What motivates students to pursue a career in gerontological nursing? The cultural adaptation and validation of the Spanish version of the CMGN questionnaire.

Background: Career motivation toward gerontological nursing (CMGN) has been studied by various authors. It is essential to identify the influencing factors and guarantee that undergraduate nursing degrees provide adequate social and healthcare responses to the current demand for gerontological care. Objective: In the absence of a validated instrument to measure students' career motivation in geriatric nursing in our sociocultural context, this study aimed to adapt and validate the original questionnaire Chinese CMGN. Methods: Cross-sectional data from 316 nursing students were collected in May 2021. The cultural and linguistic adaptation process was conducted in accordance with the recommendations of Ramada-Rodilla and Beaton. A committee of experts was established to assess content validity. The CMGN questionnaire consists of 20 items divided into 2 subscales: "Expectancy" (6 items) and "Values" (14 items). To determine the psychometric properties, the following analyses were carried out: content validity (Aiken's V coefficient and Pearson's coefficient of variation), internal consistency (Cronbach's α) and construct validity (confirmatory factor analysis and convergent and divergent validity). To verify the model once the parameters were estimated, we calculated the goodness-of-fit between the model and the data. Data analyses were performed using SPSS for Windows (IBM SPSS Statistics 25.0) and Analysis of Moment Structures (AMOS 27.0). Results: A total of 316 nursing students were surveyed, of which 91.1% were women and the mean age was 21.61 ± 5.45 years (range: 18-56). The results indicate that the psychometric properties of the questionnaire were adequate in terms of content and construct validity. The internal consistency using Cronbach's alpha for both subscales was greater than 0.8. The AMOS results revealed that the final model fit statistics of CMIN/df (2.204), GFI (0.922), CFI (0.948) and RMSEA (0.062) indicated a satisfactory model fit. Finally, an original second-order model was obtained, resulting in the Spanish version of the CMGN (SV-CMGN) instrument. Conclusions: We developed a valid SV-CMGN questionnaire that is socially and culturally adapted to the Spanish context and is capable of measuring the motivation of nursing students toward a career in gerontological nursing, from the newest to the most experienced. This new version opens up the possibility of studying the phenomenon of motivation in other Spanish-speaking countries. Keywords: Gerontological nursing; Motivation; Students, nursing; Validation study; Surveys and questionnaires.

Kaleidoscope of emotions in hospital childbirth: A phenomenological study.

The childbirth process represents a moment of transition in the life of each woman, and is a source of complex and dynamic emotions. The aim of this study was to describe the emotions women experience during hospital childbirth and to determine the conditioning factors. A qualitative prospective study with a phenomenological approach was conducted using semi-structured interviews with 42 women. The negative emotions the women highlighted were fear, anguish, suffering, concern and nervousness, and they were related to factors such as: the evolution of childbirth, the appearance of complications, pain, the doubt about the ability to give birth and poor communication. The positive emotions highlighted were joy, satisfaction, security, confidence and tranquillity, and they were related to the first skin-to-skin contact, effective communication, partner support and participation in decisions. The findings may contribute to the development of policies aimed at achieving the women and newborns' maximum health and life potential.

Gender differences in unplanned hospital admission: A population-based approach.

Gender inequities are present not only in the health status of individuals but also in access to health services. Unplanned hospitalizations can indicate dysfunction in health systems by detecting unmet health problems prior to the health care needs of a person, while planned hospitalizations indicate effective management by the system. Thus, we aim to analyze the association between sex and the probability of unplanned or planned hospitalization for different diseases. A cross-sectional retrospective study was performed with data regarding the 700 447 hospitalizations at all registered centers in the Basque Country from 2016 to 2018. Adjusted odds ratios were carried out to determine the association between sex and admission circumstances for each diagnostic category. Results showed that women had higher odds ratio for unplanned hospitalization for various diseases of the circulatory system and inguinal hernia among others, while men had a higher odds ratio for diseases such as neoplasms, metabolic diseases, and multiple sclerosis. The differences by sex indicate that the odds applied to the circumstance of hospitalization is a sensitive indicator and potentially applicable for detecting diseases likely to generate gender-based inequalities.

The voice of memory in hospital birth: A phenomenological study.

OBJECTIVE: To examine the perception of the hospital birth experience in women at 8 weeks and 8 months after the birth and to determine if there have been any changes in that perception. DESIGN: This was a prospective qualitative study with a phenomenological approach based on semi-structured, individual and in-depth interviews at 8 weeks and 8 months after childbirth as well as participant's observations. The data were transcribed and analysed thematically using ATLAS.ti 8 software. PARTICIPANTS: 43 women participated in the first interview, and 33 of those participated in the second interview. SETTING: Donostia University Hospital, Gipuzkoa, Spain, 2016-2017. FINDINGS: Two main topics emerged from the data analysis which summarize the women's perception of childbirth: (1) memory allows us to recall the experience of hospital birth in time and space; (2) some moments are specially remembered. In the second topic, three subtopics were distinguished: fondest memory: meeting the newborn for the first time; highlighted positive memories: support from partners and professionals; and the worst memories were marked by feelings of worry and fear. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: In the perception of the birth experience, positive and negative memories remain in intensity and continuity for at least up to 8 months. Their creation and evocation are highly influenced by the emotional experience and the initial visual impact of meeting the newborn for the first time, which constitutes a milestone in women's lives. The emotions experienced in childbirth and during the postpartum period shape the awareness, memory and new identity of being a mother.

Hospital Childbirth: Perspectives of Women and Professionals for a Positive Experience-A Qualitative Study.

The perception and interpretation of childbirth are changing as values change. This requires women and professionals to adapt to new circumstances. The objective of this study was to analyze the perspectives of women and professionals on hospital birth and to identify improvement areas in order to achieve a positive perinatal experience. A qualitative prospective study with a phenomenological approach was conducted using semi-structured interviews with women, two and eight months after childbirth, participant observation, and professional focus groups. The analysis of the transcribed texts involved a thematic inductive approach. Four improvement areas emerged from the analysis: (a) strengthening communication and the therapeutic relationship; (b) unifying criteria between hospitals and primary care centers to provide coordinated and coherent information; (c) involvement of the partner in the whole process of pregnancy-childbirth-puerperium; (d) improvement of the spaces used in prenatal care and births. The need for a continuity of care from the beginning of pregnancy to the postpartum period is emphasized, which requires an improvement in information, participation, and the promotion of shared decision-making. To this end, coordinated interdisciplinary work, involvement of the partner and the improvement of the spaces used in prenatal care and births are essential.

A qualitative study of hospital birth perceptions: The helix of priority needs.

OBJECTIVE: To understand which needs are considered priorities in the hospital birth experience from the perspectives of postpartum women. DESIGN: This qualitative prospective study used a phenomenological approach. Data were collected through participant observations and semi-structured interviews recorded at eight weeks and eight months after childbirth. The data were analysed using a thematic approach. PARTICIPANTS: The study cohort consisted of 43 participants at eight weeks after childbirth and 33 participants eight months after childbirth. SETTING: Donostia University Hospital, San Sebastián, Spain, in 2016-2017. FINDINGS: Through the analysis, the following four main themes emerged, each in different categories: (a) Professional care: symbiosis between the woman and the professional: (a.1) professional treatment and its characteristics, (a.2) professional competence, and (a.3) professional information and listening: pillars in the support relationship. (b) Control and hospital safety: (b.1) hospital environment: external control. (c) Presence of the partner: (c.1) support, guidance, and participation. (d) Perception of observed feelings: (d.1) fear of complications or separation from the child, (d.2) fear of internal lack of control, and (d.3) fear of an instrumental delivery and/or caesarean section. CONCLUSIONS AND IMPLICATIONS FOR PRACTISE: The core of the hospital birth experience is constituted by the need to establish a supportive relationship based on mutual trust, exchange information that offers internal and external control and the security necessary to overcome feelings of fear, and obtain support and guidance from an involved partner.

Significado de la experiencia del cuidado en el parto hospitalario: voces de las profesionales / The meaning of care experience with hospital births: voices of the professionals

Objetivo: Abordar el significado de la experiencia del cuidado en el parto hospitalario desde la perspectiva de las profesionales. Metodología: Metodología cualitativa fenomenológica interpretativa mediante grupos focales formados por profesionales del Servicio de Partos del Hospital Universitario Donostia. El análisis de los textos incluyó una comparación cíclica para obtener los temas principales que definen el fenómeno. Resultados: Tras la práctica reflexiva realizada por las profesionales, se han detectado cambios en las demandas que las mujeres realizan durante el parto hospitalario, observando que han pasado de tener un talante totalmente pasivo a presentar diferentes comportamientos, que van desde la indiferencia hasta la actitud activa partícipe. Respecto a la necesidad de control, seguridad y responsabilidad, el aumento de las demandas es una de las características más frecuentemente señaladas. La información constante, antes, durante y después del parto, es la reclamación más evidente identificada. La interacción constante entre estos elementos y la influencia de los cambios socioculturales continuos resultan fundamentales para entender el significado de la experiencia de cuidado en el parto hospitalario y poder realizar propuestas de mejora. Conclusiones: La adaptación continua al contexto sociocultural precisa contemplar una gestión innovadora en la que se respete la voluntad de las mujeres, y que los profesionales no perciban por ello temor a obtener resultados adversos. Las profesionales observan la necesidad de establecer protocolos interdisciplinarios de información y continuidad de los cuidados

Aim: To address the meaning of care experience with hospital births from the perspective of professionals. Methodology: A qualitative design using a phenomenology approach with focus groups made up of professionals from the Birthing Unit at Donostia University Hospital. The analysis of the texts included a constant cyclic comparison in order to obtain the main issues that define the phenomenon. Results: After reflective practice carried out by professionals, changes in the demands women make during hospital births have been detected. It has been observed that their disposition changed from being completely passive, to presenting different behaviours ranging from indifference to an attitude of active participation. With regards to the need for control, safety and responsibility, the increase in demands is one of the most frequently indicated characteristics. Constant information before, during and after the birth is the most noticeable demand identified. Constant interaction between these elements and the influence of continuous sociocultural changes are fundamental in order to understand the meaning of care experience with hospital births and to be able to make proposals for improvement. Conclusions: Continuous adaptation to the sociocultural context requires the consideration of innovative management where the wishes of women are respected, and where professionals therefore aren't afraid to obtain adverse results. The professionals see the need to establish interdisciplinary information protocols and continuity of care

Beneficios de las intervenciones profesionales de apoyo en la lactancia materna. Revisión bibliográfica / Benefits of professional intervention in support of breastfeeding. Literature review

A pesar de los reconocidos beneficios de la lactancia materna exclusiva, tal como la Organización Mundial de la Salud recomienda, existe una cierta preocupación en los últimos años debido al descenso de su prevalencia. Todos los profesionales sanitarios pueden y deben trabajar para mejorar dichos indicadores, ofreciendo un apoyo profesional individualizado, de forma que se potencie una adecuada instauración y ésta vaya siendo adaptada-reforzada en función de las necesidades de las madres lactantes. Para todo ello es fundamental la aportación de la información correcta acompañada del apoyo emocional necesario. En este artículo se presenta una revisión bibliográfica sobre los beneficios de las intervenciones prenatales profesionales de apoyo a la lactancia materna, en el momento del parto y también posnatales, para poder así responder a las necesidades existentes y crear estrategias profesionales para la promoción, la protección y el apoyo de la lactancia materna exclusiva

Despite the recognized benefits of exclusive breastfeeding as the World Health Organization recommends, there has been a concern in recent years of the decline in this practice. All health professionals can and should work to improve the adoption of breastfeeding for new born infants, by providing individualized professional support. A proper introduction to breastfeeding should be provided to nursing mothers so the practice can be adapted and reinforced according to their needs. The information presented should be fundamental, and accompanied by the necessary emotional support. Therefore, there is the need to review and reinforce the benefits of professional support interventions in prenatal breastfeeding at the time of delivery and postnatal. Additionally, it is important to aid health professionals in the creation of strategies for the promotion, protection and support of exclusive breastfeeding