An Exploration of Resilience and Positive Affect among Undergraduate Nursing Students: A Longitudinal Observational Study.

BACKGROUND: The purpose of this study is to analyze the variation in resilience and emotional state scores in nursing students throughout the four years of training for the nursing degree. METHODS: This is a longitudinal observational study of a paired and prospective cohort of 176 nursing students who enrolled in the first year of a bachelor's degree in 2019. The study followed up with the students in 2022 and examined several sociodemographic factors, including sex, marital status, date of birth, living arrangements and occupation. Additionally, the study investigated changes in negative affect, positive affect, and resilience. RESULTS: A total of 176 students participated in the study. The study found that resilience increased from 68.24 ± 10.59 to 70.87 ± 9.06 (p < 0.001), positive affect increased from 28.16 ± 4.59 to 33.08 ± 8.00 (p < 0.001), and the negative affect score decreased from 25.27 ± 5.12 to 21.81 ± 7.85 (p < 0.001). The study also found that married individuals experienced an increase in negative affect (p = 0.03) compared to singles or those in open relationships. Furthermore, the change in resilience was greater in men than in women (p = 0.01). CONCLUSIONS: Throughout their four-year training, nursing students experience an increase in resilience and positive affect, as well as a decrease in negative affect.

Virtual Active Learning to Maximize Knowledge Acquisition in Nursing Students: A Comparative Study.

BACKGROUND: Nursing students need to acquire knowledge through active methods that promote critical thinking and decision making. The purpose of this study is to analyze whether there are differences in the acquisition of knowledge by nursing students between active face-to-face or virtual teaching methods. METHODS: In this comparative study, nursing students enrolled in the psychology course were divided into two groups: a face-to-face group that received active teaching methods and a virtual group. The virtual group was exposed to the Effective Learning Strategy (ELS), which included seminars based on video content through the Virtual Campus and answering questions using the H5P tool. In addition, participants engaged in reflection tasks on the content. Covariate data were collected, and knowledge tests were administered to both groups before and after the course. After three months, subjects were re-evaluated with a final exam to assess content retention. RESULTS: A total of 280 students were randomized. No differences were found in students' scores at the end of the knowledge test or in their final grades in the subject. Having study habits (b = 0.12, p = 0.03) and social support from relevant people (b = 0.09; p = 0.03) were associated with better post-intervention scores, and inversely with social support from friends (b = -0.12, p < 0.01). Final grades were inversely associated with digital safety literacy (b = -0.101, p = 0.01). No factors were associated with the scores of each group separately. CONCLUSIONS: The ELS virtual active learning model is as effective as face-to-face active learning methods for teaching psychology to first-year nursing students. This study was not registered.

A scale for assessing nursing students' emotional competence: A validation study.

BACKGROUND: The wellbeing of nursing professionals can be affected by emotionally challenging situations. Emotional intelligence (EI) is a recognised ability to manage stress, reduce work overload, and improve clinical relationships and decision making. Therefore, these emotional skills should be identified and developed throughout nursing education. OBJECTIVES: The aim of this study is to create an observer-based emotional measurement tool to assess the level of emotional skills in university students. DESIGN: This is a cross-sectional study. SETTING: Complutense University in Madrid, Spain. PARTICIPANTS: A total of 415 first- and fourth-year nursing students participated. METHODS: The Situational Emotional Response Scale (ERES) is a questionnaire for observing emotional competence in nursing practice. It underwent content validation using the Delphi method with 6 experts, resulting in a final version of 34 items. Focus group sessions were conducted with nursing students to ensure readability and appropriateness. Participants completed the ERES after viewing two clinical interaction videos, resulting in two sets of responses. Half of the responses were used for exploratory factor analysis (EFA) and half for confirmatory factor analysis (CFA). RESULTS: A total of 415 nursing students participated in the study. Four factors were extracted, explaining 55.1 % of the variance. The CFA was conducted with 208 students, yielding a total of 4 factors and a variance of 55.1 %. The internal consistency of the scale was high, with Cronbach's α and McDonald's ω coefficients of 0.947 and 0.949, respectively. Test-retest reliability showed a moderate intra-class correlation coefficient of 0.604 (95 % CI: 0.503-0.688) over a 15-day interval. CONCLUSIONS: The ERES questionnaire is well grounded in the theoretical framework of emotional competence as manifested in clinical practice. The empirical evidence provided by this study suggests that the ERES is a reliable, valid, useful, and innovative instrument for measuring emotional competence in university students.

Emotional empowerment through information research and communication to reduce fear of COVID-19 among nursing students: a randomised controlled trial.

BACKGROUND: Despite an existing body of literature on anxiety reduction using multi-component methods, little is known about the effect of active student participation in research and communication of scientific information on anxiety and fear reduction. The aim of this study is to evaluate the impact of quality scientific information research and the production of informative videos on the preventive aspects of COVID-19 on fear and anxiety reduction. METHODS: A randomised controlled trial was conducted with 220 undergraduate nursing students in the first year of the nursing degree. The participating students were randomised into two groups. The experimental group carried out an intervention based on a database search for information on preventing COVID-19 and production of a video giving scientific reasons why prevention measures should be followed. In the control group, students created posters and videos about theoretical aspects of one module of the nursing degree. Both groups were surveyed before and after the intervention, measuring their state of resilience, preventive behaviours, level of anxiety, and fear of COVID-19. RESULTS: The intervention group showed a greater decrease in fear levels after the intervention than those in the control group. There were no differences between the groups in terms of resilience, preventive behaviours, or anxiety. In the experimental group, there was a significant decrease in anxiety levels and fear levels after the intervention compared to the baseline levels. CONCLUSIONS: An intervention based on active participation in searches for high-quality scientific information and production of information videos on COVID-19 prevention reduced fear and anxiety caused by COVID-19 among nursing students. TRIAL REGISTRATION: We have retrospectively registered the trial in Open Science Framework and the identification number is https://doi.org/10.17605/OSF.IO/6QU5S .

Utilización de medicamentos off-label y unlicensed en una unidad de cuidados intensivos pediátricos de un hospital de alta complejidad español. Estudio descriptivo / Off-label and unlicensed drug use in a pediatric intensive care unit of a tertiary care Spanish hospital. A descriptive study

Introducción. En las unidades de cuidados intensivos pediátricos, se utiliza gran cantidad de medicamentos, muchos prescritos fuera de las condiciones establecidas en su ficha técnica (prescripciones off-label y unlicensed). El objetivo de este estudio fue describir el uso de medicamentos y estimar la prevalencia de fármacos off-label y unlicensed en una unidad de cuidados intensivos pediátricos de un hospital de tercer nivel español. Población y métodos. Estudio transversal, observacional, de una cohorte de niños ingresados en una unidad de cuidados intensivos pediátricos. El estudio se llevó a cabo en 2017. Se revisó cada fármaco prescrito, sus condiciones de uso y administración. Además, se analizaron las fichas técnicas de los fármacos implicados con la finalidad de identificar si el uso de los medicamentos se realizaba según sus condiciones de autorización, o bien se hacía fuera de prospecto (off-label) o como unlicensed. Resultados. La muestra fue de 97 pacientes. El 74,2 % (n = 72) de los pacientes recibieron algún fármaco off-label o unlicensed. El 23,8 % (n = 243) de las prescripciones fueron off-label y el 8,7 % (n = 89), unlicensed. El subanálisis realizado por grupos de edad mostró que el grupo de edad que recibió mayor número de prescripciones totales (n = 611) y el mayor porcentaje de fármacos prescritos en condiciones off-label y/o unlicensed (38,4 %) fue el de menores de 2 años. Conclusiones. La prescripción de fármacos off-label y/o unlicensed es una práctica habitual en la unidad de cuidados intensivos pediátricos. Este estudio permite documentar la complejidad de la terapéutica en niños.

Introduction. In pediatric intensive care units, a large number of drugs are used, many of which are prescribed for condition beyond those established in their summary of product characteristics (off-label and unlicensed drug prescriptions). The objective of this study was to describe drug use and estimate the prevalence of off-label and unlicensed drugs in a pediatric intensive care unit of a tertiary care Spanish hospital. Population and methods. Cross-sectional, observational study with a single cohort of children admitted to a pediatric intensive care unit. The study was conducted in 2017. Each drug prescription, its conditions of use and administration were reviewed. In addition, the summary of product characteristics of drugs used were analyzed in order to identify whether they were used according to their conditions of authorization, or whether they were used in an off-label or unlicensed manner. Results. The sample included 97 patients. At least one off-label or unlicensed drug was administered to 74.2% (n = 72) of patients; 23.8% (n = 243) corresponded to off-label prescriptions and 8.7% (n = 89), unlicensed prescriptions. A sub-analysis by age group showed that the age group that received a higher number of total prescriptions (n = 611) and a higher percentage of off-label and/or unlicensed drug prescriptions (38.4%) was under 2 years of age. Conclusions. Off-label and/or unlicensed drug prescription is a common practice in the pediatric intensive care unit. This study allowed us to document the complexity of therapeutics in children.

Use of infographics for facilitating learning of pharmacology in the nursing degree.

AIM: To evaluate the impact of an educational intervention focused on teaching students to create infographics to improve pharmacology learning. DESIGN: This is a comparative study. METHODS: The population was 250 nursing students who had to create two infographics in groups related to the content that had been addressed in pharmacology in two different moments. Students and professors evaluated the infographics through a 5-point Likert scale. Scores from the official exam of the pharmacology subject were obtained. RESULTS: Most of the students scored below 50% for the "excellent" and "good" categories. Intraclass correlation and kappa correlations among students and professors' evaluations were low. The comparison between both times of students' evaluations only yields significant correlation values for the criterion "Understanding of information" (r = .039, p = .024) and the "Visual presentation of information" (r = .041, p = .019). No correlation was obtained between the test and evaluations values of the infographic.

Off-label and unlicensed drug use in a pediatric intensive care unit of a tertiary care Spanish hospital. A descriptive study. / Utilización de medicamentos off-label y unlicensed en una unidad de cuidados intensivos pediátricos de un hospital de alta complejidad español. Estudio descriptivo.

Introduction. In pediatric intensive care units, a large number of drugs are used, many of which are prescribed for condition beyond those established in their summary of product characteristics (off-label and unlicensed drug prescriptions). The objective of this study was to describe drug use and estimate the prevalence of off-label and unlicensed drugs in a pediatric intensive care unit of a tertiary care Spanish hospital. Population and methods. Cross-sectional, observational study with a single cohort of children admitted to a pediatric intensive care unit. The study was conducted in 2017. Each drug prescription, its conditions of use and administration were reviewed. In addition, the summary of product characteristics of drugs used were analyzed in order to identify whether they were used according to their conditions of authorization, or whether they were used in an off-label or unlicensed manner. Results. The sample included 97 patients. At least one off-label or unlicensed drug was administered to 74.2% (n = 72) of patients; 23.8% (n = 243) corresponded to off-label prescriptions and 8.7% (n = 89), unlicensed prescriptions. A sub-analysis by age group showed that the age group that received a higher number of total prescriptions (n = 611) and a higher percentage of off-label and/or unlicensed drug prescriptions (38.4%) was under 2 years of age. Conclusions. Off-label and/or unlicensed drug prescription is a common practice in the pediatric intensive care unit. This study allowed us to document the complexity of therapeutics in children.

Introducción. En las unidades de cuidados intensivos pediátricos, se utiliza gran cantidad de medicamentos, muchos prescritos fuera de las condiciones establecidas en su ficha técnica (prescripciones off-label y unlicensed). El objetivo de este estudio fue describir el uso de medicamentos y estimar la prevalencia de fármacos off-label y unlicensed en una unidad de cuidados intensivos pediátricos de un hospital de tercer nivel español. Población y métodos. Estudio transversal, observacional, de una cohorte de niños ingresados en una unidad de cuidados intensivos pediátricos. El estudio se llevó a cabo en 2017. Se revisó cada fármaco prescrito, sus condiciones de uso y administración. Además, se analizaron las fichas técnicas de los fármacos implicados con la finalidad de identificar si el uso de los medicamentos se realizaba según sus condiciones de autorización, o bien se hacía fuera de prospecto (off-label) o como unlicensed. Resultados. La muestra fue de 97 pacientes. El 74,2 % (n = 72) de los pacientes recibieron algún fármaco off-label o unlicensed. El 23,8 % (n = 243) de las prescripciones fueron off-label y el 8,7 % (n = 89), unlicensed. El subanálisis realizado por grupos de edad mostró que el grupo de edad que recibió mayor número de prescripciones totales (n = 611) y el mayor porcentaje de fármacos prescritos en condiciones off-label y/o unlicensed (38,4 %) fue el de menores de 2 años. Conclusiones. La prescripción de fármacos off-label y/o unlicensed es una práctica habitual en la unidad de cuidados intensivos pediátricos. Este estudio permite documentar la complejidad de la terapéutica en niños.

COVID-19 Infection among Nursing Students in Spain: The Risk Perception, Perceived Risk Factors, Coping Style, Preventive Knowledge of the Disease and Sense of Coherence as Psychological Predictor Variables: A Cross Sectional Survey.

The exploration of patterns of health beliefs about COVID-19 among nursing students may be beneficial to identify behaviors, attitudes and knowledge about contagion risk. We sought to analyze the variables of risk perception, perceived risk factors, coping style, sense of coherence and knowledge of preventive measures as possible predictors of having suffered from COVID-19. Participants were nursing students from 13 universities in Spain. Sociodemographic and health variables were collected. To test the independent variables, the Perception Risk Coping Knowledge (PRCK-COVID-19) scale was created and validated because there was no specific survey for young people adapted to the pandemic situation of COVID-19. It was validated with adequate psychometric properties. A total of 1562 students (87.5% female, mean age 21.5 ± 5.7 years) responded. The high perception of the risk of contagion, the high level of knowledge and a coping style focused on the situation were notable. Significant differences by gender were found in the coping styles, problem-focused, avoidance and knowledge scales, with women scoring higher in all categories. The multiple regression analysis was significant (F = 3.68; p < 0.001). The predictor variables were the coping styles subscale search for support and the intrinsic and extrinsic perceived risk factors. Our model predicts that nursing students with a social support-based coping style are at a higher risk of becoming infected with COVID-19, based on their own health belief model.

Psychological Impact during Confinement by COVID-19 on Health Sciences University Students-A Prospective, Longitudinal, and Comparative Study.

BACKGROUND: The objective was to analyze the factors that influence reactions to confinement situations, such as personality, humor, coping with stressors, and resilience, and to compare this population with a normal situation of exposure to an intense academic stressor such as a partial test, and with the confinement situation caused by the COVID-19 pandemic. METHODS: A longitudinal study was performed involving 116 health sciences students from Spain. Three situations were evaluated: a basal situation of normality at the beginning of the course, situation facing an academic stressor (partial test), and confinement situation due to COVID-19. The Positive and Negative Affect Schedule (PANAS), Coping Orientation to Problems Experienced (COPE), Connor-Davidson Resilience Scale, and NEO-FFI scale were used. RESULTS: Significant differences were observed in the increase in negative humor and decrease in positive one, as well as decrease in "Focus on and Venting of Emotions". Personality factors that better predict humor at confinement were "conscientiousness" for having positive humor and low "extraversion" for negative humor. CONCLUSIONS: The confinement situation due to COVID-19 has caused changes in predominant humor, as well as in coping strategies. Personality factors positively or negatively influence the situation.

Aplicación del método canguro durante la vacunación en población pediátrica / Application of Kangaroo-Mother care method (development-focused care) during vaccination in pediatric population

Objetivo principal: Comparar el dolor de niños menores de 12 meses durante la vacunación inyectada, aplicada con técnica convencional (TCon) o técnica canguro (TC), y evaluar nivel de satisfacción de padres con estas técnicas. Metodología: Estudio transversal con 70 niños en consultas de enfermería pediátrica de Atención Primaria. Se evaluó dolor inmediato tras vacunación con escala LLANTO y nivel de satisfacción de padres con escala “semáforo”. Se analizaron datos con prueba t-Student, análisis de varianza, regresión lineal, prueba de Bonferroni y análisis multivariante. Resultados principales: La puntuación media de dolor de niños vacunados con TC (1,43 ± 0,6) fue menor respecto a los vacunados con TCon (3,94 ± 1,3 puntos), siendo la diferencia estadísticamente significativa (p<0,001). El nivel de satisfacción de padres fue mayor en los vacunados con TC (83,3 % VS 3,3 %). Conclusión principal: El grupo TC mostró menores puntuaciones de dolor y mayor nivel de satisfacción de los padres.(AU)

Objective: To compare pain showed in children under 12 months during vaccine injection, applied either with conventional technique (CT) or kangaroo-mother care method (KC), and to assess satisfaction level of parents with these techniques. Methods: Cross-sectional study with 70 children in pediatrics nursing consultations in Primary Healthcare. Immediate pain after vaccination was assessed with LLANTO scale and satisfaction level of parents was assessed with “signal” scale. Data were analyzed with Student-t test, analysis of variance, lineal regression, Bonferroni test and multivariate analysis. Results: The mean pain score of the children vaccinated with KC (1.43 ± 0.6) was lower than those vaccinated with the CT (3.94 ± 1.3 points), being statistically significant difference (p<0.001). The satisfaction level of parents was higher in children vaccinated with KC (83.3% VS 3.3%). Conclusions: The CT group showed lower pain scores and higher satisfaction level of parents.(AU)

Occupational and Leisure-Time Physical Activity Related to Job Stress and Job Satisfaction: Correspondence Analysis on a Population-Based Study.

BACKGROUND: Leisure-time physical activity (LTPA) is not the same as occupational activity. Various factors influence both forms of physical activity, including job stress and job satisfaction, but the associations found are weak, and the need for new studies in large populations is emphasized. The objective was to study the relationship between job stress and job satisfaction, and the relationship between these and occupational and leisure-time physical activity according to the National Survey of Health 2017. METHODS: A population-based study of 8716 workers between 18 and 65 years of age. The variables age, sex, leisure, and occupational-time physical activity (OTPA), educational level, type of occupation, job stress level, and job satisfaction were collected. A simple and multiple correspondence analysis was performed between the variables that reached statistical significance. RESULTS: 4621 cases (53.02%) correspond to men with a mean age of 44.83 years (SD 10.22) and 4095 cases to women with a mean age of 44.55 years (SD 10.23). Women had higher percentages of higher education (p < 0.001), intermediate to high occupations and unskilled (p < 0.001), job stress (p < 0.001), covered the most extreme levels of satisfaction (p = 0.003), and do less LTPA (p < 0.001) and OTPA (p < 0.001). Also, in women a relationship was found between job stress and LTPA (p = 0.024), as well as between satisfaction and both forms of physical activity (OTPA p = 0.013 and LTPA p < 0.001). In men, significance was only reached in the relationship between job stress and OTPA (p <0.001). CONCLUSIONS: The higher the job stress, the less the job satisfaction, but the relationship is reversed in the intermediate categories. For both sexes, job stress is related to a sedentary lifestyle and higher employment and education levels. Higher levels of satisfaction correspond to higher levels of occupancy. The relationship between job satisfaction and educational level is direct in women but inverse in men. In women, there is a relationship between sedentary occupations and job satisfaction. In addition, intense physical activity at work is related to higher levels of job stress, lower satisfaction levels, and less physical activity in leisure-time.

Design of the EBE-ST Questionnaire among Nursing Students: Multicenter Study from Eight Universities in Spain.

BACKGROUND: Twenty years after the degree in nursing was introduced in Spain, the subject of evidence-based nursing is still unstructured and unestablished in most faculties. Moreover, there are hardly any rigorous studies at a national level that evaluate the current state of this competence in our faculties. Understanding the starting point is essential for the curricular design to ensure that evidence-based practice is implemented among future professionals. AIM: To design and validate an evidence-based nursing competency questionnaire for fourth-year nursing students. METHODS: A specific questionnaire was developed and validated (EBE-ST). A cross-sectional survey design with psychometric validation of an instrument. Participants were 304 senior year nursing students from eight universities in Spain (2020). RESULTS: The EBE-ST questionnaire is composed of 33 items that determine eight factors. It presents adequate reliability and validity (alpha = 0.882), measuring knowledge, attitudes and the practical application of evidence-based practice. CONCLUSIONS: We have created an instrument with good psychometric properties to measure evidence-based practice competence among senior nursing students. The heterogeneity of knowledge regarding evidence-based nursing in our country suggests that further reflection is warranted on the incorporation of this topic during undergraduate training. We have designed and validated an evidence-based nursing competency questionnaire specific to nursing students.

Validación de la escala de convivencia con artrosis en la población española / Validation of the living with osteoarthritis in Spanish population

Objetivo: Presentar los resultados psicométricos de la escala de convivencia con artrosis (EC-Artrosis) en la población española. Diseño: Estudio observacional, multicéntrico y transversal, con retest en una fracción de la muestra. Emplazamiento: Centros públicos y privados de atención primaria y secundaria, así como asociaciones de pacientes con artrosis de Navarra, La Rioja, Madrid, Valencia y Málaga. Participantes: La muestra estuvo compuesta por un total de 291 pacientes con diagnóstico de artrosis por su médico, en cualquier estadio de la enfermedad de atención primaria o especializada, nacionalidad española, y no hospitalizados. Intervenciones: De manera adicional a la EC-Artrosis, se incluyó un cuestionario sociodemográfico y escalas para evaluar el apoyo social percibido por el paciente (DUFSS), la calidad de vida relacionada con la salud (WHOQOL-BREF) y la escala de satisfacción con la vida del paciente. Mediciones principales: Se analizaron las propiedades psicométricas de la escala EC-Artrosis, tales como viabilidad y aceptabilidad, fiabilidad (consistencia interna y estabilidad), precisión y validez de constructo (convergente, interna y para grupos conocidos). Resultados : El 100% de los datos fueron computados. La calidad de los datos y la aceptabilidad fueron excelentes. El alfa de Cronbach para el total de la escala fue de 0,87 y el índice de homogeneidad de 0,22. El ICC para el total de la escala fue de 0,88. En cuanto a la precisión, el valor del EEM fue de 5,18 (<½DE=7,47). Conclusiones: La EC-Artrosis ha mostrado ser un instrumento válido y fiable para evaluar la convivencia del paciente con artrosis a nivel nacional.(AU)

Objective: Present the psychometric results of the Living with Osteoarthritis (LW-OA) in Spanish population. Design: Observational, cross-sectional and multicenter study, with retest on a fraction of the sample. Location: Public and private centres of primary and secondary healthcare, as well as patient associations from Navarra, La Rioja, Madrid, Valencia and Malaga. Participants: The sample was composed by 291 patients with OA with a medical diagnosis in every stage of the disease from primary or secondary healthcare, Spanish nationality and not hospitalized. Interventions: In addition to LW-OA, a sociodemographic questionnaire was included, as well as scales to evaluate social support perceived from the patient (DUFSS), quality of life (WHOQOL-BREF) and satisfaction with life. Main measurements: Psychometric properties of the LW-OA were measured, as viability and acceptability, reliability (internal consistency and reproducibility), precision and construct validity (convergent, internal and known-groups). Results: 100% of the data were computable. Excellent data quality was obtained. Cronbach's alpha for the scale total was 0.87 and the homogeneity index 0.22. ICC for the scale total was 0.88. As for precision, the SEM was 5.18 (<½DE=7.47). Conclusions: The LW-OA is a valid and feasible measure to evaluate the process of living with OA in Spain.(AU)

[Validation of the living with osteoarthritis in Spanish population]. / Validación de la escala de convivencia con artrosis en la población española.

OBJECTIVE: Present the psychometric results of the Living with Osteoarthritis (LW-OA) in Spanish population. DESIGN: Observational, cross-sectional and multicenter study, with retest on a fraction of the sample. LOCATION: Public and private centres of primary and secondary healthcare, as well as patient associations from Navarra, La Rioja, Madrid, Valencia and Malaga. PARTICIPANTS: The sample was composed by 291 patients with OA with a medical diagnosis in every stage of the disease from primary or secondary healthcare, Spanish nationality and not hospitalized. INTERVENTIONS: In addition to LW-OA, a sociodemographic questionnaire was included, as well as scales to evaluate social support perceived from the patient (DUFSS), quality of life (WHOQOL-BREF) and satisfaction with life. MAIN MEASUREMENTS: Psychometric properties of the LW-OA were measured, as viability and acceptability, reliability (internal consistency and reproducibility), precision and construct validity (convergent, internal and known-groups). RESULTS: 100% of the data were computable. Excellent data quality was obtained. Cronbach's alpha for the scale total was 0.87 and the homogeneity index 0.22. ICC for the scale total was 0.88. As for precision, the SEM was 5.18 (<½DE=7.47). CONCLUSIONS: The LW-OA is a valid and feasible measure to evaluate the process of living with OA in Spain.

The role of psychological variables in improving resilience: Comparison of an online intervention with a face-to-face intervention. A randomised controlled clinical trial in students of health sciences.

BACKGROUND: Most studies on improving resilience lack representative samples and pre- and post-intervention assessments. Results regarding the effectiveness of online interventions versus face-to-face interventions are mixed. OBJECTIVES: To evaluate the effectiveness of online and face-to-face programmes for the improvement of coping strategies to develop resilience to stressful situations, and to assess their relationship with personality traits, mood, and academic stressors. DESIGN: Randomised controlled clinical trial. Three-armed parallel design. PARTICIPANTS: 245 students of the Nursing and Physical Therapy Degree. METHODS: Students were randomly assigned to the control group (CG), intervention group 1 (IG-1, face-to-face) or intervention group 2 (IG-2, online). They were assessed after the intervention with the following instruments: the Positive and Negative Affect Schedule (PANAS), the Academic Stressors Scale, the Coping Orientation to Problems Experienced (COPE), the Connor-Davidson Resilience Scale, and the NEO-FFI scale. RESULTS: Negative affect was higher in IG-1 (p = 0.12). The greatest stressors were methodological deficiencies of the teaching staff, academic overload, and beliefs about academic performance. The most widely used coping strategies were "Active Problem-Focused Coping" and "Seeking Social Support". There were differences between IG-1 and IG-2 only regarding "Focus on and Venting of Emotions" (p = 0.086). On the Resilience scale, "Persistence, Tenacity, and Self-Efficacy" was higher in the CG, and there were differences with IG-1 (p = 0.06). With respect to the traits measured by the NEO-FFI questionnaire, higher levels of emotional instability (neuroticism) were observed in IG-1 than in the CG (p = 0.06). CONCLUSIONS: The results of both interventions are similar, with increased self-awareness of negative personality traits, which is useful for those ignoring their areas for improvement. In addition, these factors are further increased in individuals with high levels of neuroticism and low levels of extraversion. The online intervention was as effective as the face-to-face intervention.

Prevalence of Nipple Soreness at 48 Hours Postpartum.

Background: Although most women start breastfeeding after delivery, difficulties often arise. One of the main reasons is nipple soreness, which contributes greatly to early cessation of breastfeeding. A soreness evaluation through validated scales, performed by health care professionals during the first few days, can contribute to improve breastfeeding and support for the mothers. Research Aim: Knowing the prevalence of nipple soreness during breastfeeding at 48 hours postpartum at the Infanta Cristina University Hospital (Madrid, Spain) through a cross-sectional descriptive study. Materials and Methods: The study took place between February and March 2019. A survey of 58 postpartum second day mothers was conducted including the Visual Analogue Scale (VAS) and Lactation Assessment Scale (LATCH) score for breastfeeding assessment. A descriptive analysis of secondary variables and subsequent bivariate inferential was performed for 95% confidence interval (CI). Results: The prevalence of nipple soreness observed is 97% (95% CI = 92-100%). It was found, significantly (p = 0.001), that the higher the score on LATCH, the lower the score on VAS and therefore the less pain. We found a relationship between women who were in skin-to-skin contact with their babies for 2 hours without interruption after birth and a higher pain score (p = 0.046). No other associations were found between VAS and other variables such as parity, type of birth, artificial milk supplements for the newborn, or using a pacifier. Conclusions: The high percentage of nipple soreness detected highlights that breastfeeding can be unpleasant in the first days after delivery. It is important to include in clinical practice the assessment of nipple soreness and the effectiveness of breastfeeding using validated scales.

Diagnóstico de Enfermería: dolor crónico. Análisis crítico de sus características definitorias / Nursing diagnosis: chronic pain. Critical analysis of its defining characteristics

OBJETIVO: análisis crítico de las características definitorias propuestas en el Diagnóstico de Enfermería [00133] Dolor Crónico, según la taxonomía NANDA. MÉTODO: revisión narrativa de las características definitorias del diagnóstico y su relación con el mismo. Se llevó a cabo una búsqueda bibliográfica en diferentes bases de datos: Cinahl, Pubmed, Cuiden, Scopus, Dialnet y Scielo. Se usaron los descriptores: "chronic pain", "diagnosis" y "nursing". La búsqueda se limitó a publicaciones de los últimos cinco años, en español e inglés. RESULTADOS: el dolor crónico es un problema de salud pública mundial que persiste durante un periodo superior a tres meses. El dolor crónico se considera no solo como un síntoma sino como una enfermedad asociada a alteraciones en el ámbito físico, psicológico, emocional, laboral, social y sexual. Con respecto al aspecto psicológico y emocional prevalece la depresión, la ansiedad y el miedo, lo que en el plano físico puede conllevar a una discapacidad. Las características definitorias del diagnóstico de Enfermería dolor crónico encontradas fueron: "Alteración en la habilidad para continuar con las actividades previas", "Cambios en el patrón del sueño", "Atención centrada en el yo", "Anorexia", "Informes, autoinformes y listas de verificación como características definitorias del diagnóstico". CONCLUSIONES: es necesario revisar las características definitorias de "alteración en la habilidad para continuar con las actividades previas" y "anorexia" al no haber encontrado evidencias de que estas sean realmente características que identifiquen este diagnóstico. Valorar la inclusión de "miedo al dolor" con el fin de ayudar a identificar más fácilmente este diagnóstico

OBJECTIVE: a critical analysis of the defining characteristics described in the Nursing Diagnosis [00133] Chronic Pain, according to the NANDA taxonomy. METHOD: a narrative review of the defining characteristics of the diagnosis and their relationship with it. A bibliographic search was conducted in different databases: Cinahl, Pubmed, Cuiden, Scopus, Dialnet and Scielo. The following keywords were used: "chronic pain", "diagnosis" and "nursing". The search was limited to publications within the past five years, in Spanish and English. RESULTS: chronic pain is a global public health problem which persists during a period over three months. Chronic pain is not only considered a symptom but a disease, associated with alterations in the physical, psychological, emotional, occupational, social and sexual settings. In terms of the psychological and emotional aspect, there is a prevalence of depression, anxiety and fear, which can lead to disability. The defining characteristics found in the Chronic Pain Nursing Diagnosis were: "Altered ability to continue previous activities", "Changes in Sleep Pattern", "Self-focused", "Anorexia", "Reports, self-reports and check-lists as defining characteristics of diagnosis". CONCLUSIONS: it is necessary to review the characteristics defining "Altered ability to continue previous activities" and "Anorexia", because no evidence was found that these were really characteristics identifying this diagnosis. The inclusion of "Fear of Pain" must be assessed, with the aim to help to identify this diagnosis more easily

Impact of social and occupational factors over job control.

BACKGROUND: Psychosocial risk factors, among which job control has proved to be a key dimension, can have a negative impact on the health of workers. Various research projects have found a relationship between low levels of free time at work and stress and job satisfaction indicators. OBJECTIVES: to assess to what extent certain social and employment variables influence "job control". METHODS: A descriptive study was carried out on a sample of workers to analyse the influence of certain socio-demographic and work-related variables on job control, by means of an assessment survey on psychosocial risk and the general state of workers' health. The tools used in this study were the COPSOQ-ISTAS 21 version 1.5 psychosocial risk assessment questionnaire and a specific survey on the perceived state of health. RESULTS: Three hundred fourteen workers were asked to participate in the study. One hundred and ninety workers completed the questionnaire and were finally included. For the "job control" variable, 47.4% of workers described their situation as good. The results show that workers with a higher educational level (+78%), who have seniority in the job, have a good understanding of their situation at work (+15%), and are employed as white collars (34%), are more likely to show high job control and, therefore, could be less at risk from psychosocial factors. CONCLUSIONS: There are two parameters influencing "job control": social factors concerning educational level, and work situation factors, including seniority and being a white collar worker.

Occupational and work-related disease underestimated and linked to temporary disability through Primary Health Care Services.

AIM: To estimate the occupational disease linked to temporary incapacity (not work-related illness). BACKGROUND: The under-reporting of occupational disease is a recognized problem in Europe. METHODS: Cross-sectional study conducted in Spanish adult population using periods of temporary incapacity recorded in primary care during 2015. Rates of occupational disease were estimated using the García & Gadea study. RESULTS: A total of 130,771 episodes of temporary incapacity were studied from 91,448 people, and 56,092 were women (61.3%). The overall prevalence rate was 2,096 and was higher in women (2,504) than in men (1,665) (p < 0.001). It was estimated that 6,580 (7.2%) could be suffering from an occupational disease. Musculoskeletal complaints were the commonest, affecting 75,165 people (82.2%). For the binary logistic regression, the dependent variable was the existence or lack of incapacity due to a musculoskeletal pathology. Age acts as a protective factor (adjusted OR = 0.978). The periods off work due to musculoskeletal complaints are lower in the first quarter of the year [OR > 1; p < 0.001]. CONCLUSIONS: 7.2% of the population was estimated to be off work due to an occupational disease. This estimate reflects the well-known under-reporting of occupational diseases which are dealt with by the Public Health System instead of specialized clinics. IMPLICATIONS FOR NURSING MANAGEMENT: The interdisciplinary role of the occupational health nurse makes it an adequate professional to detect the cases of occupational diseases in primary care settings. Occupational Health Nursing has been recognized by the managers as the most suitable professionals to carry out the screening of occupational diseases in Primary Care.

The Dynamic Baropodometric Profile of Children with Idiopathic Toe-Walking A Cross-Sectional Study.

BACKGROUND: Idiopathic toe-walking (ITW) gait may present in children older than 3 years and in the absence of a medical condition known to cause or be associated with toe-walking gait. It is unknown how this gait type changes pressure distribution in the growing foot. We sought to determine whether children with ITW gait exhibit different plantar pressures and temporal gait features than typically developing children. METHODS: Children aged 3 to 6 years were recruited who had either a typical heel-toe gait pattern or a diagnosis of ITW. The ITW diagnosis was reported by the parent/caregiver and confirmed through history and physical examination. Temporal gait measures, peak pressures, and impulse percentages were measured. A minimum of ten unshod footprints were collected. Data were compared with unpaired t tests. RESULTS: The study included 40 children with typical gait and 56 with ITW gait. The ITW group displayed lower peak pressures at the hallux, midfoot, and hindfoot ( P < .05) and higher and lower pressure impulse percentages at the forefoot ( P < .001) and hindfoot ( P < .001), respectively. The ITW group spent a higher percentage of contact time at all areas of the forefoot and less at the midfoot and rearfoot ( P < .05). There were no significant differences in total step duration and foot progression angle between groups ( P > .05). CONCLUSIONS: There were differences in pressure distributions between groups. Understanding these differences may help us better understand the compensations or potential long-term impact that ITW gait may have on a young child's foot. Podiatric physicians may also consider the use of this equipment in the clinical setting to measure outcomes after treatment for ITW.