Perception of evidence-based practice and the professional environment of primary health care nurses in the Spanish context: a cross-sectional study.

BACKGROUND: The study of the factors that encourage evidence-based clinical practice, such as structure, environment and professional skills, has contributed to an improvement in quality of care. Nevertheless, most of this research has been carried out in a hospital context, neglecting the area of primary health care. The main aim of this work was to assess the factors that influence an evidence-based clinical practice among nursing professionals in Primary Health Care. METHODS: A multicentre cross-sectional study was designed, taking the 619 Primary Care staff nurses at the Balearic Islands' Primary Health Care Service, as the study population. The methodology applied consisted on a self-administered survey using the instruments Evidence-Based Practice Questionnaire (EBPQ) and Nursing Work Index (NWI). RESULTS: Three hundred and seventy seven surveys were received (60.9% response rate). Self-assessment of skills and knowledge, obtained 66.6% of the maximum score. The Knowledge/Skills factor obtained the best scores among the staff with shorter professional experience. There was a significant difference in the Attitude factor (p = 0.008) in favour of nurses with management functions, as opposed to clinical nurses.Multivariate analysis showed a significant positive relationship between NWI and level of evidence-based practice (p < 0,0001). CONCLUSIONS: Institutions ought to undertake serious reflection on the lack of skills of senior nurses about Evidence-Based Clinical Practice, even when they have more professional experience. Leadership emerge as a key role in the transferral of knowledge into clinical practice.

Self-perceived factors associated with smoking cessation among primary health care nurses: a qualitative study / Tabagismo em enfermeiras de cuidados primários à saúde: um estudo qualitativo / Tabaquismo en enfermeras de Atención Primaria: un estudio cualitativo

The aim of this work was to characterize the views of nurses about factors modulating smoking cessation. Results of this study will allow us to design helping interventions with the maximum specificity for nurses. A qualitative study through a semi-structured interview of 15 Primary Health Care nurses who were smokers was performed. In contrast with other studies in which nurses were not aware of any particular social pressure to give up smoking, 18 months after the application of the Anti-Smoking Spanish Law, this feeling was expressed. Therefore, the main reasons for giving up smoking include that smoking in public is every day worse seen, together with a sense of shame and guilt in front of their social and family environment, especially for being a professional group dedicated to health.

O objetivo deste estudo foi identificar os fatores percebidos por enfermeiras fumantes como facilitadores ao abandono do tabagismo, com o propósito de, posteriormente, elaborar intervenções de ajuda com maior especificidade para esse grupo. Foi realizado estudo qualitativo, por meio de entrevistas semiestruturadas, com 15 enfermeiras de cuidados primários à saúde, que eram fumantes. Ao contrário de outros estudos, os quais as enfermeiras não percebiam pressão social para deixar o hábito tabágico, 18 meses após a vigência da Lei de Prevenção ao Tabagismo, as enfermeiras entrevistadas expressaram sentir pressão social. Portanto, entre os principais motivos para abandonar o hábito tabágico é que, a cada dia, fumar em público é malvisto, e está aliado a sentimentos de vergonha e culpa no seu entorno social e familiar, principalmente por se tratar de um grupo profissional dedicado aos cuidados da saúde.

El objetivo de este trabajo fue identificar los factores percibidos por las enfermeras fumadoras como moduladores del cese tabáquico, con el fin de diseñar posteriormente intervenciones de ayuda con la máxima especificidad para este colectivo. Se realizó un estudio cualitativo mediante entrevista semiestructurada a 15 enfermeras fumadoras de Atención Primaria de Salud. Contrariamente a otros estudios en los que las enfermeras no percibían una especial presión social para dejar el hábito tabáquico, 18 meses después de vigencia de la Ley de Prevención del Tabaquismo sí que la expresan. Por ello, entre los principales motivos de cese figura el que cada día esté peor considerado fumar en público, unido a un sentimiento de vergüenza y de culpa ante su entorno social y familiar, especialmente por tratarse de un colectivo profesional dedicado a los cuidados de salud.

Self-perceived factors associated with smoking cessation among primary health care nurses: a qualitative study.

The aim of this work was to characterize the views of nurses about factors modulating smoking cessation. Results of this study will allow us to design helping interventions with the maximum specificity for nurses. A qualitative study through a semi-structured interview of 15 Primary Health Care nurses who were smokers was performed. In contrast with other studies in which nurses were not aware of any particular social pressure to give up smoking, 18 months after the application of the Anti-Smoking Spanish Law, this feeling was expressed. Therefore, the main reasons for giving up smoking include that smoking in public is every day worse seen, together with a sense of shame and guilt in front of their social and family environment, especially for being a professional group dedicated to health.

Tabaquismo en enfermeras de Atención Primaria: Factores que influyen en su inicio y mantenimiento / Smoking habits among Primary Health Care Nurses: Factors that influence taking up and maintaining it

Las enfermeras de Atención Primaria (AP) son profesionales adecuados en la lucha contra el tabaquismo. No obstante, algunas de ellas fuman y esto puede disminuir su credibilidad y su sentimiento de autoeficacia frente al problema. El objetivo de este estudio es evidenciar los factores que pueden influir en el inicio y el mantenimiento del hábito tabáquico.Para ello, se ha realizado un estudio cualitativo desde una perspectiva fenomenológica social, en 15 enfermeras fumadoras de AP, recogiendo los datos mediante entrevista semiestructurada en profundidad. Los principales temas que emergieron fueron la falta de concienciación y el papel socializador del tabaco. Se tiene poca conciencia del papel de la publicidad y no se considera al estrés como un determinante del hábito en el ámbito de AP. Puede resultar decisivo el control del peso corporal (AU)

Primary Health Care Nurses (PHC) are suitable professionals in the fight against the smoking habit. Nevertheless some of them smoke and this may diminish their credibility and their feeling of self-efficacy when faced with this problem. The aim of this study was to demonstrate the factors that may influence taking up and maintaining the smoking habit.Thus, we carried out a qualitative study from a social phenomenological perspective, in 15 PHC nurses who are smokers, collecting the data by means of a semi-structured in-depth interview. The main issues that emerged were lack of awareness and the socializing role of tobacco. There is little awareness of the role of publicity and stress is not considered to be a determining factor of the habit in the area of PHC. The control of body weight may be decisive (AU)

[Smoking among nursing and physical therapy students of the University of the Balearic Islands: opinions on regulation of smoking in public places]. / Hábito tabáquico entre los estudiantes de enfermería y fisioterapia de la Universitat de les Illes Balears: opinión ante la regulación del consumo en lugares públicos.

OBJECTIVE: To evaluate the prevalence, opinions and attitudes of nursing and physical therapy students at the University of the Balearic Islands toward smoking in public places and the influence of regulatory policies. METHOD: We performed a cross-sectional, descriptive, observational study using a self-administered questionnaire. The survey was designed to evaluate opinions on and the degree of agreement with smoking and regulatory policies on this issue. The assessment was performed using Likert scales. The survey was offered to all students attending class in the core subject with the greatest number of enrolled students on a normal academic day between February 15 and March 15, 2006. We calculated 95% confidence intervals for proportions. The Chi square test was used to compare qualitative variables and Student's t-test was used for quantitative variables. RESULTS: The sample consisted of 345 students, 82.2% of whom were women. The mean age was 21.9 years. The prevalence of regular smokers was 26.1% (26.9% among women and 22.6% among men). Almost all (93.8%) of the respondents agreed that smoking should be banned in closed spaces in educational institutions and 70.9% believed that the law should be complied with at the University of the Balearic Islands, with differences between 2003 and 2006. CONCLUSIONS: Smoking was less prevalent in our population than in the general regional and national populations, as well as in other Spanish nursing students of the same age and gender. The prevalence of occasional smokers has fallen since 2003. Most students had a favorable view of the new Smoking Prevention Act.

Hábito tabáquico entre los estudiantes de enfermería y fisioterapia de la Universitat de les Illes Balears: opinión ante la regulación del consumo en lugares públicos / Smoking among nursing and physical therapy students of the University of the Balearic Islands: opinions on regulation of smoking in public places

Objetivo. Evaluar la prevalencia, opiniones y actitudes de los alumnos de enfermería y fisioterapia de la Universitat de les Illes Balears (UIB) ante el consumo de tabaco en lugares públicos y la influencia de las políticas reguladoras. Método. Estudio observacional, descriptivo, trasversal, mediante cuestionario autocumplimentado. Se diseñó un cuestionario para evaluar la opinión y el grado de acuerdo respecto a cuestiones actitudinales y conductuales acerca del hábito tabáquico, así como las medidas reguladoras de éste. Para su valoración se utilizaron escalas tipo Likert. El cuestionario se propuso a todos los asistentes a clase en un día lectivo habitual, en la asignatura troncal del curso que tenía más alumnos matriculados entre el 15 de febrero y el 15 de marzo de 2006. Se calcularon los intervalos de confianza del 95% para las proporciones. En la comparación de variables cualitativas se ha usado el estadístico X2 y para las cuantitativas la t de Student. Resultados. Se obtuvo una muestra de 345 sujetos, con una media de edad de 21,9 años, el 82,2% eran mujeres. La prevalencia de fumadores habituales fue del 26,1%; el 26,9% entre las mujeres y el 22,6% entre los varones. El 93,8% estaba de acuerdo en que se prohibiera fumar en los espacios cerrados de los centros docentes y el 70,9% en que se cumpliera la ley en la UIB, habiendo diferencias entre 2003 y 2006. Conclusiones. La población estudiada tiene una prevalencia tabáquica menor que la población general nacional y autonómica, así como la de otros estudiantes de enfermería españoles, para su misma edad y sexo. La prevalencia de fumadores ocasionales ha descendido desde 2003. Los alumnos se muestran mayoritariamente favorables a la nueva Ley de Prevención del Tabaquismo

Objective. To evaluate the prevalence, opinions and attitudes of nursing and physical therapy students at the University of the Balearic Islands toward smoking in public places and the influence of regulatory policies. Method. We performed a cross-sectional, descriptive, observational study using a self-administered questionnaire. The survey was designed to evaluate opinions on and the degree of agreement with smoking and regulatory policies on this issue. The assessment was performed using Likertscales. The survey was offered to all students attending class in the core subject with the greatest number of enrolled students on a normal academic day between February 15 and March 15, 2006. We calculated 95% confidence intervals for proportions. The Chi square test was used to compare qualitative variables and Student’s t-test was used for quantitative variables. Results. The sample consisted of 345 students, 82.2% of whom were women. The mean age was 21.9 years. The prevalence of regular smokers was 26.1% (26.9% among women and 22.6% among men). Almost all (93.8%) of the respondents agreed that smoking should be banned inclosed spaces in educational institutions and 70.9% believed that the law should be complied with at the University of the Balearic Islands, with differences between 2003 and 2006. Conclusions. Smoking was less prevalent in our population than in the general regional and national populations, as well as in other Spanish nursing students of the same age and gender. The prevalence of occasional smokers has fallen since 2003. Most students had a favorable view ofthe new Smoking Prevention Act

Intervención enfermera de deshabituación tabáquica en Atención Primaria / Nurses intervention to quit smoking developed in Primary Care

Objetivos: determinar la efectividad de una terapia grupalde deshabituación tabáquica, así como las variables asociadasa la misma. Caracterizar el perfil tabáquico de lospacientes que acudieron a dicha terapia.Método: estudio de intervención sin grupo control no aleatorizadode variables socio-demográficas y referentes alhábito tabáquico, de una población de 121 clientes, queasistieron a una terapia multicomponente grupal de deshabituacióntabáquica, llevada a cabo por enfermeras, entre2001 y 2005. En las variables cualitativas se usaron proporcionesy en las cuantitativas, la media con su DesviaciónEstándar (DE) y su intervalo de confianza al 95% (IC95%).Resultados: de los 121 clientes que terminaron el taller, alaño seguían abstinentes el 52,0%, a los dos años el 42,7%y a los tres años el 32,0%. Antes de acudir a esta consultanuestros clientes fumaron una media de 24,8 años. La mediade consumo es de 28,0 cigarrillos diarios en los hombresy 20,5 en las mujeres. La media de edad fue de 41,2 años.Conclusiones: nuestra población tiene un perfil similar alde la mayoría de poblaciones que acuden a consultas dedeshabituación realizadas a nivel nacional. La tasa de abstinenciaobtenida siguiendo la terapia multicomponente auno, dos o tres años es similar o superior a la que se obtienecon el mismo u otros métodos, por enfermeros u otros profesionales,tanto a nivel nacional como internacional y portanto, contribuye a validar a las enfermeras como profesionalescompetentes en el tratamiento del tabaquismo

Objectives: to determine the effectiveness of a group therapyintervention to quit smoking as well as the variablesassociated to such intervention. To characterise the smokingprofile of patients who attended the therapy group.Method: randomised interventional study with no controlgroup containing sociodemographic variables on the smokingprofile of a population of 121 patients who attended amulticomponent group therapy intervention to quit smokingundertaken by primary care nurses between 2001 and 2005.Ratios were used to measure quality variables and MeanStandard Deviation (SD) and their 95% Confidence Interval(CI 95%).Results: of the 121 individuals who completed the intervention,52% continued their abstinence at 1 year, 42,7% at2 years and 32,0% at 3 years. Before attending the intervention,these individuals had been smoking 24,8 years onaverage. Mean consumption was 28,0 cigarettes per dayfor men and 20,5 for woman. Mean age was 41,2 years.Conclusions: the profile of the study population is similarto that of most populations that attend group therapy nationwideto quit the habit. The abstinence rate achievedwith the multicomponent therapy at 1, 2 and 3 years is similaror above that obtained with the same or with othermethods, by nurses or other professionals, both nationallyand internationally. We can thus conclude that the methoddescribed validates the work undertaken by nurses as competentprofessionals to counsel individuals who wish to quit smoking (AU)