obtaining a value of 0.81 (CI 0.692-0.888). The construct validity showed the one-dimensionality of the construct, while the discriminant validity obtained good results, so the scale appears to be able to differentiate between participants with low or high levels of knowledge. CONCLUSION: The results suggest the Sexuality and Contraception Knowledge Instrument is psychometrically valid and reliable for measuring the knowledge level concerning sexuality and contraceptive methods in young university students.

Knowledge, skills and attitudes related to evidence-based practice among undergraduate nursing students: A survey at three universities in Colombia, Chile and Spain.

Teaching nursing students about the model of evidence-based practice is a challenge for university faculty. The aim of this study was to measure knowledge, skills and attitudes related to evidence-based practice among undergraduate nursing students, as well as associated factors. The study involved a cross-sectional design using a survey of all students enrolled in a Bachelor of Nursing programme (1st to 4th year) in three nursing faculties of universities in Chile, Colombia and Spain. The Spanish version of the Evidence-Based Competence Questionnaire was used to measure knowledge, skills, attitudes and overall competency. In total, 875 students completed the questionnaire. The overall score of competency in evidence-based practice was similar in all three universities (range 1-5) (3.63 in Chile, 3.58 in Colombia and 3.68 in Spain). The score of self-rated attitudes was strongly correlated with the overall competency measured. More hours of training in research methods and reading nursing journals articles in the last month were the factors associated with higher scores in evidence-based practice competency. The undergraduate nursing students at the three universities surveyed obtained a high score in overall competency in evidence-based practice. No differences were found among them, despite the different approaches used in educational programmes.

Undergraduate Nursing Students' Attitudes, Knowledge, and Skills Related to Children's Environmental Health.

BACKGROUND: Nurses are in a privileged position to detect environmental risks among children. The objective was to determine attitudes, knowledge, and skills related to children's environmental health in undergraduate nursing students. METHOD: A cross-sectional study was designed in eight universities (n = 2,462) from September 2017 to June 2018. Descriptive values and multivariate analysis of variance were calculated using three questionnaires. RESULTS: Of the total 2,462 students in the sample, 2,155 had a good attitude regarding addressing children's environmental health problems, 501 had good knowledge, and 1,162 had good skills. Students who had attended a session on sustainability more than 3 months prior had a better attitude (9.93%), knowledge (11.16%), and skills (3.82%). Second course students and men had better environmental competency (p < .001). CONCLUSION: Undergraduate nursing students have good attitudes; however, they lack knowledge and skills. There is a need to include children's environmental health in nursing curricula. [J Nurs Educ. 2019;58(7):401-408.].

[Effectiveness of educational interventions for the prevention of pregnancy in adolescents]. / Efectividad de las intervenciones educativas para la prevención del embarazo en la adolescencia.

OBJECTIVE: To assess the effectiveness of the interventions to prevent a pregnancy in adolescence. DESIGN: Systematic review. DATA SOURCES: The following databases were consulted: PubMed, CINAHL, Scopus, Cuiden Plus, LILACS, and IME, in order to identify interventions aimed at preventing a pregnancy in adolescence. STUDY SELECTION: A total of 24 primary investigations, in which an educational program to prevent a pregnancy in the adolescence was evaluated, were selected. The quality of the selected studies was assessed according to the CASPe scale. RESULTS: Educational programs for the modification of the teenage pregnancy rate show inconclusive results, as there are 2 studies that find a reduction, and 2 that find that there are no significant changes. For secondary outcomes, it was found that educational programs are effective for increasing the knowledge level about sexuality and contraceptive methods and changing attitudes about the risk of a teenage pregnancy or the use of contraceptive methods. There are no statistically significant differences between the studies with a positive and negative outcome (P>.05) for any of the results analysed in this review. CONCLUSION: There is no a single intervention modality that is the most effective for prevention of a teenage pregnancy. More research is needed with a longitudinal approach that assess not only intermediate results, but also a modification in the pregnancy rate.

Student nurses' knowledge and skills of children's environmental health: Instrument development and psychometric analysis using item response theory.

BACKGROUND: Climate change has an important impact on health, particularly in children. Therefore, the inclusion of environmental issues in the undergraduate nursing curriculum is essential. Knowledge and skills in environmental sustainability can be measured through questionnaires. OBJECTIVES: The aim of this study was to develop and validate the Children's Environmental Health Knowledge Questionnaire (ChEHK-Q) and the Children's Environmental Health Skills Questionnaire (ChEHS-Q) to measure knowledge and skills, respectively, about children's environmental health in nursing students. DESIGN: This was an observational, cross-sectional study undertaken in four phases: (1) Development of the questionnaire and item wording, (2) content validation by an expert panel, (3) pilot test and (4) psychometric evaluation. SETTINGS: A Faculty of Health Sciences in Spain. PARTICIPANTS: 308 nursing students enrolled in the first, third and fourth years of study. METHODS: The development and validation of the children's environmental health questionnaires was carried out based on the item response theory. RESULTS: The 26-item ChEHK-Q shows good fit and reliability of 0.98 for items and 0.70 for people based on the Rasch Model. The 12-item ChEHS-Q also shows good fit and reliability of 0.87 for items and 0.76 for people based on Andrich's rating scale model. The temporal stability measured using the intraclass correlation coefficient was 0.86 in the ChEHK-Q and 0.73 in the ChEHS-Q. Both questionnaires present enough evidence for construct validity; they work well to distinguish between nursing students with low or high knowledge of or skills in children's environmental health. CONCLUSIONS: The Children's Environmental Health Knowledge Questionnaire and the Children's Environmental Health Skills Questionnaire are useful tools for measuring knowledge and skills, respectively, among nursing students. This validation study obtained good psychometric properties concerning validity and reliability.