Relationship between hair cortisol concentrations and cognitive functioning in adolescents with ADHD.

Background: Our study aimed to explore whether the hair cortisol concentration (HCC), a measure of long-term cortisol output, is associated with poorer cognitive functioning in adolescents with attention deficit and hyperactivity disorder (ADHD). We further aimed to test the potential moderating effects of sex and childhood maltreatment.Methods: In this cross-sectional study, fifty-three adolescents with ADHD were studied. The ADHD Rating Scale (ADHD-RS) and Childhood Trauma Questionnaire (CTQ) were administered. Seven cognitive tasks from the Cambridge Neuropsychological Test Automated Battery (CANTAB) were administered, and two cognitive factors (attention and memory and executive functioning) were identified by confirmatory factor analysis. A 3-cm hair sample from the posterior vertex region of the head was obtained. HCCs were determined by a high-sensitivity enzyme immunoassay kit. Multiple linear regression analyses were used to explore the association between HCCs and either cognitive performance or ADHD severity while adjusting for sex, childhood maltreatment and the ADHD-RS total score.Results: Sex moderated the relationship between HCCs and attention/memory confirmatory factor analysis (CFA) scores, with better performance in boys with higher HCCs. HCCs were not associated with executive functioning or ADHD symptoms. Childhood maltreatment was associated with inattention symptoms in adolescents with ADHD.Conclusions: Our study suggests that HCCs are positively associated with attention and memory performance in adolescents with ADHD, with a moderating effect of sex (the relationship is strongest in boys).

We studied the relationship between cortisol and cognition in adolescents with ADHD.Hair cortisol concentrations (HCCs) were determined.We explored the moderating effects of sex and childhood trauma.Sex moderated the relationship between HCCs and attention and memory.Childhood trauma did not moderate the relationship between HCCs and cognition.

Affectivity, sexuality, and autism spectrum disorder: qualitative analysis of the experiences of autistic young adults and their families.

BACKGROUND: Autistic people have communication, sensorial, and social difficulties, which on many occasions, make their adaptation on the sexual and affective levels difficult. For this reason, it is important to know the opinion of individuals with autism spectrum disorders (ASD) and their families, to offer this perspective to professionals to facilitate adapted health education programs in mental health units. METHODS: This qualitative descriptive design presents the experiences of autistic individuals and their families in relation to the affective-sexual experiences from individual, family, and social perspectives. Two focus group sessions were held with eight family members and seven individual semi-structured interviews with autistic young adults. The transcripts were qualitatively analysed using content analysis. RESULTS: Four themes (Family and social dynamic; Social behaviour of the autistic individual; Affective-sexual relationships; Addressing affective and sex education) and 13 related categories emerged from these results. Communication and social interaction problems act as barriers for young adults when developing affective-sexual relationships, leading to the emergence of negative feelings and experiences that reinforce avoidance behaviours, further intensifying their difficulties in interacting with others. Families, especially mothers, exhibit a poor perception of their ability to provide affective-sexual guidance, leading to anxiety and frustration. There are also reports of poor sex education and lack of support systems. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: The experiences of young people and their families are sometimes conflicting when it comes to affectivity and sexuality, but the parental role emerges as relevant in the sex education process. Families play a pivotal role in sex education, which is why professionals should provide them with support and information through health education programmes, foster empathetic communication and promote sexual and emotional development that is adapted to the characteristics and interests of autistic people.

COVID-19 Pandemic Has Changed the Psychiatric Profile of Adolescents Attempting Suicide: A Cross-Sectional Comparison.

The COVID-19 pandemic is having a major impact on the mental health of adolescents, leading to suicidal behaviors. However, it remains to be clarified whether the COVID-19 pandemic has changed the psychiatric profile of adolescent suicide attempters. METHODS: a retrospective observational analytical study was conducted to assess age, gender and clinical characteristics of adolescents attempting suicide during the year before and the year after the global lockdown. RESULTS: ninety adolescents (12-17 y.o.) were recruited consecutively from February 2019 to March 2021 at the emergency ward for having attempted suicide. Fifty-two (57.8%) attended before the lockdown (pre-pandemic group) and thirty-eight (42.2%) the year after (pandemic group). There were significant differences in diagnostic categories between the periods (p = 0.003). Adjustment and conduct disorders were more frequent in the pre-pandemic group, while anxiety and depressive disorders were more prevalent during the pandemic. Although the severity of suicide attempts did not show significant differences between the two study periods (0.7), the generalized linear model showed that the suicide attempt severity was significantly associated with current diagnosis (p = 0.01). CONCLUSIONS: the psychiatric profile of adolescents attempting suicide was different before and during the COVID-19 pandemic. During the pandemic, the proportion of adolescents with a prior psychiatric history was lower, and most of them were diagnosed with depressive and anxiety disorders. These diagnoses were also associated with a greater severity in the intentionality of suicide attempt, regardless of the study period.

Affectivity and Sexuality in Adolescents with Autism Spectrum Disorder from the Perspective of Education and Healthcare Professionals: A Qualitative Study.

People with autism spectrum disorder (ASD) present several different characteristics that predispose them to greater difficulties with intimate emotional and sexual relationships. This qualitative study uncovers the perspective of education and healthcare professionals on the affective and sexual needs of young people with ASD by analysing their narratives in semi-structured focus group sessions. Professionals highlight the inadequate training they receive in this aspect of health. They consider it should be commonplace for professionals working with autistic people as it would aid their collaborative efforts when treating children and adolescents with ASD. They show that, by working together with the families to establish joint objectives, these professionals can appropriately address sex and affective education, preventing risky behaviours among young people with ASD, and improving the interactions these individuals have with others. Sex and affective education is described as an indispensable tool at this stage of development and should be specially adapted for those with ASD.

Service Learning in the Nursing Bachelor Thesis: A Mixed-Methods Study.

The Final Degree Project (FDP) is a module that, although intended for the completion of a bachelor thesis (BT), consists of theoretical and clinical teaching. Therefore, introducing service learning (SL) can support student adjustments to the real-world professional role. This study plans to evaluate a teaching innovation project that combines BT and SL through Kirkpatrick's four-level model (reaction, learning, behaviour and results). It takes the form of a convergent parallel mixed-methods design study. The participants were 15 final-year students obtaining a Bachelor of Nursing degree, 4 BT supervising mentors and 4 nurses. At the request of a hospital institution, in their BT, students completed a review of evidence-based nursing protocols. For data collection, the researchers used: an SL questionnaire, student narratives, mentor field diaries and nurse interviews. According to student opinion, the results showed high satisfaction rates (4.44 out of 5), the most developed skills were Independent Work and Information Management, but they signal the need to reinforce the research methodology skills. Finally, positive feedback from all participants is that using SL promotes both the opinion that the BT is useful and also promotes a collaboration between academic and clinical settings.

The effect of writing a bachelor thesis on attitudes towards nursing research and development: A cross-sectional comparative study between students and professionals.

BACKGROUND: Research is essential to practice nursing and must be duly enhanced during university training. Therefore, writing a bachelor thesis may help to develop research skills and thus transfer this skill set to practical application. OBJECTIVES: 1) To ascertain whether writing a bachelor thesis has a bearing on attitudes towards nursing research and development; 2) to establish a comparison between groups (students and nurses), and 3) to analyse other factors (work experience, advanced training, research experience) that may influence the relationship between nurses and nursing research and development. DESIGN: A cross-sectional comparative study. SETTING AND PARTICIPANTS: The participants totalled 204: 38 nursing students and 166 nurses. METHODS: Data were gathered using the instrument Nurses' Attitudes towards Research and Development within Nursing devised by Björkström and Hamrin (2001) version II validated in Spanish. This instrument consists of 33 statements grouped into 7 factors, whose responses offer 5 alternatives on a Likert scale. RESULTS: Most participants were female (86.3 %), with a mean age of 36 (SD = 11.65). The participants who have written a bachelor thesis obtained a higher score (Mdn = 4.14; range = 2.06) than those who have not (Mdn = 3.98; range = 2.13), with a significant difference (U = 3959.5; p = 0.012) and a moderate effect size (Hedges's g = 0.40). The students are those who obtained the highest scores. Amongst the nurses, educational training is the element that is most positively correlated with attitudes towards nursing research and development (r = 0.340). CONCLUSION: The results suggest that writing a bachelor thesis engenders greater interest and a favourable attitude towards nursing research and development and displays that the most interested group is the students, followed by nurses holding a degree in nursing, and lastly those with a Diploma of Higher Education in nursing. Nurses' educational training is the most influential aspect, standing above researcher or professional experience.

Nursing student learning of biosciences through movies and concept maps: A mixed study.

BACKGROUND: acquisition of bioscience knowledge is challenging for nursing students. This calls for teaching methodologies that allow them to acquire this knowledge and add value in the nursing context. OBJECTIVE: to evaluate a teaching experience using a movie clip and the collaborative use of C-Maps in first-year bioscience learning in nursing students. DESIGN: embedded mixed methods study. PARTICIPANTS: 143 students. METHODS: data were collected in two phases: first, collecting quantitative data through a questionnaire on utility, satisfaction and perceived competency development, and collecting qualitative data on learning, teaching materials and developed competencies through an open-question instrument. The second phase consisted of a focus group to explore in greater depth learning experience. RESULTS: six themes emerged from the qualitative analysis: using C-Maps as a learning process; developing group competencies; knowledge integration and transfer; teacher-student relationship; art as a didactic support; and difficulties encountered and proposals for improvement. Regarding utility, the students highlighted learning and relating concepts. Elements of satisfaction were working in small groups and having the teacher as a guide. Finally, the competencies most developed were teamwork and learning ability. CONCLUSION: the combination of a movie clip and a C-Map is an innovative strategy motivating and valuable for learning biosciences.

Translation, Adaptation, and Psychometric Validation of the Spanish Version of the Attitudes towards Research and Development within Nursing Questionnaire.

The promotion of research competence is essential for the development of the nursing profession and discipline. The aim of this study was to translate into Spanish, adapt, and validate an instrument measuring nurses' attitudes towards nursing research and development. A quantitative, cross-sectional, analytical design was used for the cross-cultural adaptation and cultural validation of the instrument. A total of 367 participants were selected using intentional sampling. A process of translation, back-translation, expert consultation, and pilot testing was followed. Subsequently, reliability and statistical validity were assessed, a new factor structure was proposed, and means were compared to assess the power to discriminate between factors by groups of participants. The results showed internal consistency tests with a Cronbach's alpha of 0.913. Confirmatory factor analysis of the comparative fit index (CFI = 0.549) and Tucker-Lewis index (TLI = 0.491) indicate that the factors did not match the original clustering model. The new factor structure consisted of seven factors. Between-group comparisons revealed statistically significant differences. In conclusion, the instrument exhibits high levels of statistical reliability and validity compared to the original instrument. The new factorial proposal is consistent, but further research is needed to verify its replicability in other contexts.

Grupo de Investigación de Enfermería GRItaulí del Instituto de Investigación e Innovación Parc Taulí (I3PT) / The Nursing Research Group (GRItauli) from the Parc Taulí Research and Innovation Institute (I3PT)

La acreditación como grupo asociado del Grupo de Investigación en Enfermería (GRItaulí) por el Instituto de Investigación e Innovación Parc Taulí es el último paso en un camino iniciado por las enfermeras del Consorcio Corporación Sanitaria Parc Taulí (CCSPT) hace más de 20 años. La investigación desarrollada por enfermeras en el CCSPT de Sabadell tiene una larga trayectoria, entre 1997 y 2020 un total de 228 proyectos de investigación con investigador principal una enfermera han sido aprobados por el Comité de Ética de Investigación con medicamentos del Parc Taulí. En la actualidad el GRItaulí está compuesto por 13 enfermeras y matronas. Desde su acreditación en 2017, el grupo ha obtenido un total de 577.770 euros en financiación de proyectos competitivos y las investigadoras del grupo han publicado siete artículos como primeros firmantes con un factor de impacto acumulado de 8,024. Las estrategias actuales del GRItaulí son: la incentivación de actividades formativas y de divulgación del conocimiento y visibilidad del grupo; la obtención de financiación para conseguir tiempo, elemento cuya escasez se ha identificado como barrera para la investigación; el trabajo en red con otros grupos de investigación de Cataluña y resto de España, y la consolidación de líneas de investigación. Todo ello con el objetivo de promover los cuidados basados en la evidencia y el crecimiento del grupo, posibilitando así la acreditación del GRItaulí en una categoría superior

The accreditation of the Nursing Research Group (GRItaulí) as an associate group by the Parc Taulí Research and Innovation Institute is the last step in the journey started by the nurses of the Consorcio Corporación Sanitaria Parc Taulí (CCSPT) over 20 years ago. The CCSPT nurses in Sabadell have conducted research for a long time, between 1997 and 2020, with 228 research projects in total with a nurse as Primary Investigator which have been approved by the Parc Taulí Ethics Committee for Investigation with Medicinal Products. Currently, the GRItaulí consists of 13 nurses and midwives. Since its accreditation in 2017, the group has obtained 577,770 euros in total as funding for competitive products, and the group researchers have published seven articles as first signatories with a 8,024 cumulative impact factor. The current GRItaulí strategies are: to encourage training and transfer of knowledge and group visibility; to obtain funding in order to achieve time, the lack of which has been identified as a barrier for research; to promote network with other research groups in Catalonia and the rest of Spain, and to strengthen lines of research; all this with the goal to promote evidence-based nursing and group growth, thus enabling the GRItaulí to be accredited in a superior category

Barreras para la utilización de la investigación en la práctica clínica: opinión de las enfermeras de un hospital universitario / Barriers for the use of research in clinical practice: the opinion by nurses in a University Hospital

OBJETIVO: identificar las principales barreras percibidas para la utilización de la investigación en la práctica clínica por parte de las enfermeras. MÉTODO: se realizó un estudio descriptivo transversal mediante la administración del cuestionario de "Barreras para la utilización de la investigación enfermera" en profesionales de Enfermería que estaban trabajando en el Consorci Corporació Parc Taulí de Sabadell (Barcelona) en mayo-septiembre de 2017. El muestreo fue no probabilístico accidental. La distribución de este cuestionario autoadministrado se efectuó vía online. Se llevó a cabo análisis univariante y bivariante. Se consideró que había diferencias estadísticamente significativas si la p< 0,05. RESULTADOS: participaron 276 profesionales de Enfermería. 244 (88,4%) mujeres. La media (DE) de experiencia laboral fue de 18,7 años (10,4) y de 11,32 años (8) de experiencia en el servicio en el que trabajaban en el momento del estudio. Un 46,7% recibió formación pregrado en investigación y un 70,3% postgrado. Las participantes consideran que la investigación es una actividad necesaria (88,8%) que contribuye al desarrollo de la profesión (98,9%), aunque opinan que requiere una gran inversión de tiempo y esfuerzo (94,9%) para poder llevarla a cabo. Las tres barreras identificadas con mayor puntuación fueron "los artículos/informes de investigación se publican con mucha demora" con una media (DE) de 3,03 (0,89), "los médicos no colaboran en la implementación" con una media (DE) de 2,99 (0,90) y "no hay tiempo suficiente en el trabajo para implementar nuevas ideas" con una media (DE) de 2,98 (1,03). CONCLUSIÓN: las principales barreras identificadas en este estudio por parte de los profesionales de Enfermería que han participado han sido falta de tiempo, falta de conocimientos en metodología investigadora y la percepción de falta de apoyo institucional

OBJECTIVE: to identify the main barriers perceived for the use of research in clinical practice by nurses. METHOD: a descriptive cross-sectional study, conducted through the administration of the Questionnaire on Barriers for the Use of Nursing Research by Nursing professionals, which was prepared by the Consorci Corporació Parc Taulí of Sabadell (Barcelona) during May-September, 2017. There was non-probabilistic accidental sampling. This self-administered questionnaire was distributed online. Univariate and bivariate analyses were conducted. It was considered that there were statistically significant differences if p < 0.05. RESULTS: the study included 276 Nursing professionals; 244 (88.4%) were women. Their mean (SD) work experience was 18.7 years (10.4) and 11.32 years (8) of experience at the Hospital Unit where they worked at the time of the study. Of them, 46.7% had received undergraduate training in research, and 70.3% postgraduate. The participants considered that research is a necessary activity (88.8%) which contributes to the development of the profession (98.9%); although they reckon that it requires a major investment in time and effort (94.9%). The three barriers identified with the highest scores were: "research articles / reports are published with delay" with a mean (SD) 3.03 (0.89), "there is no collaboration by physicians in their implementation" with a mean (SD) 2.99 (0.90) and "there is not enough time at work to implement new ideas" with a mean (SD) 2.98 (1.03). CONCLUSION: the main barriers identified in this study by Nursing professionals who have participated are: lack of time, lack of knowledge regarding research methodology, and the perceived lack of support by the institutions

An mHealth intervention for the treatment of patients with an eating disorder: A multicenter randomized controlled trial.

OBJECTIVE: The current multicentre randomized controlled trial assessed the clinical efficacy of a combined mHealth intervention for eating disorders (EDs) based on cognitive behavioral therapy (CBT). METHOD: A total of 106 ED patients from eight different public and private mental health services in Spain were randomly assigned to two parallel groups. Patients of the experimental group (N = 53) received standard face-to-face CBT plus a mobile intervention through an application called "TCApp," which provides self-monitoring and an online chat with the therapist. The control group (N = 53) received standard face-to-face CBT only. Patients completed self-report questionnaires on ED symptomatology, anxiety, depression, and quality of life, before and after treatment. RESULTS: Significant reductions in primary and secondary outcomes were observed for participants of both groups, with no differences between groups. Results also suggested that the frequency with which patients attended their referral mental health institution after the intervention was lower for patients in the experimental group than for those in the control group. DISCUSSION: The current study showed that CBT can help to reduce symptoms relating to ED, regardless of whether its delivery includes online components in addition to traditional face-to-face treatment. Besides, the additional component offered by the TCApp does not appear to be promising from a purely therapeutic perspective but perhaps as a cost-effective tool, reducing thus the costs and time burden associated with weekly visits to health professionals.

Investigación en enfermería: análisis de actitud y motivación en un centro universitario regional / Nursing research: analysis of attitude and motivation in a regional university center

OBJETIVO: Conocer la producción, motivación y consumo de investigación entre las enfermeras de nuestros centros asistenciales. MATERIAL Y MÉTODO: Se realiza un estudio descriptivo transversal mediante la administración del cuestionario de Actitud y Motivación de Enfermería hacia la Investigación. RESULTADOS: Un total de 276 enfermeras participaron en el estudio, la mayoría mujeres, con 18,7 años de experiencia laboral media, 45 % con carga familiar alta o muy alta y formación profesional variada en cuanto a postgrados, máster y especialidades. Un 46,7 % recibió formación pre-grado en investigación y un 70,3 %, postgrado. Las participantes consideran que la investigación es una actividad necesaria (88,8 %) que contribuye al desarrollo de la profesión (98,9 %), aunque opinan que requiere una gran inversión de tiempo y esfuerzo (94,9 %) para poder llevarla a cabo. Se muestran los resultados en las distintas dimensiones del cuestionario. CONCLUSIÓN: Se pone de manifiesto que las barreras expresadas por las profesionales pueden ser convertidas en un incentivo positivo en la motivación profesional que nos permita la difusión, crecimiento y facilitación de la investigación enfermera, aplicando estrategias de favorecimiento relacionadas con las necesidades expresadas por las enfermeras que han participado en el estudio

OBJECTIVE: We have to know the production, motivation and consumption of research between the nurses of our healthcare centers. MATERIAL AND METHOD: We have realized a cross-sectional descriptive study by administering the Nursing Attitude and Motivation to Research questionnaire. RESULTS: A total of 276 nurses took part in the study, most of them women, with 18.7 years of average work experience, 45 % with high or very high family burden and varied professional training in postgraduate, master's and specialties. 46.7 % received pre-graduate training in research and 70.3 %, postgraduate. The competitors consider that research is a necessary activity (88.8 %) that contributes to the development of the profession (98.9 %), although they believe that it requires a great investment of time and effort (94.9 %) to carry it out. The results are shown in the different dimensions of the questionnaire. CONCLUSION: It is evident that the barriers expressed by the professionals can be converted into a positive incentive in the professional motivation that allows us the diffusion, growth and facilitation of the nursing research, applying strategies of favoring related to the needs expressed by the nurses who have participated in the study

Efficacy of a Short Psychoeducational Group Intervention for the Prevention of Cardiovascular Risk in Patients With Severe Mental Disorder: A Randomized Trial.

Psychoeducational interventions to improve healthy habits regarding cardiovascular risk (CVR) in people with a severe mental disorder showed scarce results in the literature. In this article, we showed the results of a randomized clinical trial including 80 adult outpatients (mainly psychosis spectrum) with moderate to very high CVR. A short-term psychoeducational group intervention to improve healthy habits regarding CVR was added to their as-usual individual psychoeducational schedule. With an intention-to-treat analysis, we expected improvements in the different parameters. Baseline and 1-year follow-up included CVR factors and indexes (REGICOR, SCORE, and DORICA). Basal characteristics did not show statistically significant differences between the groups. No significant improvements in any of the variables studied were observed in the intervention enriched group compared with the control individual group. Compliance with the sessions was scarce. The satisfaction with the intervention and the acquisition of knowledge were adequate. Moreover, the benefits of both interventions were weak.

Measure of clinical improvement in children and adolescents with psychiatric disorders: an evaluation of multiple perspectives with HoNOSCA. / Valoración de la mejoría clínica en niños y adolescentes con trastornos psiquiátricos: una evaluación de múltiples perspectivas con HoNOSCA.

INTRODUCTION: Routine outcome assessment is helpful to inform decision-making, resource allocation, and health policy design. Routine outcome assessment in the hospital setting for children and adolescents with psychiatric disorders remains limited. The clinical instrument HoNOSCA (Health of the Nation Outcome Scales for Children and Adolescents), which has recently become available in Spanish and Catalan, allows outcome assessment in this population from the perspective of patients, their parents or legal guardians, and clinicians. HoNOSCA measures 13 areas of health and psychosocial functioning. OBJECTIVES: The aim of this study was to assess mental health outcomes in psychiatric day hospital pediatric patients from three perspectives (patient, par-ent/legal guardian, clinician), using the Spanish and Catalan versions of HoNOSCA. METHODS: We recruited patients up to 18 years old with any psychiatric disorder at the day unit of the Salut Mental Parc Taulí Hospital Universitari (Sabadell, Catalonia, Spain). We obtained admission and discharge HoNOSCA scores for the patients, their parents or legal guardians, and their clinicians. RESULTS: We recruited 99 patients over the study period (January 2015 to December 2017), 11 of which were lost to follow-up. Among the remaining 88, we found significant improvement in HoNOSCA scores from admission to discharge. Agreement between the HoNOSCA scores for the three different groups of evaluators (patients, parents/legal guardians, and clinicians) was weak at admission but better at discharge. In general, evaluations from patients and their parents or legal guardians had lower HoNOSCA scores (indicating a better mental health status) at admis-sion compared to those from clinicians. At discharge, however, the scores were more homogenous across the three groups of stakeholders. CONCLUSIONS: Use of HoNOSCA allows for routine evaluation of mental health outcomes in the psychiatric day hospital setting from the perspective of pa-tients, their parents or legal guardians, and clinicians.

INTRODUCCIÓN: La evaluación rutinaria de variables de resultado ayuda en la toma de decisiones, la asignación de recursos y el diseño de políticas en salud. La evaluación rutinaria de variables de resultado en el entorno hospitalario para niños y adolescentes con trastornos psiquiátricos sigue siendo limitada. La Health of the Nation Outcome Scales for Children and Adolescents, HoNOSCA, que recientemente se ha traducido al español y al catalán, permite la evaluación de resultados en esta población desde la perspectiva de pacientes, padres o tutores legales y clínicos. Este instrumento mide 13 áreas de salud y funcionamiento psicosocial. OBJETIVOS: Evaluar variables de resultado en salud mental entre pacientes jóvenes de hospital de día de psiquiatría desde estas tres perspectivas usando Health of the Nation Outcome Scales for Children and Adolescents. MÉTODOS: Reclutamos pacientes pediátricos (18 años o menos) con cualquier trastorno psiquiátrico en el hospital de día de la unidad de psiquiatría y psicología juvenil del Hospital Salut Mental Parc Taulí (Sabadell, Cataluña, España). Obtuvimos puntuaciones de Health of the Nation Outcome Scales for Children and Adolescents desde la perspectiva de pacientes, sus padres o tutores legales y clínicos, al ingreso y al alta. RESULTADOS: Reclutamos 99 pacientes entre enero de 2015 y diciembre de 2017; once se perdieron durante el seguimiento. Entre los 88 restantes, encontramos una mejora significativa en las puntuaciones de Health of the Nation Outcome Scales for Children and Adolescents desde el ingreso hasta el alta. El acuerdo en las puntuaciones de esta escala entre los diferentes evaluadores fue débil al inicio, pero mejor al alta. En general, los pacientes y los padres o tutores legales reportaron puntuaciones más bajas de Health of the Nation Outcome Scales for Children and Adolescents (mejor estado de salud) al ingreso en comparación con los profesionales de la salud. Al alta, las puntuaciones fueron homogéneas desde las tres perspectivas. CONCLUSIONES: La Health of the Nation Outcome Scales for Children and Adolescents permite la evaluación rutinaria de variables de resultado en salud mental en el entorno de hospital de día de psiquiatría desde la perspectiva de los pacientes, sus padres o tutores legales y los profesionales de la salud.

Valoración de la mejoría clínica en niños y adolescentes con trastornos psiquiátricos: una evaluación de múltiples perspectivas con HoNOSCA / Measure of clinical improvement in children and adolescents with psychiatric disorders: an evaluation of multiple perspectives with HoNOSCA

INTRODUCCIÓN La evaluación rutinaria de variables de resultado ayuda en la toma de decisiones, la asignación de recursos y el diseño de políticas en salud. La evaluación rutinaria de variables de resultado en el entorno hospitalario para niños y adolescentes con trastornos psiquiátricos sigue siendo limitada. La Health of the Nation Outcome Scales for Children and Adolescents, HoNOSCA, que recientemente se ha traducido al español y al catalán, permite la evaluación de resultados en esta población desde la perspectiva de pacientes, padres o tutores legales y clínicos. Este instrumento mide 13 áreas de salud y funcionamiento psicosocial. OBJETIVOS Evaluar variables de resultado en salud mental entre pacientes jóvenes de hospital de día de psiquiatría desde estas tres perspectivas usando Health of the Nation Outcome Scales for Children and Adolescents. MÉTODOS Reclutamos pacientes pediátricos (18 años o menos) con cualquier trastorno psiquiátrico en el hospital de día de la unidad de psiquiatría y psicología juvenil del Hospital Salut Mental Parc Taulí (Sabadell, Cataluña, España). Obtuvimos puntuaciones de Health of the Nation Outcome Scales for Children and Adolescents desde la perspectiva de pacientes, sus padres o tutores legales y clínicos, al ingreso y al alta. RESULTADOS Reclutamos 99 pacientes entre enero de 2015 y diciembre de 2017; once se perdieron durante el seguimiento. Entre los 88 restantes, encontramos una mejora significativa en las puntuaciones de Health of the Nation Outcome Scales for Children and Adolescents desde el ingreso hasta el alta. El acuerdo en las puntuaciones de esta escala entre los diferentes evaluadores fue débil al inicio, pero mejor al alta. En general, los pacientes y los padres o tutores legales reportaron puntuaciones más bajas de Health of the Nation Outcome Scales for Children and Adolescents (mejor estado de salud) al ingreso en comparación con los profesionales de la salud. Al alta, las puntuaciones fueron homogéneas desde las tres perspectivas. CONCLUSIONES La Health of the Nation Outcome Scales for Children and Adolescents permite la evaluación rutinaria de variables de resultado en salud mental en el entorno de hospital de día de psiquiatría desde la perspectiva de los pacientes, sus padres o tutores legales y los profesionales de la salud.

INTRODUCTION Routine outcome assessment is helpful to inform decision-making, resource allocation, and health policy design. Routine outcome assessment in the hospital setting for children and adolescents with psychiatric disorders remains limited. The clinical instrument HoNOSCA (Health of the Nation Outcome Scales for Children and Adolescents), which has recently become available in Spanish and Catalan, allows outcome assessment in this population from the perspective of patients, their parents or legal guardians, and clinicians. HoNOSCA measures 13 areas of health and psychosocial functioning. OBJECTIVES The aim of this study was to assess mental health outcomes in psychiatric day hospital pediatric patients from three perspectives (patient, par-ent/legal guardian, clinician), using the Spanish and Catalan versions of HoNOSCA. METHODS We recruited patients up to 18 years old with any psychiatric disorder at the day unit of the Salut Mental Parc Taulí Hospital Universitari (Sabadell, Catalonia, Spain). We obtained admission and discharge HoNOSCA scores for the patients, their parents or legal guardians, and their clinicians. RESULTS We recruited 99 patients over the study period (January 2015 to December 2017), 11 of which were lost to follow-up. Among the remaining 88, we found significant improvement in HoNOSCA scores from admission to discharge. Agreement between the HoNOSCA scores for the three different groups of evaluators (patients, parents/legal guardians, and clinicians) was weak at admission but better at discharge. In general, evaluations from patients and their parents or legal guardians had lower HoNOSCA scores (indicating a better mental health status) at admis-sion compared to those from clinicians. At discharge, however, the scores were more homogenous across the three groups of stakeholders. CONCLUSIONS Use of HoNOSCA allows for routine evaluation of mental health outcomes in the psychiatric day hospital setting from the perspective of pa-tients, their parents or legal guardians, and clinicians.

Validation of the Spanish and Catalan versions of the Health of the Nation Outcome Scale for Children and Adolescents (HoNOSCA).

Outcome measurement in outpatient and day-care mental health facilities for children and adolescents in Spain remains limited, in part due to a lack of validated scales. To address this issue, we translated HoNOSCA (glossary, score sheet, self-rated questionnaire, and parent/legal guardian questionnaire) into Spanish and Catalan using a reverse translation approach. We ascertained the validity and psychometric quality of the HoNOSCA in Spanish by assessing correlation with the Children's Global Assessment Scale (C-GAS). We recruited 64 participants 7-17 years of age in five day-care Psychiatry hospitals in Catalonia (Spain). Two evaluators administered both instruments twice, two weeks apart. Patients and parents/legal guardians completed the corresponding HoNOSCA versions. We calculated Cronbach's alpha for assessing internal consistency, intra-class correlation coefficients (ICC) for inter-rater and test-retest reliability, and Pearson's correlation coefficients for validity. We found that all HoNOSCA versions in Spanish presented satisfactory internal consistency, inter-rater and test-retest reliability. Concurrent validity for HoNOSCA-Glossary was also acceptable, with Pearson's coefficients of -0.543 and -0.519 for evaluators in the first administration, and of -0.675 and -0.685 in the second administration. HoNOSCA was also successfully translated into Catalan; acceptability was determined using cognitive interviews.

Crisis en el sector sanitario: impacto percibido en las condiciones de trabajo de las enfermeras / Crisis in the health sector: Impact on nurses’ working conditions

En un contexto de crisis económica y de políticas de reducción del déficit público, los presupuestos del Instituto Catalán de la Salud (ICS) fueron recortados en un 15,33% entre 2010 y 2014. Objetivo: Evaluar el impacto percibido de las medidas de contención del gasto sanitario en las condiciones de trabajo de las enfermeras. Método: El diseño del estudio fue descriptivo y transversal. Una muestra de 1.760 enfermeras de la provincia de Barcelona respondió un cuestionario sobre el impacto percibido de las medidas de contención del gasto sanitario implementadas en su centro de trabajo durante los primeros años de la crisis. Resultados: Entre los aspectos principales del impacto percibido por las medidas de contención del gasto, un 86,6% de las enfermeras identificaron una reducción salarial. También percibieron un aumento en los siguientes parámetros relevantes de las condiciones de trabajo: número de horas trabajadas (66,7%), ratio definitivo de pacientes atendidos (35,2%), complejidad y presión asistencial (75,3%), rotación por diversos servicios (31,5%), cambio de turno (21,4%) o ámbito (23,4%) de trabajo, precariedad laboral (58,4%) y pérdida del empleo por despido (6,6%) o no renovación del contrato (9%). Conclusiones: El impacto percibido de la crisis mostró un triple componente de signo negativo: recorte salarial, sobrecarga de trabajo e inseguridad en el empleo. Y como efecto combinado de esta múltiple tendencia se reconoció un deterioro de las condiciones de trabajo y de la calidad de vida laboral de las enfermeras

In a context of economic crisis and policies to reduce the public deficit, the budgets of the Catalan Health Institute (CHI) were cut by 15.33% between 2010 and 2014. Objective: To assess the perceived impact on nurses’ work conditions of measures to contain health spending. Method: The study design was descriptive and transversal. A sample of 1,760 nurses from the province of Barcelona answered a questionnaire on the perceived impact of health spending containment measures implemented in their workplace during the early years of the crisis. Results: Among the main aspects of the perceived impact of these measures, 86.6% of the nurses identified a pay cut and an increase in the following relevant parameters of their working conditions: number of hours worked (66.7%), final ratio of treated patients (35.2%), task complexity and workload (75.3%), rotation through various departments (31.5%), work shifts (21.4%) or work areas (23.4%), job insecurity (58.4%) and loss of employment by dismissal (6.6%) or non-renewal of contract (9%). Conclusions: The perceived impact of the crisis showed a triple negative component: Pay cut, work overload and job insecurity. As a combined effect of this multiple trend, the nurses acknowledged a deterioration in their working conditions and quality of working life

Crisis in the health sector: Impact on nurses' working conditions. / Crisis en el sector sanitario: impacto percibido en las condiciones de trabajo de las enfermeras.

In a context of economic crisis and policies to reduce the public deficit, the budgets of the Catalan Health Institute (CHI) were cut by 15.33% between 2010 and 2014. OBJECTIVE: To assess the perceived impact on nurses' work conditions of measures to contain health spending. METHOD: The study design was descriptive and transversal. A sample of 1,760 nurses from the province of Barcelona answered a questionnaire on the perceived impact of health spending containment measures implemented in their workplace during the early years of the crisis. RESULTS: Among the main aspects of the perceived impact of these measures, 86.6% of the nurses identified a pay cut and an increase in the following relevant parameters of their working conditions: number of hours worked (66.7%), final ratio of treated patients (35.2%), task complexity and workload (75.3%), rotation through various departments (31.5%), work shifts (21.4%) or work areas (23.4%), job insecurity (58.4%) and loss of employment by dismissal (6.6%) or non-renewal of contract (9%). CONCLUSIONS: The perceived impact of the crisis showed a triple negative component: Pay cut, work overload and job insecurity. As a combined effect of this multiple trend, the nurses acknowledged a deterioration in their working conditions and quality of working life.

Continuidad asistencial desde atención primaria en un plan de cuidados interniveles para un caso de trasplante hepático pediátrico / Assistance continuity from primary care in an inter-level nursing plan for a case of pediatric liver transplant

España es uno de los países donde más trasplantes de órgano sólido se realizan al año, de los cuales, según datos del 2014, un 2,7% se dan en la edad pediátrica. Dada la complejidad y la gravedad de la patología es necesario establecer un plan de cuidados que abarque tanto el pretrasplante como el postrasplante, con una estrecha colaboración entre los diferentes niveles asistenciales para abordar los variados problemas que se presentan y así asegurar la continuidad asistencial. En el siguiente caso, una adolescente de origen gambiano en riesgo de exclusión social hizo que la colaboración entre la enfermera de asistencia primaria y la enfermera de trasplante de órgano sólido fuera clave para dar continuidad a los cuidados. Se utilizaron múltiples estrategias en el plan de cuidados para garantizar una mejor adherencia y cumplimiento terapéutico. A pesar de ello, se ha de profundizar en el conocimiento de la cultura de origen para establecer planes de cuidados más individualizados y mejorar así los resultados. El plan de cuidados incluyó problemas formulados de acuerdo con la taxonomía NANDA, NOC, NIC

Spain is one of the countries where most solid organ transplants are performed each year, in the year 2014 a 2.7% of them were given in childhood. Given the complexity and severity of this disease it is necessary to establish a care plan that covers both pre-transplant and post-transplant, with close cooperation between different levels of care, to approach the several problems that can appear and assure continuum of care. In the following example, a Gambian teen with risk of social exclusion fostered a collaboration between the primary care nurse and transplant nurse that was the key to continuum care. Multiple strategies were used in the care plan to ensure better adherence and compliance of the treatment. However, the knowledge of the culture of origin must be deepened to establish more individualized care plans and thus improve results. The care plan included problems according to the NANDA, NOC, NIC taxonomy

Assistance continuity from primary care in an inter-level nursing plan for a case of pediatric liver transplant. / Continuidad asistencial desde atención primaria en un plan de cuidados interniveles para un caso de trasplante hepático pediátrico.

Spain is one of the countries where most solid organ transplants are performed each year, in the year 2014 a 2.7% of them were given in childhood. Given the complexity and severity of this disease it is necessary to establish a care plan that covers both pre-transplant and post-transplant, with close cooperation between different levels of care, to approach the several problems that can appear and assure continuum of care. In the following example, a Gambian teen with risk of social exclusion fostered a collaboration between the primary care nurse and transplant nurse that was the key to continuum care. Multiple strategies were used in the care plan to ensure better adherence and compliance of the treatment. However, the knowledge of the culture of origin must be deepened to establish more individualized care plans and thus improve results. The care plan included problems according to the NANDA, NOC, NIC taxonomy.