Factor structure and validity of the Parental Competence Questionnaire in the Paediatric Hospital Emergency Setting (ECP-U).

OBJECTIVE: To confirm the structure and examine the psychometric properties of the Parental Competence Questionnaire in the Paediatric Hospital Emergency Setting (ECP-U). METHODS: An instrumental validation study of the ECP-U questionnaire and an examination of its psychometric properties were carried out. RESULTS: The participants were 260 mothers and fathers seeking care in the paediatric emergency department of a hospital in Valencia (Spain) with children aged 0 to 14 years old. The five-factor structure of the ECP-U was confirmed with excellent statistical fits. Second-order models and a more parsimonious four-factor structure with adequate but marginal fits are proposed. With the exception of the "parental agency" factor (in both models examined) and the "active social support" factor (in the original five-factor structure), the internal consistency of the different factors was modest (≥ 0.70). A negative correlation was found between the Parental Stress Scale and the ECP-U for most factors. CONCLUSIONS: Validity and reliability analyses indicate that the ECP-U is an instrument with modest psychometric properties. IMPLICATIONS FOR PRACTICE: The ECP-U is an instrument that can be used by future researchers to identify different levels of parental competence in paediatric hospital emergency departments. This will enable help to be given to families with parenting issues and problems. The underlying concern is to reduce the number of frequent users and "Non-Urgent Presentations" to paediatric emergency departments due to low parental competence.

Development and validation of a parental competence questionnaire in the paediatric hospital emergency setting (ECP-U).

OBJECTIVE: To develop and validate a parental competence questionnaire for parents of children seeking care in hospital emergency departments. METHODS: An instrumental study of the development of an assessment questionnaire was carried out in three phases: 1) review of relevant measures and item generation, 2) content validity evaluation, 3) psychometric evaluation. Exploratory factor analysis was performed to examine the factorial structure. Internal consistency was evaluated using ordinal alpha. Hypothesis testing was determined between the resulting factors, the Parental Stress Scale and the State-Trait Anxiety Inventory. RESULTS: The participants were 270 parents of children aged 0-14 years old from a referral hospital in Valencia (Spain). An 18-item questionnaire was developed, comprising five factors that explain 53.0% of the variance: 1) "emotional management and expression", 2) "passive social support", 3) "parental agency", 4) "basic needs and care" and 5) "active social support". The internal consistency for the different factors was modest (>0.70). A negative correlation between the Parental Stress Scale and the parental competence questionnaire was found for most of the factors. CONCLUSIONS: This questionnaire on parental competence in the hospital emergency department (ECP-U) is a useful and simple self-report instrument for assessing the parental competence of parents with children in the emergency department. PRACTICAL IMPLICATIONS: The resulting questionnaire is of practical value to both healthcare professionals and researchers in this field. It can be administered quickly in clinical practice and used to identify parents' levels of parental competence and refer those with difficulties to appropriate support services.

Psychometric Properties of the Spanish Version of the Iowa Infant Feeding Attitude Scale in Fathers.

BACKGROUND: Research gaps exist with regard to paternal attitudes towards breastfeeding and the association between fathers' attitudes and the type of breastfeeding. RESEARCH AIMS: (1): To analyze the psychometric properties of the Spanish version of the Iowa Infant Feeding Attitude Scale in fathers, and (2) to examine the association between fathers' attitudes and type of breastfeeding. METHOD: We used a cross-sectional study design to analyze the scale's psychometric properties and performance. RESULTS: A total of 639 fathers participated in the study. The mean age was 35.83 years (SD = 4.65) and 67.3% (n = 430) were married or in a civil partnership. We observed an adequate fit in the confirmatory factor analysis: TLI = 0.96, CFI = 0.97 and RMSEA = 0.05. The overall internal consistency was 0.76. Between 1-6 months, 48% (n = 307) of participants' babies were exclusively breastfed, 35.2% (n = 225) were partially breastfed, and 16.7% (n = 107) were exclusively formula fed. Statistically significant differences were shown in attitudes towards breastfeeding, depending on the type of breastfeeding, between 1 and 6 months (F = 54.67; p < .001). Fathers who reported that their baby had been exclusively breastfed scored higher on attitudes towards breastfeeding. Statistically significant differences were also found between partial breastfeeding and formula feeding. CONCLUSIONS: The Spanish version of the Iowa Infant Feeding Attitude Scale is a valid and reliable instrument for measuring paternal attitudes towards breastfeeding.

Effectiveness of a standardised patient simulation programme in undergraduate nursing students 6 months after implementation: A quasi-experimental study.

AIMS: The objectives were to evaluate the effectiveness of a standardised patient simulation programme and to analyse to what extent the students transferred the skills covered in the simulation to clinical practice 6 months after the intervention. DESIGN: A quasi-experimental study was carried out, with measurements taken pre-, post- and 6 months after the implementation of a standardised patient simulation programme in a single group. METHODS: Eligible to participate were all final year nursing undergraduates during the 2020-2021 academic year. In total, 41 undergraduate nursing students took part in all stages of the study. It was measured attitude towards communication, self-efficacy, communication skills and resilience. The degree to which communication skills were used in the real setting was also assessed. RESULTS: The students' scores for self-efficacy and perceived communication skills improved and were maintained after six months. Regarding to resilience, improvement was even evident six months following the intervention. In terms of the transfer to clinical practice, the students were making moderate to high use of the communication skills learned in the simulation.

Development of an Instrument to Evaluate the Intake of Liquids, Food and Supplements in Endurance Competitions: Nutritional Intake Questionnaire for Endurance Competitions-NIQEC.

BACKGROUND: In the last few years endurance sports have experienced a great increase in the number of competitions and participants. Dietary-nutritional planning is key for performing well during such competitions. To date, there is no questionnaire expressly developed to be able to analyze the consumption of liquids, foods, and supplements, as well as gastrointestinal problems in these events. This study describes the development of the Nutritional Intake Questionnaire for Endurance Competitions (NIQEC). METHODS: The study was composed in the following phases: (1) Bibliographic search for the most important nutrients, (2) focus groups (17 dietitian-nutritionists and 15 experienced athletes) and generation of items, (3) Delphi surveys, and (4) cognitive interviews. RESULTS: After an initial shaping of the questionnaire with the items that emerged in the focus groups, their relevance was evaluated by means of the Delphi survey, which showed more than 80% approval for most items. Finally, the cognitive interviews indicated that the questionnaire was simple and complete for its purpose. The final NIQEC (n = 50 items) was divided in 5 sections: Demographic data; sports data; consumption of liquids, food and supplements before, during, and after the competition; gastrointestinal complaints, and dietary-nutritional planning for the competition. CONCLUSIONS: The NICEQ is a useful tool that allows collecting information from participants on sociodemographic factors and gastrointestinal complaints, and estimating the intake of liquid, food, and supplements, for endurance competitions.

Effectiveness of nontechnical skills educational interventions in the context of emergencies: A systematic review and meta-analysis.

INTRODUCTION: In recent years, the importance of training healthcare professionals in nontechnical skills using effective methodologies has been increasingly recognised as a means of preventing clinical errors in the practice of health care. The aim of this study was to evaluate the effectiveness of educational interventions on nontechnical skills in the emergency medical services and/or critical care unit settings. METHODS: A systematic search was carried out in the PubMed, SCOPUS, CINAHL, and Web of Science databases according to predetermined inclusion and exclusion criteria. After the initial search, 7952 records were selected after duplicates removed. Finally, a selection of 38 studies was included for quantitative analysis. Separate meta-analyses of standardised mean changes were carried out for each outcome measure assuming a random-effects model. Cochran's Q-statistic and I2 index were applied to verify study heterogeneity. Weighted analyses of variance and meta-regressions were conducted to test the influence of potential moderators and funnel plots using Duval and Tweedie's trim-and-fill method, and Egger's regression test were used to examine publication bias. RESULTS: All the variables analysed had a significant effect size, with the exception of situational awareness (d+ = -0.448; 95% confidence interval [CI] = -1.034, 0.139). The highest mean effect size was found for knowledge (d+ = -0.925; 95% CI = -1.177, -0.673), followed by the mean effect sizes for global nontechnical skills (d+ = -0.642; 95% CI = -0.849, -0.434), team nontechnical skills (d+ = -0.606; 95% CI = -0.949, -0.262), and leadership nontechnical skills (d+ = -0.571; 95% CI = -0.877, -0.264). Similar mean effect sizes were found for attitude (d+ = -0.406; 95% CI = -0.769, -0.044), self-efficacy (d+ = -0.469; 95% CI = -0.874, -0.064), and communication nontechnical skills (d+ = -0.458; 95% CI = -0.818, -0.099). Large heterogeneity among the standardised mean changes was found in the meta-analyses (I2 > 75% and p < .001), except for self-efficacy where I2 = 58.17%, and there was a nonstatistical result for Cochran's Q. This great variability is also reflected in the forest plots. DISCUSSION: The use of simulation interventions to train emergency and critical care healthcare professionals in nontechnical skills significantly improves levels of knowledge, attitude, self-efficacy, and nontechnical skills performance.

Relationships between parent-infant bonding, dyadic adjustment and quality of life, in an intra-partner sample.

The transition to parenthood represents a moment of change and adaptation in which the dyadic marital relationship becomes a triadic relationship. Facilitating a positive transition requires a thorough understanding of the explanatory model of the relationship between parental-infant bonding, dyadic adjustment and quality of life (QoL) from an integrative perspective of the family unit. The aim of this work was to analyse the relationships between parent-infant bonding, dyadic adjustment and QoL from an intra-partner perspective, 6-12 months after the birth of a child. A cross-sectional observational study was performed in a convenience sample of 222 couples 6-12 months postpartum, enrolled from October 2013 to March 2016. The mean age of the mothers was 34.07 years (SD = 3.67), and for the fathers, it was 35.75 years (SD = 4.02). Mothers perceived better QoL and greater mother-infant bonding compared to fathers. The perception of an adequate dyadic adjustment, together with positive parent-infant bonding, had positively influenced the individual QoL of both members of the couple 6-12 months after birth. From an intra-partner perspective, the positive transition was influenced by the relationship between parent-infant bonding, dyadic adjustment and QoL. Positive parent-infant bonding in mothers and fathers, as well as promotion of the quality of the relationships between couples, can help promote a better QoL. Positive health results can be achieved in terms of individual and family well-being by designing healthcare interventions that encourage the presence and participation of the family unit.

Juegos de azar en adolescentes y jóvenes de la Comarca del Río Mula, Región de Murcia / Gambling in adolescents and young persons from the Comarca del Río Mula, Region of Murcia

Objetivo: determinar la prevalencia de uso de juegos de azar y apuestas de jóvenes y adolescentes matriculados en centros públicos en la Comarca del Río Mula de la Región de Murcia, España. Método: estudio descriptivo transversal realizado entre octubre y noviembre de 2020. La población de estudio la conformaron 494 estudiantes de dos institutos públicos (de 13 a 25 años). Se midieron variables sociodemográficas, académicas, de consumo de sustancias, juegos de azar utilizados, motivos de juego [cuestionario GMQ (emociones positivas, afrontamiento del estrés, causa social)] y problemas de juego [escala SOGS-RA (no jugador o no problemático; jugador de riesgo; problema de juego)]. Se realizaron análisis descriptivo y bivariante. Resultados: participaron 147 estudiantes (65,3% mujeres; 82,3% de 13 a 18 años). El 37,7% había jugado alguna vez; los juegos más frecuentes fueron loterías, quinielas y rascas (32,7%), bingo (19,7%). El juego en línea fue ≤ 3,4%. El motivo de juego con mayor media fue la búsqueda de emociones positivas (= 5,48 sobre 15 puntos). Según la escala SOGS-RA un 3,4% era jugador de riesgo y un 2,1% tenía problemas de juego. Se encontró una proporción superior de problemas o riesgo de problemas con el juego en hombres y en quienes consumían sustancias recreativas. Conclusión: un alto porcentaje de adolescentes y jóvenes se han iniciado en el juego, una parte de los cuales están en riesgo o han desarrollado un problema de adicción. El juego es accesible a pesar de la prohibición legal. Es necesaria la actuación sobre estos problemas.(AU)

Objective: to determine the prevalence of gambling and betting activities among young persons and adolescents enrolled in public centres from the Comarca del Río Mula of the Region of Murcia, Spain. Method: a descriptive cross-sectional study conducted between October and November 2020. The study population consisted of 494 students from public secondary schools (13 to 25 years old). Sociodemographic and academic variables were measured, as well as substance use, games of chance used, reasons for gambling [GMQ questionnaire (positive emotions, coping with stress, social causes)] and gambling problems [SOGS-RA scale (not gamblers or non-problem; at risk; gambling problem)]. Descriptive and bivariate analyses were conducted. Results: the study included 147 students (65.3% female; 82.3% from 13 to 18 years old). Of these, 37.7% had gambled at some point; the most frequent games were lotteries, betting games and scratch cards (32.7%), and bingo (19.7%). Online gambling was ≤ 3.4%. The reason for gambling with the highest mean value was the search for positive emotions (= 5.48 over 15 scores). According to the SOGS-RA scale, 3.4% were gamblers at risk and 2.1% had gambling problems. A higher proportion of problems or risk of problems with gambling was found in men and in those using recreational substances. Conclusion: a high proportion of adolescents and young persons have started gambling, and part of them are at risk or have developed a gambling problem. There is access to gambling regardless of the legal prohibition. It is necessary to act upon these problems.(AU)

Experience of women with multiple sclerosis during the period of compulsory home confinement due to COVID-19 in Spain.

Compulsory home confinement due to COVID-19 pandemic has had an influence on the physical and emotional health. Nevertheless, it has been more prevalent in women and in people with chronic illness such as multiple sclerosis, so the aim of this study was to know the experience of women with multiple sclerosis during the home confinement period in Spain. Seven women aged over 18 years, with a definitive diagnosis of multiple sclerosis and who belonged to multiple sclerosis associations completed semi-structured interviews. Two main themes and multiple subthemes were identified. The first them was "living with multiple sclerosis during home confinement" which included the physical and emotional impact, confinement coping ability and time for reflection. The second theme was "the environment during confinement" and it included solidarity and support, family cooperation, importance of peer contact and adjustments in the health environment during the pandemic. The period of compulsory home confinement in Spain did not worsen the physical and emotional symptoms of these women. This might be related to the increased support they had received as well as the continuity of their rehabilitation activities at home. Regarding changes in health system, the participants referred the necessity to return to face-to-face visits.

Spanish Linguistic validation of the self-efficacy questionnaire in communication skills.

BACKGROUND: Self-efficacy is a critical element of social cognitive theory and refers to a person's estimation of their ability to complete a specific task. Self-efficacy scales evaluate the effectiveness of communication skills training programs. There were not validated scales in Spanish. AIMS: to cross-culturally adapt the Self-efficacy questionnaire-12 scale in communication skills in Spanish, evaluate its psychometric properties, and analyse the sample's descriptive characteristics. DESIGN: we conducted an instrumental study to develop evaluation scales. METHODS: nursing students were invited to participate (N = 387). The inclusion criteria were: (1) enrolment in first or fourth academic course year; (2) not having received specific training in communication skills; and (3) understanding written and spoken Spanish fluently. A total of 334 undergraduates participated (86.3% response rate); their mean age was 21.9 years (SD = 5.8), 83.2% were female. RESULTS: data showed high internal consistency (0.94) and a good fit to the model. The overall instrument score correlated with the attitude towards communication skills (r = 0.20; p < 0.001). Moderate communication self-efficacy scores were observed in these nursing students. IMPACT STATEMENT: Evaluating communication skills through self-efficacy scales allows teachers to know each student's perceived proficiency to handle communication with users safely and to understand users' needs, giving information about aspects to improve and to establish effective institutional strategies as one of the inherent characteristics of the concept of skills-based evaluation. CONCLUSIONS: The Spanish version of the Self-efficacy questionnaire-12 in communication skills was a valid and reliable instrument, essential for evaluating the perceived self-efficacy towards communication in nursing.

Efficacy of a Standardised Patient Simulation Programme for Chronicity and End-of-Life Care Training in Undergraduate Nursing Students.

BACKGROUND: Standardised patient simulations seem to be useful for improving the communication skills of health sciences students. However, it is important to define the effectiveness of these types of interventions in complex scenarios linked to disease chronicity and end-of-life contexts. METHODS: A quasi-experimental study with pre- and post-intervention measures was carried out in a single group. A total of 161 nursing students completed different assessment instruments to measure their attitudes towards communication (Attitude Toward Communication Scale), self-efficacy (Self-Efficacy of Communication Skills, SE-12), and communication skills (Health Professionals Communication Skills Scale, EHC-PS) before and after simulation training with standardised patients. The objective of the program was to train students in non-technical skills for complex situations involving chronicity and end-of-life care. It comprised eight sessions lasting 2.5 h each. RESULTS: The results showed notable baseline gender differences in attitudes towards communication and in the informative communication dimension, with women obtaining higher scores. The participants' self-efficacy and communication skills significantly improved after completing the intervention, with no significant differences being found for the attitudes towards communication variable. CONCLUSION: The standardised patient simulation programme for complex scenarios related to chronicity and end-of-life contexts improved communication self-efficacy and communication skills in these nursing students. In future work it will be important to analyse the influence of gender and attitudes towards communication as variables in the learning of communication skills in nursing students.

European Educational Programmes in Health Emergency and Disaster Management: An Integrative Review.

There is a need for trained health professionals who can swiftly respond to disasters occurring worldwide. Little is known about whether the currently available programmes in disaster management are in line with the recommendations of expert researchers. Our objective was to qualitatively review the characteristics of European educational programmes in health emergency and disaster management and to provide guidance to help improve their curricula. We carried out an integrative review to extract the main characteristics of the 2020/21 programmes available. We identified 34 programmes, the majority located in Spain, the UK or France. The primary qualification types awarded were master's degrees, half of them lasting one year, and the most common teaching method was in person. Almost all of the programmes used a virtual university classroom, a third offered multidisciplinary disaster management content and teachers, and half of them employed situational simulations. The quality of European educational programmes in health emergency and disaster management has improved, especially in terms of using more practical and interactive teaching methodologies and in the inclusion of relevant topics such as communication, psychological approaches and evaluation of the interventions. However, generally, the educational programmes in disaster management have not yet incorporated the skills related to the intercultural and interprofessional awareness aspects.

Psychometric properties of the Attitudes towards Medical Communication Scale in nursing students.

BACKGROUND: Adequate communication skills in healthcare professionals are one of the key elements required for achieving high-quality healthcare. Thus, measurement instruments able to assess the dimensions related to these skills, including attitudes towards communication, are useful and convenient tools. OBJECTIVES: To (a) cross-culturally adapt and validate a scale to measure attitudes towards communication in a sample of nursing students in the Spanish environment; (b) describe the perceived attitudes of nursing degree students towards communication. METHODS: We conducted an instrumental study. First, we adapted the scale by applying a standardised linguistic validation procedure. After that, we determined its structural equivalence and evaluated its psychometric properties. PARTICIPANTS: A total of 255 students participated; their average age was 22.66 years (SD = 4.75) and 82% were female. RESULTS: The internal consistency of the scale was adequate (0.75), and the data fit well with the model (CFI = 0.99; TLI = 0.99; RMSEA = .01 95% CI [.00-.05]). The overall instrument score poorly correlated with the self-efficacy in communication skills variable. CONCLUSIONS: The attitudes towards communication scores for these nursing students were high. The Spanish version of the Attitudes Towards Health Communication scale had adequate psychometric properties and this tool could quickly and easily be applied to assess the attitudes of health profession students.

Cross-cultural adaptation and validation of two crisis resource management scales.

BACKGROUND: Simulation training programs in crisis resource management must be evaluated using valid and reliable instruments. We translated into Spanish and linguistically validate The Mayo High Performance Teamwork Scale (MHPTS) and Ottawa Crisis Resource Management Global Rating Scale (Ottawa GRS) non-technical skills assessment instruments. METHOD: We performed a standardised cross-cultural adaptation process. The psychometric properties of both instruments in their versions adapted to Spanish were subsequently evaluated in a sample of 100 students by using exploratory factor analysis and assessing internal consistency and convergent validity through a total of 94 simulation scenarios in urgent medical situations RESULTS: Our results for the MHPTS showed a one-dimensional structure containing 8 items which explained a total variance of 72.84%; the Ottawa GRS also had a one-dimensional structure, this time with 5 items, which explained a total variance of 91.79%. According to the Cronbach alpha, the internal consistency for the MHPTS was 0.94 (1-8 items) and 0.98 for the Ottawa GRS. In addition, there was a strong correlation between the MHPTS and Ottawa GRS (r = 0.97; p < 0.001). CONCLUSION: We found strong evidence for the high validity and reliability of the Spanish versions of both these tools when tested in Spanish simulated emergency contexts.

Más allá de la COVID: los retos éticos de la reanudación de los servicios de salud mental / Beyond COVID: the ethical challenges of restarting mental health services

El objetivo de este trabajo de reflexión es establecer los valores éticos que deberían sustentar el restablecimiento de la asistencia sanitaria tras las primeras oleadas de la COVID-19, sabiendo que los brotes y las nuevas olas parecen inevitables hasta la masiva vacunación. Por ello, consideraremos diferentes cuestiones éticas a tener en cuenta en la fase de reanudación de la actividad de las unidades asistenciales de salud mental, tanto por gestores como por las y los profesionales de las mismas. (AU)

This reflection paper aims to establish the ethical values that should underpin the re-establishment of health care after the first waves of COVID-19, knowing that outbreaks and new waves seem inevitable until mass vaccination. To this end, we will consider different ethical issues to be taken into account in the phase of resumption of activity in mental health care units, both by managers and professionals. (AU)

Mixed-method study on the satisfaction of a high-fidelity simulation program in a sample of nursing-degree students.

BACKGROUND: Training emotionally complex communication skills with standardized patients brings realism to simulation scenarios, and moreover, is associated with high levels of satisfaction among the students. OBJECTIVES: (1) To measure the satisfaction of nursing students and factors related to their satisfaction and (2) to explore the effects perceived by nursing students after having a high-fidelity simulation training program using standardized patients. DESIGN AND PARTICIPANTS: Mixed design. Pre-post quasi-experimental phase in which the Satisfaction Scale Questionnaire with High-Fidelity Clinical Simulation was administered in 156 students; a second, semi-structured interview qualitative phase was completed by 11 students. RESULTS: Nursing students showed high satisfaction scores. The scores for utility and communication were correlated with the students' attitudes towards communication. In the second phase, two main themes and four sub-themes emerged. CONCLUSIONS: Teachers could implement high-fidelity simulation programs with standardized patients for training emotionally complex communication skills to nursing students. These programs allow students to participate in their own learning processes and help them to feel motivated and satisfied about the usefulness of their learning experiences.

Beauty stereotypes as a form of violence in Spanish context: A mixed-method model.

The authors' purpose was to analyse the influence of beauty stereotypes on the everyday life of men and women and the behaviours adopted in order to satisfy such ideals using mixed methods of an exploratory nature. Taking into account that 76.7% of participants agree that the current established beauty stereotypes affect their everyday lives, we aim to explain the influence of beauty stereotypes and the behaviours adopted in order to comply with them. Assessing the degree of assimilation of gender-related socio-cultural beauty stereotypes allows us to examine how this can trigger behavioural responses in order to shape one's identity.

Psychometric Properties of the Health Professionals Communication Skills Scale in University Students of Health Sciences.

Communication is one of the determining factors of healthcare quality; however, a health model that prioritizes clinical over non-technical skills remains prevalent. The aims of this article were: (a) to validate a communication skills scale in a sample of fourth-year nursing degree students from two Spanish universities and (b) determine their perception of communication skills. The study included 289 fourth-year nursing undergraduate students with a mean age of 22.7 (SD = 4.87) years; 81.7% were female. The Health Professionals Communication Skills Scale (HP-CSS) questionnaire was adapted for use among nursing students. We analysed the psychometric properties and relationships with the variable attitudes toward communication skills. The HP-CSS showed a high internal consistency (0.88) and good fit of data to the model (TLI = 0.98; CFI = 0.97; RMSEA = 0.05 [95% CI = 0.04-0.06]). The total score and subscale scores correlated with the variable attitude towards communication skills. High scores were obtained for the students' perception of communication skills. The HP-CSS is a valid and reliable tool to assess the communication skills in nursing students. This scale provides university teachers with a rapid and easily applied instrument to assess the level of communication skills and relationship with patients.

[Evolution and status of the community model of mental health care. SESPAS Report 2020]. / Evolución y estado del modelo comunitario de atención a la salud mental. Informe SESPAS 2020.

The legislative and ideological transition produced in recent years in Spain has favoured the implementation of the community model of mental health care. However, there is still strong resistance to the inclusion of community approaches in the care of people with mental health problems and to the implementation of integrated care and attention with a salutogenic approach. The purpose of the following report is to describe the evolution of the community model of mental health care in the Spanish National Health System and to assess its current status. Initially, a review of the published national mental health plans and strategies was carried out. Subsequently, the evaluation was carried out taking as reference the Consensus Document on the Fundamental Principles and Key Elements of Community Mental Health, which establishes the criteria for evaluating the quality of community care. In the absence of updated plans or strategies, international reports and recommendations were included. The results were grouped into: 1) social perspective, where the controversy about the capacity of the users to make decisions despite the recognition of their rights as autonomous moral agents is evident; 2) perspective of the centrality of the users of mental health care services, where the resistance to the implementation of integrated community care and attention is expressed; and 3) professional perspective in relation to the effectiveness of the interventions and the community network of care principles, which highlights the need to transform the institutions to carry out community interventions in mental health based on evidence and in an intersectoral, comprehensive, integrated and integrating manner.

The Spanish version of the Mothers' Postnatal Sense of Security Scale: Psychometric properties and predictive utility.

Postnatal sense of security is a relevant construct related to several variables of motherhood. However, it has not yet been studied in the Spanish context. The aims were: (a) To analyze the psychometric properties of a Spanish version of the Mothers' Postnatal Sense of Security Scale (PPSS-S); (b) analyze the factors related to mothers' sense of security during the first 2 weeks following childbirth (sociodemographic variables and factors related to maternity); and (c) examine the predictive utility that mothers' sense of security has on symptoms of postpartum depression 6-11 months after childbirth. This was a prospective longitudinal study performed in the first 6-11 months post-partum in four regions of Spain. A total of 928 mothers whose mean age was 33.67 years (standard deviation = 4.54) participated. The confirmatory factor analysis showed adequate adjustment to the original structure (χ2 = 17,272.79, df = 153, p < .001; Tucker-Lewis index = 0.98; comparative fit index = 0.98; root mean square error of approximation = 0.058 [0.053-0.063])and the overall internal consistency was 0.89. Direct relationships were shown between women' sense of security and already having had a child, the absence of postpartum health complications (either in the mother or the newborn) and receiving consistent information from healthcare professionals. Our results showed adequate evidence for the reliability and validity of the Spanish version of the PPSS-S. Understanding mothers' sense of security during the early months of motherhood, as well as related factors in the postpartum period, will allow health professionals to implement preventive measures to promote mental health and could help reduce symptoms of postpartum depression.