Placing myself in a new normalized life: The process of becoming a first-time father. A grounded theory study.

Becoming a first-time father is an important transition period in men's lives that is frequently accompanied by joy and happiness. Engaging fathers has a broader impact on family and community and on fathers' own well-being. This study explores the process of men becoming first-time fathers and the experiences and challenges involved. Seventeen interviews with men in different stages of pregnancy, childbirth, and the postpartum period were conducted. Through a grounded theory design, a novel four-stage theoretical model emerged that represents the journey to first-time fatherhood. These stages are beginning the journey, fatherhood in limbo, facing reality, and settling down. Participants suggested that achieving a new normality was the final stage where they finally felt located with a sense of mastery in their journey to fatherhood. The novel theoretical approach of addressing the process of men's transition allowed more complete access to their perspectives. Men's needs are different at every phase of the transition to fatherhood, and the use of these findings can help care providers in caring for every man according to the stage he is facing.

Internal developmental assets and substance use among Hispanic adolescents. A cross-sectional study.

AIMS: To determine the associations between internal assets (planning and decision-making, interpersonal competence and commitment to learning) and substance use (tobacco, alcohol, binge drinking, marijuana use and other drugs). DESIGN: A cross-sectional study was conducted in four countries (Chile, Mexico, Spain and Peru). METHODS: Adolescents aged 12-18 self-completed a multi-purpose questionnaire between 2016 and 2019. Multiple logistic regressions and structural equation models were performed to analyse the association between internal assets (planning and decision-making, interpersonal competence, and commitment to learning) and substance use. RESULTS: The results indicate that planning and decision-making and commitment to learning are conducive to the prevention of substance use. On the contrary, interpersonal competence was not associated with substance use. CONCLUSION: The present study shows that planning and decision-making and commitment to learning can be relevant factors in explaining substance use during adolescence. Internal assets can be an important aspect to include in health promotion interventions with children, youth and families to prevent substance use. These findings may be useful for researchers, schools, paediatric nurse practitioners, and health professionals in general to design health programs focused on children and adolescents. Furthermore, the Developmental Assets framework has been proved as a suitable frame of reference for paediatric nurse practitioners to assess and develop child and adolescent positive development and design health promotion interventions to prevent substance use.

Development of a taxonomy of activities in health prevention and promotion for primary care.

AIM: To develop a taxonomy of activities in health prevention and promotion for primary care. BACKGROUND: Despite health promotion being considered a keystone for population health and health care sustainability, its implementation remains insufficient. Customized evaluation tools are needed to address prevention and promotion omissions in primary care. METHOD: A taxonomy was designed using documentary analysis. Documents describing frontline primary care professionals' health prevention and promotion activities or omissions were identified and analysed using framework analysis. RESULTS: The 'Taxonomy of Activities in Health Prevention and Promotion for Primary Care' (TaxoPromo) includes 43 activities grouped into eight categories: planification, situational analysis, capacity building, development of awareness/public opinion, advocacy, development of networks, development of partnerships and intervention strategies. CONCLUSION: By contrasting the usual practices with the activities collected in the TaxoPromo, opportunities for improvement can be unveiled. IMPLICATIONS FOR NURSING MANAGEMENT: The TaxoPromo can be used at organisational and system levels to identify actions to integrate health prevention and promotion activities into a systematic, data-driven process; design implementation plans and tailor-made strategies for capacity building; enable benchmarking; and address omissions. The TaxoPromo can serve as a catalyst tool for the clarification and expansion of the nursing role in health prevention and promotion.

A valid and reliable scale to assess cultural sensibility in nursing.

BACKGROUND: Cultural sensibility is an important concept linked to the achievement of cultural competence. Health professionals must first improve their cultural sensibility to become culturally competent and to be able to offer competent care to culturally diverse populations. Aim To develop and psychometrically test the Cultural Sensibility Scale for Nursing (CUSNUR), a cultural sensibility scale that can be used in nursing for the achievement of competencies needed to care for culturally diverse populations. DESIGN AND METHODS: The cross-sectional survey was conducted over two stages. The first stage involved the cross-cultural and discipline-specific adaptation of an existing scale addressing this concept in the field of law using the reverse translation method. Second, validation of the scale was carried out from October 2016-June 2017 by studying the psychometric properties of the questionnaire through an analysis of content acceptability and reliability and through exploratory factor analysis (EFA). RESULTS: The questionnaire was designed to be clear, easy to understand, and of adequate length, and experts involved in content validation agreed that the scale meets these criteria. A total of 253 nursing students participated in the validation stage. Four factors were identified from the EFA: (1) patient and health professional behaviours, (2) self-assessments, (3) self-awareness, and (4) cultural influence. Two items were excluded. Factorial saturation is adequate for all factors (>0.30). The Cronbach alpha was measured as 0.75. CONCLUSIONS: This study presents the first version of the CUSNUR and demonstrates that the scale is valid and reliable.

Different Responses to Stress, Health Practices, and Self-Care during COVID-19 Lockdown: A Stratified Analysis.

The aim of the present cross-sectional study was to analyze the differential impact of the first COVID-19 lockdown (3 April 2020) on stress, health practices, and self-care activities across different Hispanic countries, age range, and gender groups. One thousand and eighty-two participants from Spain, Chile, Colombia, and Ecuador took part in this study. Irrespective of the country, and controlling for income level, young people, especially females, suffered a greater level of stress, perceived the situation as more severe, showed less adherence to health guidelines, and reported lower levels of health consciousness, in comparison to their male peers and older groups. However, in the case of self-care, it seems that older and female groups are generally more involved in self-care activities and adopt more healthy daily routines. These results are mostly similar between Colombia, Ecuador, and Spain. However, Chile showed some different tendencies, as males reported higher levels of healthy daily routines and better adherence to health guidelines compared to females and people over the age of 60. Differences between countries, genders, and age ranges should be considered in order to improve health recommendations and adherence to guidelines. Moreover, developing community action and intersectoral strategies with a gender-based approach could help to reduce health inequalities and increase the success of people's adherence to health guidelines and self-care-promoting interventions. Future studies should be addressed to explore the possible causations of such differences in more cultural-distant samples and at later stages of the current outbreak.

Six-month breastfeeding maintenance after a self-efficacy promoting programme: an exploratory trial.

BACKGROUND: Breastfeeding care plays a fundamental role in establishing breastfeeding and longer duration after discharge. Practices though vary among professionals involved and are often inconsistent with good practices recommended, being a threat to women's breastfeeding self-efficacy. Breastfeeding self-efficacy is considered a predictor for successful breastfeeding and a significant variable amenable to intervention for promoting lactation AIM: To evaluate the efficacy, feasibility and acceptability of a new breastfeeding self-efficacy promoting programme (SIALAC) on 6-month breastfeeding maintenance. METHODS: In this exploratory multi-centre controlled trial, participants were allocated into control and intervention groups sequentially. Professionals in charge of the treatment groups were trained in between, with an especial focus on reducing practice variability. Control and intervention group women received usual care, and the intervention group received in addition SIALAC, a three-stage breastfeeding self-efficacy promoting programme. Primary outcome was breastfeeding maintenance up to 6 months analysed by Kaplan-Meier and Cox proportional hazard regression analysis. Student's t-test or chi-square tests were also used for continuous and categorical variables. Data on breastfeeding status and breastfeeding self-efficacy were collected at baseline, and 4, 8 and 24 weeks after birth. RESULTS: From May 2014 through November 2015, participants were enrolled. The sample consisted of 112 women. No relevant socio-demographic or obstetric difference was found between groups. The intervention achieved a significant difference between groups in breastfeeding survival (X2  = 4.94, p = 0.026). Six-month breastfeeding maintenance was significantly higher in the intervention group (67% vs. 55%; X2  = 5.384, p = 0.020). Breastfeeding dropout in the control group was 3.3 (CI 1.1, 10.1) times higher than that of the intervention group at 6 months. Breastfeeding self-efficacy scores were higher in the intervention group although without significant statistical difference. The programme showed good acceptability. CONCLUSION: Breastfeeding self-efficacy promoting programme SIALAC was beneficial in fostering 6-month breastfeeding survival. Full-scale trial should consider feasibility-related issues identified.

Connections between Family Assets and Positive Youth Development: The Association between Parental Monitoring and Affection with Leisure-Time Activities and Substance Use.

This study aimed to determine the associations between parental monitoring and affection and three adolescent lifestyle aspects: constructive leisure, non-constructive leisure and substance use. A cross-sectional study was conducted in four countries (Chile, Mexico, Spain and Peru). Adolescents aged 12-15 self-completed a multi-purpose questionnaire. Multiple logistic regressions were performed to analyse the association between the parental monitoring and affection variables and the outcomes in terms of the children's lifestyles. The results indicate that parental monitoring is conducive to more constructive leisure and less non-constructive leisure and seems to be conducive to the prevention of substance use. Furthermore, parental affection is conducive to constructive leisure and the prevention of substance use. The discussion focuses on the fact that the family can be a protective resource associated with positive adolescent development.

Design, implementation and evaluation of an education course to promote professional self-efficacy for breastfeeding care.

The objective of this study was to determine the effect of an education short course on professional' self-efficacy in the area of breastfeeding care. The intervention had a pre-post design. A total of 43 healthcare professionals attended the course. The Kirkpatrick model for the development, implementation and evaluation of education actions was used for a 4.5-h course. The aspects evaluated included professionals' satisfaction and learning regarding confidence to support lactating mothers, perceived transfer of knowledge to the workplace and organizational changes. Data were collected using self-administered questionnaires (participants, unit managers, and education planners), before and after the intervention. Participants' satisfaction with the education action was high in all of the aspects measured (greater than 3.9 in scores of 0-5). Professionals showed a significant increase in self-efficacy levels for supporting breastfeeding (Wilcoxon test p-value = < 0.05, before intervention: median = 55, [IQR] = 11; after intervention: median = 60, [IQR] = 14). Participants, managers and organizers of the course identified changes in the way that professionals cared for breastfeeding mothers. In conclusion, this educational intervention enhanced professional self-efficacy and performance in breastfeeding care.

Encounters between children's nurses and culturally diverse parents in primary health care.

The objective of this study was to analyze the healthcare encounters between nurses and parents of different cultural backgrounds in primary health care. An ethnographic study was carried out using participant observations in health centers and interviews with nurses. Data were analyzed using thematic content analysis and constant comparative method. Four main themes were identified when nurses met parents of other cultural backgrounds: lack of mutual understanding, electronic records hamper the interaction, lack of professionals' cultural awareness and skills, and nurses establish superficial or distant relationships. The concepts of ethnocentrism and cultural imposition are behind these findings, hampering the provision of culturally competent care in primary health services. There were difficulties in obtaining and registering culturally related aspects that influence children's health and development. This was due to e-records, language barriers, and the lack of cultural awareness and skills in health professionals making the encounters difficult for both nurses and parents. These findings show that there is a clear threat for health equity and safety in primary care if encounters between nurses and parents do not improve to enable nursing care to be tailored to any individual family needs.

Social and emotional competence as key element to improve healthy lifestyles in children: A randomized controlled trial.

AIM: To show the results of an exploratory trial based on social and emotional learning to promote healthy lifestyles in 5-6 aged children. DESIGN: A randomized controlled trial. METHOD: The study was conducted from 2015-2016. Thirty-seven children were allocated to the intervention group (N = 19) and control group (N = 18). A multi-method and multi-component evaluation approach was used to capture the preliminary efficacy, acceptability, and feasibility of the programme. Repeat measures ANOVA followed by an ANCOVA tests were applied for the inferential analysis and for qualitative data, a content analysis was used. RESULTS: Positive effects on emotional perception and resilience were found in children's intervention group. Children and families showed high programme's acceptability and a wide range of barriers and facilitators were identified during the implementation process. CONCLUSION: Predicted mechanisms to improve healthy lifestyles in children throughout social and emotional competence seem to be supported by some of the study's results. However more research is needed to replicate such results and confirm these mechanisms. ClinicalTrials.gov Identifier: NCT02975544.

Cinco paradojas de la promoción de la salud / Five paradoxes in health promotion

La Organización Mundial de la Salud considera que la promoción de la salud es una estrategia fundamental para aumentar la salud de la población, concibiéndola como un proceso global que permite a las personas incrementar el control sobre su salud para mejorarla. Así, la promoción de la salud no se centra únicamente en capacitar a los individuos trabajando sus conocimientos, actitudes y habilidades, sino que tiene en cuenta las esferas políticas, sociales, económicas y ambientales que influyen en la salud y el bienestar. La complejidad de aplicar estos conceptos se refleja en las cinco paradojas de la promoción de la salud que surgen entre la retórica y la puesta en práctica de sus principios. Las paradojas que se identifican y discuten en este trabajo son el paciente versus la persona, lo individual versus lo colectivo, los profesionales de la enfermedad versus los profesionales de la salud, los indicadores de enfermedad versus los indicadores de salud y la salud como gasto versus la salud como inversión. Hacer explícitas estas contradicciones puede ayudar a identificar los motivos por los que resulta tan compleja la aplicación de los conceptos relacionados con la promoción de la salud, y a plantear líneas de trabajo que faciliten su puesta en práctica (AU)

The World Health Organization states that health promotion is a key strategy to improve health, and it is conceived as a global process of enabling people to increase control over, and to improve, their health. Health promotion does not focus solely on empowering individuals dealing with their knowledge, attitudes and skills, but it also takes political, social, economic and environmental aspects influencing health and wellbeing into account. The complexity of applying these concepts is reflected in the five paradoxes in health promotion; these arise in between the rhetoric in health promotion and implementation. The detected paradoxes which are described herein involve the patient versus the person, the individual versus the group, disease professionals versus health professionals, disease indicators versus health indicators, and health as an expense versus health as an investment. Making these contradictions explicit can help determine why it is so complex to put the concepts related to health promotion into practice. It can also help to put forward aspects that need further work if health promotion is to put into practice (AU)

[Five paradoxes in health promotion]. / Cinco paradojas de la promoción de la salud.

The World Health Organization states that health promotion is a key strategy to improve health, and it is conceived as a global process of enabling people to increase control over, and to improve, their health. Health promotion does not focus solely on empowering individuals dealing with their knowledge, attitudes and skills, but it also takes political, social, economic and environmental aspects influencing health and wellbeing into account. The complexity of applying these concepts is reflected in the five paradoxes in health promotion; these arise in between the rhetoric in health promotion and implementation. The detected paradoxes which are described herein involve the patient versus the person, the individual versus the group, disease professionals versus health professionals, disease indicators versus health indicators, and health as an expense versus health as an investment. Making these contradictions explicit can help determine why it is so complex to put the concepts related to health promotion into practice. It can also help to put forward aspects that need further work if health promotion is to put into practice.

Diseño y validez de un instrumento para evaluar la autoeficacia percibida por los profesionales de la salud acerca de su capacidad para procurar cuidados a las madres que amamantan / Design and validity of an instrument to evaluate health professionals' perceived self-efficacy to care for nursing mothers

La promoción y apoyo a la lactancia materna proporcionado por profesionales de la salud en diferentes entornos es una de las estrategias con evidencia de resultados exitosos. El propósito de este estudio es desarrollar una escala para conocer la autoeficacia percibida por los profesionales de salud acerca de su capacidad para procurar cuidados a las madres que amamantan. METODOLOGÍA. El diseño de la escala se hizo utilizando la versión española de la escala BreastfeedingSelf-EfficacyScale-Short Form para madres. Las pruebas de validación se realizaron creando un grupo de expertos y pilotando la herramienta con profesionales que cuidaban a madres lactantes de dos centros asistenciales. Las propiedades psicométricas de la escala se examinaron analizando su validez, fiabilidad, sensibilidad y factibilidad. RESULTADOS. La escala "Autoeficacia Profesional para los Cuidados en Lactancia" (APCLA)contiene 14 ítems conforme al dominio de interés, con opciones de respuesta de 1 a 5. Se elaboró en formato papel y electrónico. Tras la valoración del comité de expertos, se pilotó con 43 enfermeras y matronas. La escala muestra resultados prometedores con respecto a su validez, fiabilidad (Alpha de Cronbach 0,967), sensibilidad (p<0,05) y factibilidad. CONCLUSIÓN. Aunque será necesario continuar con el proceso de validación en otras poblaciones y con mayor número de participantes, el instrumento ha mostrado buenos resultados para la medición de la autoeficacia profesional. La valoración de la autoeficacia profesional para proporcionar cuidados a madres que amamantan ayudará a identificar áreas de formación para profesionales que permitan la reducción de la variabilidad de los cuidados.

The promotion and support of breastfeeding by health professionals in different settings is an interventional strategy with evidence of successful results. The purpose of this study is to develop a scale to understand the self-efficacy perceived by health professionals about their ability to care for breastfeeding mothers. METHODOLOGY. The design of the scale was made using the Spanish version of the 'Breastfeeding Self-Efficacy Scale-Short Form' scale for mothers. The validation tests were done by creating a group of experts and piloting the tool with professionals caring for nursing mothers from two centres. The psychometric properties of the scale were examined by analysing their validity, reliability, sensitivity and feasibility. RESULTS. The scale "Professional Self-Efficacy for Breastfeeding Care" (Autoeficacia Profesional para los Cuidados en Lactancia, APCLA) contains 14 items according to the domain of interest, with response options from 1 to 5. It was elaborated in paper and electronic format. After the assessment of the committee of experts, it was piloted with 43 nurses and midwives. The scale shows promising results with respect to its validity, reliability (Cronbach's Alpha 0.967) sensitivity (p <0.05) and feasibility. CONCLUSION. Although it will be necessary to continue the validation process in other populations and larger numbers of participants, the instrument has shown good results for the measurement of professionals' self-efficacy. Assessing professional perceived self-efficacy to care for breastfeeding mothers will help identify areas of training for professionals and reduce variability in care provision.