Nursing students' attitude toward euthanasia following its legalization in Spain.

BACKGROUND: Euthanasia is a controversial practice in many countries. Since Spain's Euthanasia Law came into effect on March 24, 2021, healthcare providers have faced a new challenge since they must inform patients, provide care, accompany them, and implement the law. It also represents a new stumbling block at universities, which must adapt to regulatory changes and educate future professionals accordingly. Little is known about the attitude of nursing students in Spain toward euthanasia since this law was implemented. OBJECTIVE: This study aims to answer the following research questions: What is the attitude of nursing students toward euthanasia? What factors influence this attitude? RESEARCH DESIGN: A cross-sectional study was conducted using an online questionnaire. PARTICIPANTS AND RESEARCH CONTEXT: The study population comprised all nursing students at a public university in Barcelona (n = 444), Spain, during the 2022-2023 academic year. The validated Spanish version of the Euthanasia Attitude Scale was employed. A bivariate analysis was performed. ETHICAL CONSIDERATIONS: The university Ethics Committee (CEEAH 6247) approved this study. All participating students signed an informed consent form. Participation was voluntary, and data anonymity and confidentiality were guaranteed. RESULTS: Two hundred and forty-four nursing students responded to the questionnaire. The mean total score was 79.64. Participants with religious beliefs presented lower scores, indicating a more negative attitude toward euthanasia. Participants in their second, third, or fourth year of the nursing degree scored higher, demonstrating a more positive attitude. CONCLUSIONS: The attitude of nursing students toward euthanasia was remarkably positive. Working on ethical content during the degree course and clinical practice are factors that help to develop a more positive attitude. In addition, nursing education should encourage professional aspects to prevail over religious beliefs in euthanasia situations.

[The euthanasia law and professional experiences: tensions in clinical practice]. / La ley de eutanasia y experiencias profesionales: tensiones en la práctica clínica.

OBJECTIVE: To analyze the process of assisted death provision in Catalonia and identify the main tensions, difficulties, and/or sources of discomfort related to professional practice. METHOD: A qualitative study was conducted based on interviews (n=29) and focus groups (n=19) with professionals who participated in the euthanasia process. The selection of participants combined the snowball and maximization of variability procedures, taking into account the variables of professional profile, setting, gender, age and territoriality. Intentional and theoretical sampling process. RESULTS: The assisted death process is divided into four main moments: 1) reception of the request, 2) medical-bureaucratic procedure, 3) the actual procedure, and 4) closure. At each of these moments, difficulties arise that can be a source of discomfort and have to do with the limits and tensions between the legal and moral, the conception of one's own professional role, the lack of recognition of some professional roles, stress and overload, the lack of formal and informal support, and the relationship with the patient and his/her family. The bureaucratic-administrative stress derived from a protective law, with both prior and subsequent verifying control, stands out, given that it stresses the professionals immersed in a healthcare system already under high pressure after budget cuts and the COVID-19 epidemic. CONCLUSIONS: Throughout the assisted death process, the sources of distress are diverse and of a psychological, psychosocial, and structural nature. These results may lead to interventions for psychological and peer support, information, training, institutional involvement, and burden reduction.

Knowledge about the best practice guidelines in the nursing degree: A non-randomized post-test design.

AIM: To compare knowledge of Nursing Degree students about Best Practice Guidelines when there are included as teaching content in a subject vs knowledge through having the usual internship experience without teaching specific guidelines contents. DESIGN: Non-randomized post-test-only design with a comparison group. METHODS: 143 students of the nursing degree at the Autonomous University of Barcelona were recruited. The intervention group received a classroom training in three Best Practice Guidelines with Problem-Based Learning methodology. The comparison group only attended internship, without specific guidelines contents. Knowledge was evaluated with an ad hoc post intervention questionnaire. The information was collected between 2016 and 2018. RESULTS: The average score of knowledge was low, 5.1 out of 10, and differs between guides. The best results were obtained by the students with internships and that had consulted the guides on some occasions. Synchronized effort and leadership in Academia and Healthcare are needed to favour evidence-based practice. The combination of the consultation of the Best Practice Guidelines in theoretical learning combined with the practice, increases the knowledge of the Best Practice Guidelines and will favour the implementation of evidence-based practice. Some students were involved in questionnaire design.

Expert patients leading activities on social justice: towards patient-centered education.

BACKGROUND: Social justice is recognized by reputable international organizations as a professional nursing value. However, there are serious doubts as to whether it is embodied in Catalan nursing education. OBJECTIVES: To explore what nursing students take away from two teaching activities led by expert patients (one presentation and three expert patient illness narratives) on the topics of social justice, patient rights, and person-centered care. RESEARCH DESIGN: Qualitative study using a content analysis approach. The research plan included (1) think-pair-share activities (additional faculty-assisted presentation and three faculty-assisted, semi-structured scripted narratives); (2) paired reflections; (3) focus groups; and (4) content analysis of paired reflections and focus groups. PARTICIPANTS AND RESEARCH CONTEXT: Fourth-year nursing degree students at the Autonomous University of Barcelona (UAB), Spain. Convenience sampling was used. ETHICAL CONSIDERATIONS: The UAB Research Ethics Committee did not deem it necessary to apply any specific measures. We fully explained to patients that they could decide what medical information they would share with the students that was relevant to their learning, and we provided students with guidelines about patient confidentiality, dignity, and respect. FINDINGS/RESULTS: The students engaged in reflection about their education (recognizing that it had been centered on the professional and not the patient) and their relationship with the patient, in which they reproduced low-involvement patient care by modeling behaviors of their nurse educator. Moreover, they valued a person-centered care model with an emphasis on the emotional part but left out decision-making as an individual right of people. CONCLUSIONS: The think-pair-share activities were useful to spark self-reflection among students, who identified aspects to change in their own practice, and reflected about their own education process, both of which promote change.

Implementation of web-based respondent driven sampling in epidemiological studies.

BACKGROUND: Respondent-driven sampling (RDS) is a peer chain-recruitment method for populations without a sampling frame or that are hard-to-reach. Although RDS is usually done face-to-face, the online version (WebRDS) has drawn a lot of attention as it has many potential benefits, despite this, to date there is no clear framework for its implementation. This article aims to provide guidance for researchers who want to recruit through a WebRDS. METHODS: Description of the development phase: guidance is provided addressing aspects related to the formative research, the design of the questionnaire, the implementation of the coupon system using a free software and the diffusion plan, using as an example a web-based cross-sectional study conducted in Spain between April and June 2022 describing the working conditions and health status of homecare workers for dependent people. RESULTS: The application of the survey: we discuss about the monitoring strategies throughout the recruitment process and potential problems along with proposed solutions. CONCLUSIONS: Under certain conditions, it is possible to obtain a sample with recruitment performance similar to that of other RDS without the need for monetary incentives and using a free access software, considerably reducing costs and allowing its use to be extended to other research groups.

Exploring the Decision-Making Process of People Living with HIV Enrolled in Antiretroviral Clinical Trials: A Qualitative Study of Decisions Guided by Trust and Emotions.

The informed consent is an ethical and legal requirement for potential participants to enroll in a study. There is ample of evidence that understanding consent information and enrollment is challenging for participants in clinical trials. On the other hand, the reasoning process behind decision-making in HIV clinical trials remains mostly unexplored. This study aims to examine the decision-making process of people living with HIV currently participating in antiretroviral clinical trials and their understanding of informed consent. We conducted a qualitative socio-constructivist study using semi-structured interviews. Eleven participants were selected by purposive sampling in Argentina until data saturation was reached. A content analysis was performed. The findings highlight the fact that some participants decided to enroll on the spot, while others made the decision a few days later. In all cases, the decision was based on different aspects of trust (in doctors, in the clinical research site, in the clinical trials system) but also on emotions associated with HIV and/or treatment. Moreover, while people living with HIV felt truly informed after the consent dialogue with a researcher, consent forms were unintelligible and unfriendly. The immediacy of patient decision-making has rarely been described before. Enrollment in an HIV clinical trial is mainly a trust-based decision but this does not contradict the ethical values of autonomy, voluntariness, non-manipulation, and non-exploitation. Thus, trust is a key issue to be included in reshaping professional practices to ensure the integrity of the informed consent process.

Educational Interventions for Newly Diagnosed Patients With Inflammatory Bowel Disease: A Scoping Review.

The latest consensus standards for patients with inflammatory bowel disease published by the European Crohn's and Colitis Organisation conclude that optimizing quality of care in inflammatory bowel disease involves information and education after diagnosis. A scoping review was performed to identify educational interventions in newly diagnosed inflammatory bowel disease patients. A systematic literature search was conducted using five databases and gray literature. Inclusion criteria were studies with at least one group of patients whom were less than 2 years from their initial inflammatory bowel disease diagnosis. The review process initially identified 447 articles, resulting in four relevant studies: three randomized controlled trials and one pre-/post-test. Only one study exclusively included newly diagnosed inflammatory bowel disease patients. All studies included a multidisciplinary assessment and three were based on a group intervention, but none of them was described in enough detail to be replicated. The content was the same for all patients regardless of the time elapsed since diagnosis. Education of newly diagnosed patients does not seem to be a priority given the lack of publications meeting our criteria despite the evidence of their need. Interventions and outcomes are heterogeneous. Interventions did not consider patient needs and suggest that they centered more on the professional than on the patient. More evidence is clearly needed about this topic.

Assessing the Underestimation of HIV Risk Infection among Young Men Who Have Sex with Men in Argentina.

The aim of this study is to describe the discordance between the self-perceived risk and actual risk of HIV among young men who have sex with men (YMSM) and its associated factors. An online, cross-sectional study was conducted with 405 men recruited from an Argentinian NGO in 2017. Risk discordance (RD) was defined as the expression of the underestimation of risk, that is, as a lower self-perception of HIV risk, as measured with the Perceived Risk of HIV Scale, than the current risk of HIV infection, as measured by the HIV Incidence Risk Index. Multivariate logistic regression models were used to analyze the associations between the RD and the explanatory variables. High HIV risk was detected in 251 (62%), while 106 (26.2%) showed high self-perceived risk. RD was found in 230 (56.8%) YMSM. The predictors that increased RD were consistent condom use with casual partners (aOR = 3.8 [CI 95:1.5-11.0]), the use of Growler to meet partners (aOR = 10.38 [CI 95:161-121.94]), frequenting gay bars (aOR = 1.9 [95% CI:1.1-3.5]) and using LSD (aOR = 5.44 [CI 95:1.32-30.29]). Underestimation of HIV risk in YMSM is associated with standard HIV risk behavior and modulated by psychosocial aspects. Thus, prevention campaigns aimed at YMSM should include these factors, even though clinical practice does not. Health professionals should reconsider adapting their instruments to measure the risk of HIV in YMSM. It is unknown what score should be used for targeting high-risk YMSM, so more research is needed to fill this gap. Further research is needed to assess what score should be used for targeting high-risk in YMSM.

Nursing students' care of and attitudes towards lesbian, gay, bisexual, trans, and intersex people in times of COVID-19 in Spain: A cross-sectional study.

OBJECTIVE: The objective of this work is to measure the knowledge and attitudes of Catalan nursing students regarding lesbian, gay, bisexual, trans, and intersex (LGBTI) patients, as well as their perception of specific training in this area, according to their internship modalities, sociodemographic circumstances, and academic background during the COVID-19 pandemic. BACKGROUND: During the COVID-19 pandemic, the Spanish Government created the "Health-Aid" internship: A paid alternative to curricular internships. There is extensive evidence that paid work environments perpetuate negative attitudes towards LGBTI patients. METHOD: A cross-sectional survey aimed at Catalan nursing students. The "Attitudes Towards and Knowledge About Lesbian, Gay, Bisexual, Trans and Intersex Patients" questionnaire was adapted. A descriptive study and backward regression models were constructed. RESULTS: Three hundred thirty-seven students, mean age 23.80 years (SD: 5.17) participated; 85% women and 54 (16%) completing the Health Aid internship modality. More than 50% did not attend specific training on the care of the lesbian, gay, bisexual, trans, and intersex population. Differences between internship modalities showed higher values in the curricular internship group: Attitudes (U = 6526.50, p = .031) and training perception (U = 5926.50, p = .008). CONCLUSIONS: Nursing students' attitudes towards lesbian, gay, bisexual, trans, and intersex patients and their perception of specific training on care for this population were negatively influenced by the paid Health Aid internship during the pandemic. IMPLICATIONS FOR NURSING MANAGEMENT: Even under dire circumstances, clinical training must be properly managed to address the specific health needs of vulnerable populations, such as lesbian, gay, bisexual, trans, and intersex patients. Paid internships in emergency scenarios may impede these objectives.

Gender differences in the decision-making process for undergoing total knee replacement.

OBJECTIVE: To assess gender differences in the decision-making process for treatment of knee osteoarthritis (OA). METHODS: A secondary analysis of a randomized trial was conducted (n = 193). Knowledge of OA and total knee replacement (TKR), decisional conflict, satisfaction with the decision-making process, treatment preference and TKR uptake 6 months later were compared by gender. Multivariate regression models were developed to identify gender-specific predictors. RESULTS: Women showed less knowledge (MD = -7.68, 95% CI: -13.9, -1.46, p = 0.016), reported less satisfaction (MD = -6.95, 95% CI: -11.7, -2.23, p = 0.004) and gave more importance to avoiding surgery (U = 2.09, p = 0.019). In women, more importance attributed to the time needed to relieve symptoms significantly reduced the odds of surgery (OR = 0.76, p = 0.016). CONCLUSION: The provision of information and/or promotion of shared decision-making could be of lower quality in female patients, although other explanations such as differences in information needs or preference for involvement in decision-making cannot be ruled out with the current evidence. Given the study's limitations, especially regarding the sample size, further confirmation is needed. PRACTICE IMPLICATIONS: A systematic, shared decision-making approach in consultation is needed to avoid potential gender-based biases.

Knowledge, Perceptions, Attitudes and Practices of Midwives Regarding Maternal Influenza and Pertussis Vaccination: A Qualitative Study.

The coverage of maternal vaccination against pertussis and, particularly, influenza is lower than expected. The lack of recommendation from healthcare providers conditions non-vaccination in pregnant women. The purpose was to determine the knowledge, perceptions, attitudes and practices of midwives regarding maternal influenza and pertussis vaccination. A qualitative descriptive study based on semi-structured, face-to-face interviews with seventeen midwives was conducted, including purposive sampling and thematic analyses. Midwives had disparate knowledge and perceptions about the severity of influenza and pertussis in pregnant women, and influenza was not considered very serious. The vaccines were generally considered safe. However, because midwives did not have enough information about the safety of the influenza vaccine, there was a tendency not to recommend it. While most midwives had a positive attitude toward vaccination, their advocation for vaccination against influenza was not as clear as it was for pertussis. Not wanting to influence the decision and assuming an informative-facilitating role also led providers to recommend the influenza vaccine less frequently. Midwives are among the main sources of professional advice for pregnant women. Addressing their understanding and professional practices regarding maternal vaccination is key to change the attitude of pregnant women and thus increase vaccine uptake among them, particularly for influenza.

Transformative learning experience among nursing students with patients acting as teachers: Mixed methods, non-randomized, single-arm study.

AIM: To examine the effects of expert HIV patients acting as teachers to Spanish nursing students both on their HIV-related knowledge, attitudes and practices and on their approach to the care model as well as to explore their learning experience. DESIGN: Non-randomized, single-arm study with quantitative before and after measurements and qualitative data. METHODS: The intervention consisted of five 90-min workshops led by two women living with HIV. Thirty-four nursing students participated, and quantitative and qualitative data were gathered from February to June 2018. We used the Patient-Practitioner Orientation Scale (PPOS) and the KAP questionnaire on HIV/AIDS to collect quantitative data. RESULTS: Statistically significant differences were found in the global score for care orientation and its two dimensions, caring and sharing. About the changes resulting from the workshops, the quantitative results-more patient-centred care perception and better attitudes towards people living with HIV-match the qualitative findings in all the aspects studied, except in sharing. CONCLUSION: Incorporating expert patients as teachers in the nursing bachelor's degree resulted in more patient-centred care and improved knowledge, attitudes and practices. The workshops conducted by qualified expert patients showed transformative learning power, as the participants improved professional and personal aspects.

Influenza and Pertussis Maternal Vaccination Coverage and Influencing Factors in Spain: A Study Based on Primary Care Records Registry.

The purpose was to determine the coverage of maternal vaccination against influenza and pertussis, and the characteristics associated with being vaccinated, in a health area of Catalonia, Spain. Some 36,032 anonymized and computerized clinical records registries of pregnant women from Primary Care Centres (e-CAP database) were analysed, from between 2015 and 2018. Vaccination coverage and the association with sociodemographic variables and clinical conditions were estimated using a Poisson regression model. Maternal vaccination coverage against influenza ranged between 11.9% in 2015 and 6.8% in 2018, following a decreasing trend (p < 0.001). Coverage with the tetanus toxoid, diphtheria toxoid, and acellular pertussis vaccine varied between 49.8% in 2016 and 79.4% in 2018, following an increasing trend (p < 0.001). Having living children and suffering from obesity were factors associated with not being vaccinated against both infections. The predictive variables of vaccination against influenza were diabetes (IRR: 2.17, 95% CI: 1.42−3.30) and asthma (IRR: 2.05, 95% CI: 1.76−2.38); and for pertussis, it was asthma (IRR: 1.10, 95% CI: 1.03−1.17). Different socio-demographic factors and chronic conditions in pregnant women were associated with maternal vaccination, and which will have to be taken into account in clinical practice when implementing strategies to improve the coverage of the programme.

Health outcomes and psychosocial risk exposures among healthcare workers during the first wave of the COVID-19 outbreak.

The aim is to describe the health and psychosocial risk factors of Spanish healthcare workers during the COVID-19 pandemic. METHODS: A cross-sectional study by means of an online questionnaire (April-May 2020). The data comes from the database resulting from the COTS project "Working conditions, insecurity, and health in the context of the COVID-19 pandemic". The sample consisted of 1989 health care workers. RESULTS: Women, young people (doctors and nurses) and the middle-aged (assistants) had poorer health and greater exposure to psychosocial risks. Geriatric assistants were the most-affected occupational group. CONCLUSIONS: gender, occupation, and age are focuses of inequality in the exposure of health care workers to psychosocial risks.

Understanding factors that influence the decision to be vaccinated against influenza and pertussis in pregnancy: A qualitative study.

AIMS AND OBJECTIVES: To identify how pregnant women perceive pertussis and influenza and the factors that influence their decision to be vaccinated. BACKGROUND: Suffering from influenza during pregnancy increases complications in the pregnant woman, foetus and newborn. Pertussis in children under six months of age causes severe complications. Maternal vaccination against influenza and pertussis is effective and safe. However, vaccination rates are insufficient. DESIGN: We conducted a qualitative descriptive study, using semi-structured interviews. This research adheres to the COREQ guidelines and checklist. METHODS: We carried out 18 semi-structured face-to-face interviews with pregnant women, using intentional sampling and thematic analysis. RESULTS: We identified an overarching theme, 'factors that influenced participants' decision to be vaccinated or not', which was composed of four subthemes that were in turn made up of 12 categories. The factors that influenced participants' decision to be vaccinated against influenza and pertussis were related to their knowledge of and their perception of risk for these diseases. Participants perceived the risk of pertussis to be greater, and they focused their concern on the newborn. The recommendations and convictions of nurse-midwives were the most important factors encouraging vaccination. Participants trusted their nurse-midwives and most reported that they would have been vaccinated if their midwife had recommended it. Other factors were linked to lack of information, fear and concerns about economic interests. CONCLUSIONS: The convictions and actions of the nurse-midwife in recommending vaccination to pregnant women are decisive. Strategies to improve vaccination rates should be directed to helping health professionals understand how their practice affects the final decision of pregnant women. RELEVANCE TO CLINICAL PRACTICE: Understanding the factors that limit vaccination rates among pregnant women provides valuable information to nurse-midwives that can help to improve vaccination strategies and practices. Increased maternal vaccination rates would reduce morbidity and mortality among pregnant women and newborns.

Cumplimiento y satisfacción con el aislamiento durante la pandemia de COVID-19 en Argentina y exploración de su impacto psicológico / Compliance and satisfaction with lockdown during the COVID-19 pandemic in Argentina and exploration of its psychological impact ISSN 2718-7845. Actualizaciones en sida e infectología. Buenos Aires. julio 2021. volumen 29. número 106: 72-84 Esta obra está bajo una licencia de Creative Commons Reconocimiento-NoComercial 4.0Internacionalhttps://creativecommons.org/licenses/by-nc/4.0/i

Como respuesta a la propagación de la pandemia de COVID-19, Argentina implementó el aislamiento social, preventivo y obligatorio (ASPO). Este estudio analizó factores asociados con el cumplimiento y la satisfacción con el ASPO a 30 días de su implementación en Argentina e indagó en las respuestas emocionales autoinformadas a esta medida. Una encuesta en línea, diseñada ad hoc, fue respondida por 2965 participantes de los 24 distritos del país entre el 18 y el 21 de abril de 2020. El 68,4% (n = 2021) eran de género femenino y el 31,6% (n = 935) masculino. La media de edad fue 43,49 años (DE = 14,97). Se realizaron pruebas de chi-cuadrado y análisis de regresión logística para explorar asociaciones entre diferentes variables y los niveles de cumplimiento y satisfacción. Las respuestas emocionales se analizaron cualitativamente. Pertenecer a un grupo en riesgo para COVID-19, haber experimentado una reducción en los ingresos del hogar y una mayor satisfacción con el ASPO se asociaron con mayores probabilidades de cumplimiento total. La menor satisfacción se asoció con ser de género masculino, pertenecer a un grupo en riesgo para COVID-19, priorizar la economía tanto como (o más que) la salud, y haber experimentado una reducción en los ingresos del hogar. Las respuestas emocionales reportadas con mayor frecuencia estuvieron relacionadas con la ansiedad y el afecto negativo o deprimido, aunque también se mencionaron estrategias de afrontamiento y emociones positivas. Estos resultados contribuyen a generar recomendaciones para mejorar la efectividad en la implementación de estas medidas para el control de la pandemia de COVID-19

In response to the spread of the COVID-19 pandemic, Argentina implemented social, preventive, and mandatory lockdown (SPML). This study analyzed factors associated with compliance and satisfaction with the SPML 30 days after its implementation in Argentina and self-reported emotional responses to this measure. An online survey, designed ad hoc, was answered by 2,965 participants from the 24 districts of the country between April 18 and 21, 2020. From them, 68.4% (n = 2021) were female and 31.6% (n = 935) were male. The mean age was 43.49 years (SD = 14.97). Chi-square tests and logistic regression analysis were performed to explore associations between different variables and levels of compliance and satisfaction. Emotional responses were qualitatively analyzed. Belonging to a group at risk for COVID-19, having experienced a reduction in household income, and greater satisfaction with the SPML were associated with higher odds of total compliance. Lower satisfaction was associated with being male, belonging to a group at risk for COVID-19, prioritizing economy as much as (or more than) health, and having experienced a reduction in household income. The most frequently reported emotional responses were related to anxiety and negative or depressed affect, although coping strategies and positive emotions were also mentioned. These results contribute to generating recommendations to improve the effectiveness of the implementation of these measures for the control of the COVID-19 pandemic.

Emotion management and stereotypes about emotions among male nurses: a qualitative study.

BACKGROUND: Nursing requires a high load of emotional labour. The link between nursing, emotional labour and the female sex, complicates the figure of the male nurse, because masculinity is associated with physical or technical (rather than emotional) and moreover is defined in contrast to femininity. Our objective was to understand how emotion management is described by male nurses who work in the paediatrics department of a Spanish tertiary hospital. METHODS: Qualitative descriptive study. The participants were selected through intentional sampling in the paediatrics department of a Spanish tertiary hospital. We conducted semi-structured interviews until reaching data saturation. We carried out a content analysis, using Lincoln and Guba's definition of scientific rigour. RESULTS: We identified two key themes in the data: 1) Stereotypes related to the emotional aspects of care: Participants took for granted some gender stereotypes while questioning others and defended alternative ways of managing emotions related to care. 2) Emotion management strategies: Participants described keeping an emotional distance, setting boundaries, relativising problems and using distraction and humour. DISCUSSION: Nursing care is conditioned by gender roles and stereotypes that present men as less capable than women of feeling and managing emotions. However, emotion management is necessary in nursing care-especially in paediatrics-and our participants reported using strategies for it. Although participants continued to interpret care in terms of traditional roles, they contradicted them in adapting to the emotional labour that their job requires. CONCLUSIONS: New behaviours are emerging among male nurses, in which care and emotion management are not exclusively the purview of women. Our participants reproduced some gender stereotypes while disrupting others, and they tended to cling to the stereotypes that were favourable to them as male nurses. As we work towards a gender-neutral profession, these results represent a first step: male participants reported that they provide care and manage their emotions as well as (or better than) women. However, because they substantiated their claims by drawing on negative stereotypes of women, further progress must be made.

Decision-making in HIV clinical trials: a study with patients enrolled in antiretroviral trials / Toma de decisiones en los ensayos clínicos sobre el VIH: estudio con pacientes incluidos en ensayos de antirretrovirales

Objective: To explore the decisional process of people living with human immunodeficiency virus (HIV) currently enrolled in antiretroviral clinical trials. Method: Cross-sectional retrospective study. Outcome variables were reasons to participate, perceived decisional role (Control Preference Scale), the Decisional Conflict Scale and the Decisional Regret Scale. Descriptive statistics were calculated, and associations among these variables and with sociodemographic and clinical characteristics were analyzed with non-parametric techniques.Results: Main reasons to participate were gratitude towards Fundación Huesped (47%), the doctor's recommendation (32%), and perceived difficulty to access treatment in a public hospital (28%). Most patients thought that they made their decision alone (54.8%) or collaboratively with the physician (43%). Decisional conflict was low, with only some conflict in the support subscale (median=16.67). Education was the only significant correlate of the total decisional conflict score (higher in less educated patients; p=0.018), whereas education, recent diagnosis, living alone, lower age, being man and doctor's recommendation to go to Fundación Huésped related to higher conflict in different subscales. Nobody regretted to participate. Conclusions: The decision making regarding participation in HIV trials, from the perspective of participants, was made respecting their autonomy and with very low decisional conflict. Currently, patients show no signs of regret. However, even in this favorable context, results highlight the necessity of enhancing the decision support in more vulnerable patients (e.g., less educated, recently diagnosed or with less social support), thus warranting equity in the quality of the decision making process. (AU)

Objetivo: Explorar el proceso de decisión de las personas que viven con el virus de la inmunodeficiencia humana (VIH) y participan en ensayos clínicos de antirretrovirales. Método: Estudio retrospectivo transversal. Las variables de resultado fueron los motivos para participar, el rol de participación percibido (Escala de preferencia de control), la Escala de conflicto decisional y la Escala de arrepentimiento decisional. Se realizó una estadística descriptiva y se establecieron asociaciones entre estas variables con variables sociodemográficas y clínicas usando técnicas no paramétricas. Resultados: Las razones para participar fueron la gratitud hacia la Fundación Huésped (47%), la recomendación del médico (32%) y la dificultad percibida para acceder al tratamiento en un hospital público (28%). Los pacientes opinan que tomaron su decisión solos (54,8%) o en colaboración con el médico (43%). El conflicto en la decisión fue bajo, aunque hubo cierto conflicto en la subescala de apoyo (mediana=16,67). La educación se relacionó con el conflicto en la decisión (mayor en pacientes con menor nivel educativo; p=0.018), mientras que la educación, el diagnóstico reciente, vivir solo, la menor edad y la recomendación del médico de ir a la Fundación Huésped se relacionaron con un mayor conflicto en diferentes subescalas. Nadie se arrepintió de su participación. Conclusiones: Desde la perspectiva de los participantes, en el proceso de toma de decisiones se respetó su autonomía, hubo poco conflicto decisional y no aparecen signos de arrepentimiento. A pesar de este contexto favorable, los resultados destacan la necesidad de mejorar el apoyo a las decisiones en las personas más vulnerables (con menos educación, de diagnóstico reciente o con menos apoyo social) para garantizar la equidad en la calidad del proceso de decisión. (AU)

The Bachelor's thesis in nursing: Characteristics and students' approach and satisfaction.

AIM: The aim of the study was to describe the characteristics of the Bachelor's thesis of fourth-year nursing students at a Spanish public university, the criteria that students used to choose a topic and students' degree of satisfaction after completing the Bachelor's thesis. DESIGN: Quantitative study. METHODS: We examined 420 Bachelor's theses carried out from 2013 to 2018 and conducted an online survey among fourth-year students in the 2017-18 and 2018-19 academic years (81 completed questionnaires). RESULTS: The Bachelor's thesis took the form of a research proposal. The most frequent proposal type was a qualitative hospital-based study whose objective was to understand the experiences of adult or adolescent patients, close family members, or nurses. Students chose topics for personal reasons. Most participants reported feeling satisfied with the knowledge and skills acquired. CONCLUSIONS: Students completing a Bachelor's thesis in the form of a research proposal have the potential to transfer their research skills to their nursing practice.

Feeling Informed Versus Being Informed: Mixed-Methods Analysis of Family Perceptions and Behavior Following a Pediatric Emergency Department Visit.

PURPOSE: To examine perceptions of family-centered care, satisfaction, and quality of communication with health professionals during a pediatric emergency department visit, and to evaluate the perceived usefulness of the information received and whether provider treatment recommendations were followed after discharge. DESIGN: Embedded mixed methods design with two concurrent phases. Participants in phase 1 were 385 adult relatives of children (age 6 days-17 years, mean 5.0 years, SD 4.5) seen in a pediatric emergency department. On the day of the visit, relatives completed questionnaires exploring perceptions of family-centered care, satisfaction (CSQ-8), and quality of communication with professionals (ad hoc instrument). For phase 2, we conducted daily structured telephone interviews with 37 of these parents over the six consecutive days following the emergency visit. RESULTS: Satisfaction with the visit was significantly related to the perception of family-centered care (B = 0.25; 95% CI [0.20, 0.29]; p < .001). Follow-up interviews revealed that 45.9% (n = 17) of families did not follow the prescribed treatment and 32.4% (n = 12) made a further appointment with their primary care pediatrician. Qualitative analysis suggested that families lacked certain information from care providers. CONCLUSIONS: Elements of a family-centered approach were rated positively and families believed that the information they received was useful. Importantly, more than half of the families who were followed up by telephone had doubts about provider treatment recommendations. PRACTICE IMPLICATIONS: Family-centered care in the pediatric emergency department could enhance communication and help to ensure that treatment recommendations are followed at home.