Evaluating satisfaction with teaching innovation, its relationship to academic performance and the application of a video-based microlearning.

AIM: To develop and validate a questionnaire to assess satisfaction with teaching innovation, assess the student satisfaction with a video-based microlearning intervention in its video-based modality and to verify its impact on academic performance. DESIGN: A descriptive cross-sectional study was conducted. The study used the COSMIN checklist for studies on measurement instruments. METHODS: One hundred and ten nursing students from Salus Infirmorum University Centre (Andalusia, Spain) participated in the study. The items of the instrument were designed based on a literature review and its validity and stability were analysed. After that, 6 weeks of video-based microlearning intervention were implemented. Then students were asked to fill the satisfaction questionnaire and then took the subject exam. RESULTS: The resulting questionnaire consisted of 5 items with only one dimension. The questionnaire showed good validity and reliability. A direct correlation was observed between satisfaction with the video-based microlearning intervention and the marks of the subject exam.

The Impact of Clinical Training Seminars on Stress and Perception of Clinical Placement Stressors among Spanish Undergraduate Nursing Students: A Two-Phase Mixed-Methods Study.

Stress and stressors related to clinical practice are some of the main reasons for the discomfort reported by nursing students. It is important to identify the causes of stress and seek strategies to reduce the stress levels in nursing students. Clinical training seminars have proven to be a useful tool to reduce stress levels. This study aims to evaluate the effects of a series of clinical training seminars on the levels of stress and perception of stress factors before the start of clinical practice among undergraduate Spanish nursing students. A two-phase, sequential mixed-methods design was used. For the quantitative phase, data were collected using Cohen's Perceived Stress Scale and the KEZKAK questionnaire before and after the clinical training seminars. Qualitative data were collected through a focus group session held after the clinical training period. The results show a significant reduction (p = 0.002) in perceived stress levels after the clinical training seminars, and also a change in students' perception of stressors in the clinical placement. This study provides valuable information for the development of content for clinical training seminars. Universities should develop strategies to reduce stress in their students caused by the clinical placement.

Empathy, Burnout, and Attitudes towards Mental Illness among Spanish Mental Health Nurses.

Mental health nurses, together with psychiatrists, are the healthcare professionals who display the highest levels of empathy and the best attitudes towards patients with mental disorders. However, burnout is a common problem among these professionals. The aim of our study is to describe the association between empathy, burnout, and attitudes towards patients with mental disorders among mental health nurses in Spain. A descriptive cross-sectional design was used involving a sample of 750 specialist nurses working in mental health facilities in Spain. An intentional, non-probability, non-discriminative, exponential snowball sampling method was used. The Jefferson Scale of Empathy, the Maslach Burnout Inventory, and the Community Attitudes towards Mental Illness Inventory were used to measure the study variables. A positive correlation was observed between empathy and all the study variables, with the exception of the personal accomplishment dimension of burnout and the social restrictiveness and authoritarianism dimensions of attitudes towards mental illness, where a negative relation was observed. Our findings suggest that empathy is associated with an increase in positive attitudes towards patients with mental disorders, decreasing associated stigma, but did not act as a protective factor against burnout in the study sample.

Design of a nursing objective structured clinical examination of a first-year clinical practice program.

OBJECTIVE: The aim of the present study was to design a content-valid nursing objective structured clinical examination attending a first-year clinical nursing practice program. METHOD: The examination was designed following a procedure based on the consensus of experts which was comprised of three phases: selection of the activities in which students should be competent according to the learning outcomes of the course, clinical case design, and integration of the clinical cases designed into the stations of the test. RESULTS: Of the 44 surveys submitted for the design of the stations, 37 were answered, of which 31 respondents met the inclusion criteria of the panel of experts. The activities on which the experts reached the highest degrees of consensus were: basic physical assessment and monitoring of vital signs, assessment of hygiene and skin status, ability to develop care plans, management of safety principles in administration of medication and administration of oral medication. Based on the selected activities, the experts developed 20 clinical cases, from which a four-station nursing objective structured clinical examination was designed. CONCLUSION: The structured methodology based on the design of experts enabled the design of a content-valid objective structured clinical examination appropriate for the evaluation of the learning outcomes achieved by the students attending a clinical practice program.

Design of a nursing objective structured clinical examination of a first-year clinical practice program / Projeto de um exame clínico estruturado objetivo de enfermagem de um programa de prática clínica do primeiro ano / Diseño de una prueba de evaluación clínica objetiva estructurada de cuidados de enfermería del primer curso de prácticas clínicas

ABSTRACT Objective: The aim of the present study was to design a content-valid nursing objective structured clinical examination attending a first-year clinical nursing practice program. Method: The examination was designed following a procedure based on the consensus of experts which was comprised of three phases: selection of the activities in which students should be competent according to the learning outcomes of the course, clinical case design, and integration of the clinical cases designed into the stations of the test. Results: Of the 44 surveys submitted for the design of the stations, 37 were answered, of which 31 respondents met the inclusion criteria of the panel of experts. The activities on which the experts reached the highest degrees of consensus were: basic physical assessment and monitoring of vital signs, assessment of hygiene and skin status, ability to develop care plans, management of safety principles in administration of medication and administration of oral medication. Based on the selected activities, the experts developed 20 clinical cases, from which a four-station nursing objective structured clinical examination was designed. Conclusion: The structured methodology based on the design of experts enabled the design of a content-valid objective structured clinical examination appropriate for the evaluation of the learning outcomes achieved by the students attending a clinical practice program.

RESUMO Objetivo: O objetivo do presente estudo foi elaborar um exame clínico estruturado de objetivos de enfermagem com conteúdo válido, participando de um programa de prática clínica de enfermagem do primeiro ano. Método: O exame foi elaborado seguindo um procedimento baseado no consenso de especialistas que compreendeu três fases: seleção das atividades nas quais os alunos deveriam ser competentes de acordo com os resultados de aprendizagem do curso, desenho do caso clínico e integração do quadro clínico casos projetados para as estações do teste. Resultados: Das 44 pesquisas submetidas para a concepção das estações, 37 foram respondidas, das quais 31 respondentes atenderam aos critérios de inclusão do painel de especialistas. As atividades nas quais os especialistas alcançaram maior grau de consenso foram: avaliação física básica e monitoramento dos sinais vitais, avaliação da higiene e do estado da pele, capacidade de desenvolver planos de cuidados, gestão dos princípios de segurança na administração de medicamentos e administração de medicamentos orais. Com base nas atividades selecionadas, os especialistas desenvolveram 20 casos clínicos, a partir dos quais foi elaborado um exame clínico estruturado objetivo de enfermagem em quatro estações. Conclusão: A metodologia estruturada baseada na concepção de especialistas permitiu a concepção de um exame clínico estruturado objetivo válido e de conteúdo adequado para a avaliação dos resultados de aprendizagem alcançados pelos alunos que frequentam um programa de prática clínica.

RESUMEN Objetivo: El objetivo de este estudio fue diseñar una Evaluación Clínica Objetiva Estructurada con validez de contenido para evaluar el nivel de competencias de estudiantes de primer curso de formación practico-clínica enfermera. Método: Se diseñó la prueba siguiendo un procedimiento basado en consenso de expertos con tres fases: selección de las actividades en la que los alumnos debían ser competentes en base a los resultados de aprendizaje de la asignatura, diseño de casos clínicos, e integración de los casos clínicos diseñados en las estaciones de la prueba. Resultados: Las actividades que alcanzaron mayor consenso por parte de los expertos fueron: valoración física básica y monitorización de signos vitales, valoración de la higiene y estado de la piel, capacidad para elaborar planes de cuidados, manejo de los principios de seguridad en la administración de medicación y administración de medicación oral. En base a las actividades seleccionadas, los expertos elaboraron 20 casos clínicos, a partir de los cuales se diseñó una evaluación clínica objetiva estructurada de cuidados de enfermería formada por cuatro estaciones. Conclusión: La metodología estructurada basada en el diseño de expertos permitió el diseño de una evaluación clínica objetiva estructurada adecuada para evaluar los resultados de aprendizaje alcanzados por los estudiantes de primer curso de formación práctico-clínica.

Development and Psychometric Evaluation of a Questionnaire Based on the Nursing Outcomes Classification to Determine the Knowledge of Parents on Breast-Feeding: Research Protocol.

PURPOSE: To develop and psychometrically evaluate a questionnaire based on the outcome "Knowledge: Breast-feeding" of the Nursing Outcomes Classification (NOC) to determine the knowledge of parents on breast-feeding. BACKGROUND: The NOC outcome "Knowledge: Breast-feeding" allows for nurses/midwives to assess the efficacy of interventions aimed to improve the knowledge on breast-feeding in parents thought the clinical interview/observation. However, the use of self-administered questionnaires by patients could facilitate its evaluation. METHODS: Two-phased study: (1) Development of the questionnaire based on experts' opinions; (2) Methodological design to assess its psychometric properties. IMPLICATIONS FOR NURSING PRACTICE: The availability of tools that enable the determination of the knowledge of patients would facilitate nurses/midwives to set objectives, individualize interventions, and measure their effectiveness.

Nursing diagnosis of grieving: content validity in perinatal loss situations.

PURPOSE: To validate the content of the NANDA-I nursing diagnosis of grieving in situations of perinatal loss. METHODS: Using the Fehring's model, 208 Spanish experts were asked to assess the adequacy of the defining characteristics and other manifestations identified in the literature for cases of perinatal loss. FINDINGS: The content validity index was 0.867. Twelve of the 18 defining characteristics were validated, seven as major and five as minor. From the manifestations proposed, "empty inside" was considered as major. CONCLUSION: The nursing diagnosis of grieving fits in content to the cases of perinatal loss according to experts. IMPLICATIONS FOR NURSING PRACTICE: The results have provided evidence to support the use of the diagnosis in care plans for said clinical situation.

[Profile of women with breast disease wich does self-exploration. Which are the factors associated with this practice?]. / Mujer con patología mamaria.

BACKGROUND/AIMS: In recent decades the fight against breast cancer has focused primarily on the treatment and secondary prevention (early detection mainly). In the case of breast self-examination, althought it has not been prove to reduce mortality, it is important in cases detected by women themselves (it is estimated 90% of total), mainly in the interval cancers. OBJECTIVES: To identify within women with breast cancer, how many do self-examination and identify associated factors. Describe the clinical and pathological features of cancers in women who do perform self-examination. METHODOLOGY: In women diagnosed with breast cancer during 2007 in a hospital in the province of Cadiz, Spain, is reconstructed in retrospect the story related the cancer process: symptoms, psychosocial factors that determine the contact with the health system, preventive practices (self-examination, mammography screening). A description of the pathological tumor: presenting symptom, tumor size, node negative, grade of differentiation. RESULTS: We studied 149 women with breast cancer, from whom 52% did self-exploration. Women who performed self-examination were younger (54.78 years) against the women who did not (65.63 years), married (66.2%), active workers and have a higher educational level. The assessment of the first symptoms in these women as "important" is positively correlated with those women who practice self-examination. For other preventive practices, women who does self-examination are also the most actives in early detection programs (74.4% against 29.5% which didn't do self-examination). For the pathologic characteristics of tumor in women who did self-examination: the tumor size was 2.5 cm, 50.7/are well differentiated, and 59.1% of cases the nodes are negative. CONCLUSIONS: Women who does self-examination are younger, have higher educational level, are married, are active workers and are often involved in other preventive practices. On them, the tumors diagnosed have a smaller size, are diagnosed at earlier stages and usually present better degree of differentiation.

Desarrollo y evaluacion psicometrica de una forma abreviada de la escala de posicionamiento ante el diagnostico enfermero / A forma abreviada da escala posições frente ao diagnostico de enfermagem: desenvolvimento e avaliação psicométrica / A short form of the positions on nursing diagnosis scale: development and psychometric testing

El Position on Nursing Diagnosis (PND) es una escala que utiliza la técnica del diferencial semántico para medir las actitudes hacia el concepto diagnóstico enfermero. El estudio objetivó desarrollar una forma abreviada de la versión española de esta escala, evaluar sus propiedades psicométricas y eficiencia. Se utilizó un doble enfoque empírico-teórico para obtener una forma reducida del PND, el PND-7-SV, que fuera equivalente a la original. Mediante un diseño transversal a través de encuesta, se evaluó la fiabilidad (consistencia interna y fiabilidad test-retest), validez de constructo (análisis factorial exploratorio, técnica de grupos conocidos y validez discriminante) y de criterio (validez concurrente), sensibilidad al cambio y eficiencia del PND-7-SV en una muestra de 476 estudiantes de enfermería españoles. Los resultados avalaron la utilidad del PND-7-SV para medir las actitudes hacia el diagnóstico enfermero de manera equivalente a la forma completa de la escala y en un tiempo más reducido.

O Position on Nursing Diagnosis (PND) é uma escala que utiliza a técnica do diferencial semântico para medir atitudes em relação ao conceito diagnóstico de enfermagem. O objetivo deste estudo foi desenvolver uma forma abreviada da versão em espanhol desta escala e avaliar suas propriedades psicométricas e eficiência. Foi utilizada uma dupla abordagem teórico-empírica para obter uma forma curta do PND, o PND-7-SV, que era equivalente à original. Usando um desenho transversal através de pesquisa, foi avaliada a confiabilidade (consistência interna e confiabilidade teste-reteste), validade de constructo (análise fatorial exploratória, técnica de grupos conhecidos e validade discriminante) e de critério (validade concorrente), sensibilidade à mudança e eficiência da PND-7-SV em uma amostra de 476 estudantes de enfermagem espanholas. Os resultados endossaram a utilidade do PND-7-SV para medir atitudes em relação ao diagnóstico de enfermagem de maneira equivalente à forma completa da escala e em um curto tempo.

The Positions on Nursing Diagnosis (PND) is a scale that uses the semantic differential technique to measure nurses' attitudes towards the nursing diagnosis concept. The aim of this study was to develop a shortened form of the Spanish version of this scale and evaluate its psychometric properties and efficiency. A double theoretical-empirical approach was used to obtain a short form of the PND, the PND-7-SV, which would be equivalent to the original. Using a cross-sectional survey design, the reliability (internal consistency and test-retest reliability), construct (exploratory factor analysis, known-groups technique and discriminant validity) and criterion-related validity (concurrent validity), sensitivity to change and efficiency of the PND-7-SV were assessed in a sample of 476 Spanish nursing students. The results endorsed the utility of the PND-7-SV to measure attitudes toward nursing diagnosis in an equivalent manner to the complete form of the scale and in a shorter time.

Mujer con patología mamaria. ¿qué factores se asocian a la práctica de la autoexploración? / Profile of women with breast disease wich does self-exploration. Which are the factors associated with this practice?

Antecedentes. En las últimas décadas la lucha contra el cáncer de mama se ha centrado, básicamente, en el tratamiento y en la prevención secundaria (fundamentalmente la detección precoz). La autoexploración mamaria, aunque no se ha demostrado que reduzca la mortalidad, sí es importante respecto a los casos detectados por la propia mujer (se estima que un 90% del total) y principalmente en los cánceres de intervalo. Objetivos. Identificar entre mujeres con cáncer de mama, cuántas realizan la autoexploración y los factores asociados. Describir las características clínico-patológicas de los cánceres en las mujeres que sí realizan la autoexploración. Metodología. En mujeres diagnosticadas de cáncer de mama, en un hospital de la provincia de Cádiz, España, se reconstruye de manera retrospectiva la historia relacionada con el proceso del cáncer, es decir, sintomatología, factores psicosociales que determinan el contacto con el sistema sanitario, realización de prácticas preventivas (participación en el Programa de Detección Precoz del Cáncer de Mama –PDPCM–, autoexploración mamaria,...). Se realiza una descripción clínico-patológica del tumor: síntoma de presentación, tamaño tumoral, ganglios negativos, grado de diferenciación histológica. Resultados. Se estudiaron 149 mujeres con cáncer de mama, de las cuales el 52% realizaba autoexploración. Las mujeres que realizan autoexploración son más jóvenes (54,78 años frente a 65,63), están casadas (66,2%), se encuentran laboralmente activas y tienen un nivel de estudios mayor. La valoración de la aparición del primer síntoma como algo importante se correlaciona positivamente con aquellas mujeres que practican la autoexploración. En cuanto a otras prácticas preventivas, las que se autoexploran son también las que más acuden al programa de detección precoz (74,4% frente a 29,5% en las que no se autoexploran). En cuanto a las características clínico-patológicas del tumor en las mujeres que se autoexploran: el tamaño tumoral medio es de 2,5 cm; el 50,7% se halla bien diferenciado, y en un 59,1% de los casos los ganglios son negativos. Conclusiones. Las mujeres que se autoexploran son más jóvenes, tienen un nivel educativo mayor, están casadas, se encuentran laboralmente activas y suelen participar en otras prácticas preventivas. En ellas, los tumores diagnosticados presentan un menor tamaño, se diagnostican en estadios más precoces y por lo general presentan mejor grado de diferenciación(AU)

Background/Aims: In recent decades the fight against breast cancer has focused primarily on the treatment and secondary prevention (early detection mainly). In the case of breast self-examination, althought it has not been prove to reduce mortality, it is important in cases detected by women themselves (it is estimated 90% of total), mainly in the interval cancers. Objectives: To identify within women with breast cancer, how many do self-examination and identify associated factors. Describe the clinical and pathological features of cancers in women who do perform self-examination. Methodology: In women diagnosed with breast cancer during 2007 in a hospital in the province of Cadiz, Spain, is reconstructed in retrospect the story related the cancer process: symptoms, psychosocial factors that determine the contact with the health system, preventive practices (self-examination, mammography screening). A description of the pathological tumor: presenting symptom, tumor size, node negative, grade of differentiation… Results: We studied 149 women with breast cancer, from whom 52% did self-exploration. Women who performed self-examination were younger (54.78 years) against the women who did not (65.63 years), married (66.2%), active workers and have a higher educational level. The assessment of the first symptoms in these women as «important» is positively correlated with those women who practice self-examination. For other preventive practices, women who does self-examination are also the most actives in early detection programs (74.4% against 29.5% which didn’t do self-examination). For the pathologic characteristics of tumor in women who did self-examination: the tumor size was 2.5 cm, 50.7 / are well differentiated, and 59.1% of cases the nodes are negative. Conclusions: Women who does self-examination are younger, have higher educational level, are married, are active workers and are often involved in other preventive practices. On them, the tumors diagnosed have a smaller size, are diagnosed at earlier stages and usually present better degree of differentiation(AU)

The Spanish version of the Position on Nursing Diagnosis scale: cross-cultural adaptation and psychometric assessment.

AIM: To report the adaptation into Spanish and psychometric testing of the Position on Nursing Diagnosis scale. BACKGROUND: The Position on Nursing Diagnosis is a scale that uses the semantic differential technique to measure nurses' attitudes towards the nursing diagnosis concept. DESIGN: Methodological design. METHOD: The scale was cross-culturally adapted through a process including translation, comparison with versions in other languages, back-translation, review, and pre-testing. An opportunistic sample of 621 Spanish registered nurses was recruited from August-December 2011. Reliability was evaluated through internal consistency and test-retest reliability. Construct validity, using both exploratory factor analysis and the known-group technique, and concurrent validity were assessed. FINDINGS: The Position on Nursing Diagnosis-Spanish Version was obtained from the cross-cultural adaptation process. High internal consistency and satisfactory test-retest reliability over a two week period (n = 240) were found. In the principal component analysis, all items loaded strongly on a single-factor which accounted for adequate variance, supporting the unidimensionality of the scale. A statistically significant difference was found comparing the scores of nurses who were members of the Spanish Association of Nomenclature, Taxonomy and Nursing Diagnosis and those who were not. Concurrent validity was supported by the significant correlation found between the scores and the degree of nursing diagnosis utilization and attendance to training sessions. CONCLUSION: The findings support the validity and reliability of the Position on Nursing Diagnosis-Spanish Version for its use among Spanish registered nurses as a measurement of their attitude towards the nursing diagnosis concept.

[A short form of the positions on nursing diagnosis scale: development and psychometric testing]. / Desarrollo y evaluación psicométrica de una forma abreviada de la escala de posicionamiento ante el diagnóstico enfermero.

The Positions on Nursing Diagnosis (PND) is a scale that uses the semantic differential technique to measure nurses' attitudes towards the nursing diagnosis concept. The aim of this study was to develop a shortened form of the Spanish version of this scale and evaluate its psychometric properties and efficiency. A double theoretical-empirical approach was used to obtain a short form of the PND, the PND-7-SV, which would be equivalent to the original. Using a cross-sectional survey design, the reliability (internal consistency and test-retest reliability), construct (exploratory factor analysis, known-groups technique and discriminant validity) and criterion-related validity (concurrent validity), sensitivity to change and efficiency of the PND-7-SV were assessed in a sample of 476 Spanish nursing students. The results endorsed the utility of the PND-7-SV to measure attitudes toward nursing diagnosis in an equivalent manner to the complete form of the scale and in a shorter time.

Tackling perinatal loss, a participatory action research approach: research protocol.

AIM: The aim of this study was to promote changes to improve the care provided to parents who have experienced a perinatal loss through participatory action research. BACKGROUND: The birth of a child is a joyful event for most families, however, unfortunately some pregnancies end in loss. Perinatal loss creates a heavy emotional impact not only on parents but also on health professionals, where in most cases there is an evident lack of skills, strategies and resources to cope with these kinds of situations. DESIGN: Participatory action research is the methodology proposed to achieve the purpose of this study. METHODS: Participatory action research consists of five stages: outreach and awareness, induction, interaction, implementation and systematization. The working group will include professionals from the Mother and Child Unit for patients at a tertiary level public hospital in Spain. The duration of the study will be 3 years since the approval of the protocol in January 2011. The qualitative techniques used will include group dynamics such as the SWOT analysis the nominal group technique, focus groups and brainstorming, among others that will be recorded and transcribed, generating reports throughout the evolution of the group sessions and about the consensus reached. Content analysis will be conducted on the field diaries kept by the participants and researchers. This project has been funded by the Andalusian Regional Ministry of Health. DISCUSSION: Participatory action research is a methodological strategy that allows changes in clinical practice to conduct a comprehensive transformative action in the care process for perinatal loss.