The Impact of the COVID-19 Pandemic on Adherence to Endocrine Therapy for Breast Cancer in Catalonia (Spain).

Purpose. To assess the impact of the COVID-19 pandemic on adherence to oral endocrine therapy in patients diagnosed with breast cancer in the public healthcare system in Catalonia (Spain). Methods. Retrospective cohort study in patients starting endocrine therapy from 2017 to 2021. Adherence was measured during the first year of treatment, and the impact of the pandemic was calculated according to the calendar year and whether the first year of treatment included the peak period of the pandemic in our setting (March-September 2020). Analyses were performed using a chi-square test and multivariable logistic regression, with results stratified by year, age group, and drug type. Results. Mean overall adherence during the first year of treatment was 89.6% from 2017 to 2021. In contrast, the patients who started treatment in 2019 and 2020 and whose treatment included the peak pandemic period presented an adherence of 87.0% and 86.5%, respectively. Young age and tamoxifen or combination therapy were predictors of low adherence. An increase in neoadjuvant therapy was also observed in 2020. Conclusions. The COVID-19 pandemic had only a modest impact on adherence to endocrine therapy (≈3%), despite the enormous disruptions for patients, the healthcare system in general, and cancer care in particular that were occurring in that period.

The role experience of advanced practice nurses in oncology: An interpretative phenomenological study.

AIM(S): To understand the experiences of advanced practice nurses working in cancer care. DESIGN: Phenomenological qualitative study. METHODS: Three focus groups were held to collect qualitative data. Participants were recruited through theoretical non-probabilistic sampling of maximum variation, based on 12 profiles. Data saturation was achieved with a final sample of 21 oncology advanced practice nurses who were performing advanced clinical practice roles in the four centers from December 2021 to March 2022. An interpretative phenomenological analysis was performed following Guba and Lincoln's criteria of trustworthiness. The centers' ethics committee approved the study, and all participants gave written informed consent. Data analysis was undertaken with NVivo 12 software. RESULTS: Three broad themes emerged from the data analysis: the role performed, facilitators and barriers in the development of the role and nurses' lived experience of the role. CONCLUSION: Advanced practice nurses are aware that they do not perform their role to its full potential, and they describe different facilitators and barriers. Despite the difficulties, they present a positive attitude as well as a capacity for leadership, which has allowed them to consolidate the advanced practice nursing role in unfavourable environments. IMPLICATIONS FOR THE PROFESSION: These results will enable institutions to establish strategies at different levels in the implementation and development of advanced practice nursing roles. REPORTING METHOD: Reporting complied with COREQ criteria for qualitative research. PATIENT OR PUBLIC CONTRIBUTIONS: No patient or public contribution.

Patients' and professionals' experiences with advanced practice nursing in cancer care: A qualitative study.

PURPOSE: The growing complexity of cancer treatments requires changes in how care is organized and who provides it. The incorporation of advanced practice nursing roles within multidisciplinary teams can improve care in cancer patients. This study aims to understand the lived experience of cancer patients and multidisciplinary professionals in relation to the care provided by advanced practice nurses (APN). METHODS: Phenomenological qualitative study. Data were collected through in-depth interviews and a field diary. Participants were recruited through convenience sampling; until theoretical data saturation was achieved. An interpretative phenomenological analysis was performed, following Guba and Lincoln's criteria for trustworthiness. RESULTS: Interviews were performed with 18 professionals and 11 patients, from high-complexity public hospitals between March-December 2021. The main themes that emerged were: Advanced practice nurse role and competencies, Benefits provided by the APN, and Relevant aspects of nursing care. CONCLUSION: Advanced practice nurses play a fundamental role in cancer care, making positive contributions to the patient experience and to the multidisciplinary team's work. Elucidating the contribution of advanced practice nurses in oncology will facilitate the definition of their specific competencies and, in turn, the implementation of training and management strategies to consolidate this figure in specialized centers.

National validation of the nursing Intensive-Care satisfaction scale: Research protocol.

AIM: Validate the Nursing Intensive-Care Satisfaction Scale in ICUs throughout Spain. Identify the improvement strategies recommended by the patients and professionals. DESIGN: Quantitative psychometric methodology and a cross-sectional descriptive correlational design. METHODS: The study population will be all patients discharged from 19 participating ICUs in Spain. Consecutive sampling (n = 564). Once discharged from the ICUs, they will receive the questionnaire and then, after 48 hours it will be given to them again to analyse the temporal stability. To validate the questionnaire, the internal consistency (Cronbach's Alpha) and temporal stability (test-retest) will be analysed. RESULTS: Improve the quality of nursing care by modifying, changing or strengthening behaviours, skills, attitudes or areas for improvement involved in the process.

La colaboración interdisciplinar en las unidades de cuidados intensivos / Interdisciplinary collaboration in intensive care units from the experience of nurses

Objetivo: Comprender la experiencia vivida por las enfermeras que trabajan en las UCI polivalentes de un hospital de tercer nivel de la ciudad de Barcelona en relación con la colaboración interprofesional. Metodología: Diseño cualitativo exploratorio, multicéntrico de tipo descripción interpretativa. El ámbito de estudio fue cuatro UCI polivalentes de cuatro hospitales públicos y universitarios de tercer nivel. La muestra estuvo formada por 8 enfermeras. El muestreo teórico de variación máxima. La técnica de obtención de información fue el grupo de discusión con grabación de audio. Se realizó un análisis temático de contenido. Se siguieron los criterios de confiabilidad y autenticidad, así como el proceso de reflexividad durante todo el estudio. El estudio fue aprobado por el Comité de Ética de Investigación Clínica (CEIC). Resultados: Emergieron 2 grandes temas: la definición de colaboración interprofesional y propuestas de futuro. Las enfermeras consideran que la confianza y el respeto son la base de la colaboración interprofesional y aseguran la continuidad de los objetivos planificados. La comunicación y la relación entre iguales son dos de los factores que intervienen en la colaboración interprofesional. Es necesario cambiar de una jerarquía convencional a una visión compartida que mejoraría la participación de las enfermeras. Conclusiones: Los grandes pilares de la colaboración interdisciplinar son la comunicación efectiva y el trabajo en equipo, basado en la confianza y el respeto. Las líneas futuras de trabajo van enfocadas a la formación interdisciplinar de los futuros profesionales, la implantación real del pase conjunto y la mejora del clima laboral. (AU)

Purpose: Understanding the nurses experience who work in the ICUs of a high complexity hospital in Barcelona in relation to interprofessional collaboration. Methodology: Interpretative description by a qualitative exploratory and multicenter design. The study area was four ICUs from four high complexity, public and universitary hospitals. The sample consisted of 8 nurses. Theoretical sampling of maximum variation was used. The information gathering technique was the discussion group with audio recording. A thematic content analysis was carried out. The criteria of reliability and authenticity, as well as the process of reflexivity, were followed throughout the study. The study was approved by the Clinical Research Ethics Committee (CEIC). Results: Two major themes emerged: the definition of interprofessional collaboration and proposals for the future. Nurses consider that trust and respect are the basis of interprofessional collaboration and ensure the continuity of planned objectives. Communication and the relationship between equals are two of the factors involved in interprofessional collaboration. It is necessary to change from a conventional hierarchy to a shared vision that would improve the participation of nurses. Conclusions: The great pillars of interdisciplinary collaboration are effective communication and teamwork, based on trust and respect. Future lines of work are focused on the interdisciplinary training of future professionals, the actual implementation of the clinical sessions and the improvement of the work environment. (AU)

Psychometric properties of the Nursing Intensive Care Satisfaction Scale: A multicentre cross-sectional study.

BACKGROUND: Patient satisfaction with nursing care is an indicator of patient satisfaction with the hospital stay in general. The Nursing Intensive Care Satisfaction Scale is the only scale about patient satisfaction with nursing care received in an intensive care unit that incorporates the critically ill patient's perspective into its design and validation. We validated the scale nationally, incorporating intensive care units at public and private hospitals of different levels of complexity in Spain. OBJECTIVES: The objective of this study was to validate in Spanish intensive care units the Nursing Intensive Care Satisfaction Scale, a patient-centred questionnaire that evaluates recently discharged intensive care patients' satisfaction with the nursing care they received. DESIGN: We used a psychometric quantitative methodology and a descriptive cross-sectional design. SETTING AND PARTICIPANTS: The study was conducted in intensive care units at level II and III public and private hospitals throughout Spain. The study population was all patients discharged from intensive care units from December 2018 to December 2019 from the 19 participating hospitals. We used consecutive sampling until reaching a sample size of 677 patients. The assessment instruments were given to patients at discharge and 48 h later to measure temporal stability. METHODS: The validation process included the analysis of internal consistency (Cronbach's α coefficient), temporal stability (test-retest), construct validity through a confirmatory factor analysis, and criterion validity using the Pearson correlation coefficient and three criterion items that assessed similar constructs. RESULTS: The reliability of the scale was 0.97, and the factors obtained values between 0.87 and 0.96. The intraclass correlation coefficient for the total scale was 0.83, indicating good temporal stability. Construct validity showed a good fit and a four-factor structure, in accordance with the theoretical model. Criterion validity presented a correlation that was between moderate and high (range: 0.46 to 0.57). CONCLUSIONS: The Nursing Intensive Care Satisfaction Scale has good psychometric properties, demonstrating its ability to accurately measure patient satisfaction across a range of contexts in Spain. Continuous monitoring of satisfaction will allow nurses to identify areas for improvement that can increase the quality of care.

Satisfaction of intensive care unit patients linked to clinical and organisational factors: A cross-sectional multicentre study.

BACKGROUND: The satisfaction of critical care patients with the nursing care they receive is a key indicator of the quality of hospital care. OBJECTIVES: The objectives of this study were to analyse the level of satisfaction of critical care patients in relation to the nursing care received and to determine the relationship between the level of satisfaction and sociodemographic, clinical, and organisational variables. DESIGN: This was a prospective, descriptive correlational study. SETTING AND METHODS: The population consisted of all patients discharged from the intensive care units (ICUs) of 19 hospitals in Spain between December 2018 and December 2019. The level of satisfaction was measured using the validated Nursing Intensive Care Satisfaction Scale, and sociodemographic, clinical, and organisational data were collected. RESULTS: Participants' mean age (n = 677) was 59.7 (standard deviation: 16.1), and 62.8% of them were men (n = 426). Satisfaction with the nursing care received was 5.66 (SD: 0.68) out of a possible 6. The score for overall satisfaction presented statistically significant relationships with the hours of mechanical ventilation (p = 0.034), with the participant's perception of own health status (p = 0.01), with the participant's perceived degree of own recovery (p = 0.01), with the hospital's complexity level (p = 0.002), with the type of hospital (p = 0.005), and with the type of ICU (p = 0.004). Finally, the logistic regression model shows that the Nursing Intensive Care Satisfaction Scale score was not linked to age or sex but did have a statistically significant relationship with the perceived degree of recovery (p < 0.001) and the type of ICU (p=<0.001). The variables that predicted satisfaction were age, degree of recovery, and the type of ICU. CONCLUSION: Several studies show that patient satisfaction is related to the patient's perceived health status and perceived degree of recovery, a finding that is confirmed in our study. Our study moves beyond these outcomes to show that the hours of mechanical ventilation and the characteristics of the hospital also have a significant relationship with patients' satisfaction.

Pensamiento crítico en tutoras de práctica clínica / Critical thought in female clinical practice mentors

Objetivo: conceptualizar el estado actual del pensamiento crítico en tutoras académicas y tutoras institucionales en el contexto de la práctica clínica e identificar los instrumentos más utilizados para medir el pensamiento crítico de estas.Método: revisión integrativa para la que se consultaron las bases de datos PubMed y Scopus en el periodo comprendido entre enero de 1998 y marzo de 2022. La búsqueda se efectuó utilizando los términos de lenguaje controlado (critical thinking; mentor; nurse educator; clinical practice; preceptor; Education; Nursing), y artículos publicados en español, inglés y portugués. El proceso de selección de artículos fue asistido con el software Rayyan y descrito con el diagrama de flujo de PRISMA. Se realizó un análisis de contenido de los artículos seleccionados para identificar los temas emergentes.Resultados: se incluyeron 72 artículos originales. 25 eran estudios cualitativos, tres de método mixto, un estudio Delphi, 18 descriptivos, seis cuasi-experimentales, cuatro ensayos clínicos aleatorizados, un estudio analítico, ocho revisiones de la literatura, cuatro estudios correlacionales y una revisión sistemática. Tres fueron las temáticas emergentes: los factores de contexto del pensamiento crítico, las estrategias de promoción y los instrumentos de evaluación del pensamiento crítico.Conclusiones: la profesión enfermera no ha adoptado todavía un estándar para evaluar el pensamiento crítico, esto dificulta el comparar resultados sobre el efecto de determinadas intervenciones relacionadas con el desarrollo del pensamiento crítico.(AU)

Objective: to conceptualise the current situation regarding critical thought in female academic mentors and institutional mentors in the clinical practice setting, and to identify the most widely used instruments to measure their critical thought.Method: an integrative review where the PubMed and Scopus databases were consulted in the period between January 1998 and March 2022. The search was conducted using these controlled language terms: critical thinking; mentor; nurse educator; clinical practice; preceptor; Education; Nursing; and in articles published in Spanish, English and Portuguese. The article selection process was assisted by the Rayyan software and described with the PRISMA flow diagram. There was content analysis of the articles selected, in order to identify the emerging subjects.Results: the study included 72 original articles: 25 qualitative studies, three with mixed method, one Delphi study, 18 descriptive studies, six quasi-experimental studies, four randomized clinical trials, one analytical study, eight literature reviews, four correlational studies, and one systematic review. There were three emerging subjects: context factors of critical thought, promotion strategies, and instruments for critical thought evaluation.Conclusions: the Nursing profession has not yet adopted a standard evaluation for critical thought: this makes it difficult to compare results regarding the effect of certain interventions associated with critical thought development.(AU)

Delphi survey on the application of advanced practice nursing competencies: Strong points and unfinished business in cancer care.

AIM: This study assessed the application of advanced practice nursing competencies in cancer care to identify obstacles to their full implementation. BACKGROUND: Internationally, the implementation of advanced practice nursing roles depends on the context and environment, which shape the definition, scope and competencies associated with these roles. METHODS: Nurses participated in two rounds of an online Delphi survey about the competencies of advanced practice oncology nurses. The threshold for expert consensus was set at 75%. RESULTS: Eleven competency domains were proposed; all yielded consensus of over 75%. However, for 57.8% of the specific competencies proposed in round 1 and for 62.2% in round 2, there was no consensus on which were applied in practice. There was more agreement on the competencies applied in the domains of direct clinical practice, consultation and collaboration and interprofessional relations than in dimensions such as health care promotion, quality improvement, evidence-based practice and research. Barriers related to unimplemented competencies were identified. CONCLUSIONS: The competencies applied in advanced practice nursing reflect incomplete development of these roles. Domains related to direct clinical practice, consultation and collaboration and interprofessional relations are relatively well developed, whereas those related to leadership, research, evidence-based practice and quality improvement are not. The identified barriers hindering implementation of some competencies can inform strategies to develop this role in cancer care. IMPLICATIONS FOR NURSING MANAGEMENT: Hospital administrators and nurse managers should reflect and be mindful of the development of advanced practice nurse (APN) competencies along with the challenges associated with implementing advanced practice roles.

Impact of a Nurse-Driven Patient Empowerment Intervention on the Reduction in Patients' Anxiety and Depression During ICU Discharge: A Randomized Clinical Trial.

OBJECTIVES: To assess the impact of a nurse-driven patient empowerment intervention on anxiety and depression of patients during ICU discharge. DESIGN: A prospective, multicenter, randomized clinical trial. SETTING: Three ICUs (1 medical, 1 medical and surgical, and 1 coronary) of three tertiary hospitals. PATIENTS: Adults admitted to the ICU greater than 18 years old for greater than or equal to 48 hours with preserved consciousness, the ability to communicate and without delirium, who were randomized to receive the nurse-driven patient empowerment intervention (NEI) (intervention group [IG] or standard of care [control group (CG)]) before ICU discharge. INTERVENTION: The NEI consisted of an individualized intervention with written information booklets, combined with verbal information, mainly about the ICU process and transition to the ward, aimed at empowering patients in the transition process from the ICU to the general ward. MEASUREMENTS AND RESULTS: Patients completed the Hospital Anxiety and Depression Scale before and after (up to 1 wk) ICU discharge. IG ( n = 91) and CG ( n = 87) patients had similar baseline characteristics. The NEI was associated with a significant reduction in anxiety and depression ( p < 0.001) and the presence of depression ( p = 0.006). Patients with comorbidities and those without family or friends had greater reductions in anxiety and depression after the NEI. After the intervention, women and persons with higher education levels had lower negative outcomes. CONCLUSIONS: We found that a NEI before ICU discharge can decrease anxiety and depression in critically ill survivors. The long-term effect of this intervention should be assessed in future trials. TRIAL REGISTRATION: NCT04527627 ( https://clinicaltrials.gov/ct2/show/NCT04527627 ).

Modelos de evaluación de la calidad de la atención de enfermería en el ámbito hospitalario: revisión de la literatura / Models for evaluating the quality of nursing care in the hospital environment: a literature review

Objetivo: Identificar las características de los modelos de evaluación de la calidad de la atención de enfermería y los resultados generados en términos de calidad y seguridad del paciente en un entorno hospitalario descritos en la literatura científica de los últimos 25 años. Metodología: Se realizó una búsqueda bibliográfica en PubMed y Scopus. Se incluyeron artículos sobre modelos de evaluación de la calidad publicados en inglés, español y portugués entre 1995 y 2020. La revisión se desarrolló en 5 pasos: identificación del problema; búsqueda de literatura; agrupando la información de los estudios; analizar e integrar los resultados de los estudios; e interpretar la evidencia y presentar los resultados. Cada paso fue realizado por dos revisores independientes. Resultados: Se seleccionaron 8 artículos para la revisión. Existe una gran heterogeneidad en la definición de los modelos de evaluación de la calidad y los indicadores a utilizar. El modelo de evaluación de la calidad de Donabedian es el más utilizado. Conclusión: Los modelos de evaluación de la calidad están adaptados o implementados parcialmente. (AU)

Aim: To identify the characteristics of the models for evaluating the quality of nursing care and the results generated in terms of quality and patient safety in a hospital setting described in the scientific literature over the last 25 years.Methods: A literature search was conducted on PubMed and Scopus. Articles on quality evaluation models published in English, Spanish and Portuguese between 1995 and 2020 were included. The review was developed in 5 steps: problem identification; literature search; grouping the information from the studies; analyzing and integrating the results of the studies; and interpreting the evidence and presenting the results. Each step was performed by two independent reviewers.Results: 8 articles were selected for the review. There is a great degree of heterogeneity in the definition of the quality evaluation models and the indicators to be used. Donabedian’s quality evaluation model is the most widely used.Conclusion: Quality assessment models are adapted or partially implemented. (AU)

Moral distress, emotional impact and coping in intensive care unit staff during the outbreak of COVID-19.

BACKGROUND: From the beginning, the COVID-19 pandemic increased ICU workloads and created exceptionally difficult ethical dilemmas. ICU staff around the world have been subject to high levels of moral stress, potentially leading to mental health problems. There is only limited evidence on moral distress levels and coping styles among Spanish ICU staff, and how they influenced health professionals' mental health during the pandemic. OBJECTIVES: To assess moral distress, related mental health problems (anxiety and depression), and coping styles among ICU staff during the first wave of the COVID-19 pandemic in Spain. DESIGN: Cross-sectional. SETTINGS AND PARTICIPANTS: The study setting consisted of intensive care unit and areas converted into intensive care units in public and private hospitals. A total of 434 permanent and temporary intensive care staff (reassigned due to the pandemic from other departments to units) answered an online questionnaire between March and June 2020. METHODS: Sociodemographic and job variables, moral distress, anxiety, depression, and coping mechanisms were anonymously evaluated through a self-reported questionnaire. Descriptive and correlation analyses were conducted and multivariate linear regression models were developed to explore the predictive ability of moral distress and coping on anxiety and depression. RESULTS: Moral distress during the pandemic is determined by situations related to the patient and family, the intensive care unit, and resource management of the organisations themselves. intensive care unit staff already reached moderate levels of moral distress, anxiety, and depression during the first wave of the pandemic. Temporary staff (redeployed from other units) obtained higher scores in these variables (p = 0.04, p = 0.038, and p = 0.009, respectively) than permanent staff, as well as in greater intention to leave their current position (p = 0.03). This intention was also stronger in health staff working in areas converted into intensive care units (45.2%) than in normal intensive care units (40.2%) (p = 0.02). Moral distress, coupled with primarily avoidance-oriented coping styles, explains 37% (AdR2) of the variance in anxiety and 38% (AdR2) of the variance in depression. CONCLUSIONS: Our study reveals that the emotional well-being of intensive care unit staff was already at risk during the first wave of the pandemic. The moral distress they experienced was related to anxiety and depression issues, as well as the desire to leave the profession, and should be addressed, not only in permanent staff, but also in temporary staff, redeployed to these units as reinforcement workers.

"Spanish Palliative Care Nurses' Degree of Acceptance of a Proposal for Nursing Competencies in Palliative Care".

Background: In Spain, palliative care (PC) nursing is not a recognized specialization and PC nurses do not receive systematic specialized academic training in PC. To ensure the quality of PC in Spain, the Spanish Association of Palliative Care Nursing has been working since 2011 to design a model of competencies for PC nurses. Objective: Verify whether a sample of Spanish PC nurses accepts the proposed model of PC nursing competencies describing their work. Methods: Descriptive cross-sectional observational study based on an ad-hoc questionnaire about 98 proposed competencies, which participants rated for whether they belong to the purview of PC nurses and for their degree of concordance with their own practice and their degree of importance in PC nursing. Competencies receiving approval by more than 75% of participants for the three dimensions were considered to have been accepted by consensus. Mixed logistical models were developed to study the association between demographic variables and the responses. Results: Sixty-two out of 98 proposed competencies were accepted by more than 75% of participants. We therefore considered these competencies to have been accepted by consensus. Thirty-six proposed competencies failed to meet the threshold of 75% acceptance. For competencies that were accepted overall, participants with more than 10 years of experience in PC and participants with specialized training in PC were more likely to report that these competencies were part of the purview of PC nursing. Participants age >50 were less likely to report that competencies related to research concorded with their practice. Participants accepted the importance of all 98 proposed competencies. Conclusion: The variables of experience, training and age had a statistically significant relationship with the acceptance or rejection of the proposed competencies on the basis of purview and concordance. Further research is necessary to understand more fully these relationships to eventually arrive at a consensus model for the competencies of PC nurses.

Academic evaluation, management and satisfaction of clinical practicums among undergraduate students: software CliPrAS@UB.

AIM/OBJECTIVE: To determine the development of competency acquisition, the satisfaction of the agents involved and recording incidents with a digital platform CliPrAS @UB on the Clinical Placements I and II courses in the second and third years of the Bachelor's Degree in Nursing. BACKGROUND: The teaching of clinical practice subjects requires an analysis of the competence evolution, a management structure and an analysis of the satisfaction of the agents involved in the subject. DESIGN: Prospective, analytical, observational cohort study. METHODS: The study was carried out in a public university center in Barcelona with 387 students distributed in nine centers of the network of Health Institutions. RESULTS: An increase of 2.32 points was observed in the competence dimensions of Professional Practice and with a reduction in the average score in the skills of care provision, therapeutic communication and professional development of more than 0.08 points. Regarding the seminars, a reduction of the average global score of 0.58 points was observed. CONCLUSIONS: The use of the CliPrAS @ UB computer platform has improved the implementation of the mandatory documents, the recording of incidents and the overall satisfaction of the students.

Discomfort of the critically ill paediatric patient and correlated variables.

INTRODUCTION: The care of critically ill children is usually invasive and aggressive, requiring numerous traumatic procedures that may cause fear, pain, and discomfort. OBJECTIVES: The aim of this study was to analyse the level of discomfort of patients admitted to the paediatric intensive care unit of a specialist children's hospital and to determine the sociodemographic and clinical variables that influence the degree of discomfort experienced by critically ill paediatric patients. METHODS: We performed a descriptive observational cross-sectional study that included a total of 311 children with a median age of 5.07 y (interquartile range = 0.9-11.7). A team of 10 paediatric critical care nurses assessed the degree of discomfort once for each shift (morning, afternoon, and night) on 2 successive days using the COMFORT Behavior Scale-Spanish version. RESULTS: In total, 49.8% (n = 155) of the patients were free of discomfort (score ≤10 points) vs. 50.2% (n = 156) who experienced discomfort. There was a significant negative correlation between discomfort and the length of stay in days (Rho = 0.16; p = 0.02), that is, the longer the stay, the less discomfort the patient felt. The correlation between age and degree of discomfort was found to be both positive and significant (Rho = 0.230, p < 0.001); the greater the age, the greater the discomfort. In comparison of all children who received analgosedation (n = 205), with discomfort levels of 10.77 ± 2.94, with those who did not receive analgosedation (n = 106), with discomfort levels of 11.96 ± 2.80, we did find a statistically significant difference (χ2 = -4.05; p < 0.001). CONCLUSIONS: Half of the patients admitted to the paediatric intensive care unit experienced discomfort. Age and analgosedation were the two most important variables involved with a high degree of discomfort. Clinical care practices must consider these factors and try to plan activities designed to relieve discomfort in all critically ill paediatric patients.

Nursing Intensive-Care Satisfaction Scale [NICSS]: Development and validation of a patient-centred instrument.

AIM: The aim of this study was to develop and validate the Nursing Intensive-Care Satisfaction Scale to measures satisfaction with nursing care from the critical care patient's perspective. BACKGROUND: Instruments that measure satisfaction with nursing cares have been designed and validated without taking the patient's perspective into consideration. Despite the benefits and advances in measuring satisfaction with nursing care, none instrument is specifically designed to assess satisfaction in intensive care units. DESIGN: Instrument development. METHODS: The population were all discharged patients (January 2013 - January 2015) from three Intensive Care Units of a third level hospital (N = 200). All assessment instruments were given to discharged patients and 48 hours later, to analyse the temporal stability, only the questionnaire was given again. The validation process of the scale included the analysis of internal consistency, temporal stability; validity of construct through a confirmatory factor analysis; and criterion validity. RESULTS: Reliability was 0.95. The intraclass correlation coefficient for the total scale was 0.83 indicating a good temporal stability. Construct validity showed an acceptable fit and factorial structure with four factors, in accordance with the theoretical model, being Consequences factor the best correlated with other factors. Criterion validity, presented a correlation between low and high (range: 0.42-0.68). CONCLUSIONS: The scale has been designed and validated incorporating the perspective of critical care patients. Thanks to its reliability and validity, this questionnaire can be used both in research and in clinical practice. The scale offers a possibility to assess and develop interventions to improve patient satisfaction with nursing care.

Impacto de una intervención informativa sobre el programa de cribado de cáncer colorrectal en profesionales de atención primaria / Impact of an informative intervention on the colorectal cancer screening program in primary care professionals

OBJETIVO: Evaluar el impacto de una intervención informativa a profesionales de atención primaria sobre sus conocimientos de cribado de cáncer colorrectal, recomendaciones de vigilancia posterior y estrategias de derivación. Método DISEÑO: Ensayo clínico controlado y aleatorizado por conglomerados. Emplazamiento: centros de atención primaria de L'Hospitalet de Llobregat (Barcelona). PARTICIPANTES: médicos y enfermeras de atención primaria. Intervención: sesión informativa y envío de píldoras informativas en 6 de 12 centros (seleccionados aleatoriamente) sobre el programa de cribado cáncer colorrectal. MEDICIONES PRINCIPALES: cuestionario ad hoc que recoge las características de los profesionales, los centros y 2 variables contextuales; implicación de los profesionales en el programa de cribado; conocimientos sobre el cáncer colorrectal, los factores de riesgo, los procedimientos de cribado, las recomendaciones de seguimiento posterior a la exploración diagnóstica y las estrategias de derivación. RESULTADOS: La media de la puntuación total en el primer cuestionario fue 8,07(1,38) sobre 11 y la del segundo 8,31(1,39). No se encontraron diferencias estadísticamente significativas entre el grupo intervención y control, sin embargo, en 9 preguntas se aumentó el porcentaje de respuestas correctas en el grupo intervención, mayoritariamente relacionadas con el seguimiento posterior a la exploración diagnóstica. CONCLUSIONES: La intervención mejora el porcentaje de respuestas correctas, sobre todo en aquellas en las que se obtuvo peor puntuación en el primer cuestionario. Este estudio muestra que los profesionales están familiarizados con el cribado de cáncer colorrectal, pero es importante tener una comunicación frecuente con ellos para mantener actualizada la información relacionada con el cribado y fomentar su implicación con el mismo

OBJECTIVE: To evaluate the impact of an intervention in primary care professionals on their current knowledge about colorectal cancer screening, subsequent surveillance recommendations and referral strategies. Methods DESIGN: Cluster randomized controlled trial. LOCATION: Primary Care Centers in L'Hospitalet de Llobregat (Barcelona). PARTICIPANTS: Primary Care Professionals (doctors and nurses). Intervention: Training session in six of the 12 centers (randomly selected) about the colorrectal cancer screening program, and three emails with key messages. MAIN MEASUREMENTS: Professionals and centers characteristics and two contextual variables; involvement of professionals in the screening program; information about colorectal cancer knowledge, risk factors, screening procedures, surveillance recommendations and referral strategies. RESULTS: The total score mean on the first questionnaire was 8.07 (1.38) and the second 8.31 (1.39). No statistically significant differences between the intervention and control groups were found, however, in 9 out of 11 questions the percentage of correct responses was increased in the intervention group, mostly related to the surveillance after the diagnostic examination. CONCLUSIONS: The intervention improves the percentage of correct answers, especially in those in which worst score obtained in the first questionnaire. This study shows that professionals are familiar with colorectal cancer screening, but there's a need to maintain frequent communication in order to keep up to date the information related to the colorectal cancer screening

[Impact of an informative intervention on the colorectal cancer screening program in primary care professionals]. / Impacto de una intervención informativa sobre el programa de cribado de cáncer colorrectal en profesionales de atención primaria.

OBJECTIVE: To evaluate the impact of an intervention in primary care professionals on their current knowledge about colorectal cancer screening, subsequent surveillance recommendations and referral strategies. METHODS DESIGN: Cluster randomized controlled trial. LOCATION: Primary Care Centers in L'Hospitalet de Llobregat (Barcelona). PARTICIPANTS: Primary Care Professionals (doctors and nurses). INTERVENTION: Training session in six of the 12 centers (randomly selected) about the colorrectal cancer screening program, and three emails with key messages. MAIN MEASUREMENTS: Professionals and centers characteristics and two contextual variables; involvement of professionals in the screening program; information about colorectal cancer knowledge, risk factors, screening procedures, surveillance recommendations and referral strategies. RESULTS: The total score mean on the first questionnaire was 8.07 (1.38) and the second 8.31 (1.39). No statistically significant differences between the intervention and control groups were found, however, in 9 out of 11 questions the percentage of correct responses was increased in the intervention group, mostly related to the surveillance after the diagnostic examination. CONCLUSIONS: The intervention improves the percentage of correct answers, especially in those in which worst score obtained in the first questionnaire. This study shows that professionals are familiar with colorectal cancer screening, but there's a need to maintain frequent communication in order to keep up to date the information related to the colorectal cancer screening.

Burnout en la profesión enfermera: una aproximación bibliométrica inicial / Burnout in the nursing profession: an initial bibliometric approach

Objetivo: obtener datos del estado de la investigación sobre burnout en profesionales de la Enfermería desde 1952 hasta el año 2011.Método: búsqueda bibliográfica electrónica de la literatura relevante publicada sobre el burnout de las enfermeras hasta diciembre del 2011. Las bases de datos consultadas fueron: PubMed (Medline), BVSalud Biblioteca Virtual en Salud, Biblioteca Complutense de Madrid, Trip Database, DOAJ (Directory of Open Acces Journals), ENFISPO, BioMed, Cochrane, Dialnet, Gopubmed, Psyke: catálogo de artículos sobre psicología en español, Highwire Standford University, Science Direct, SciELO, Cinahl, Cuiden, Cuidatge y Wylley-Blackwell. Resultados y conclusiones: se obtuvieron 4.506 artículos. La media de producción anual durante los 60 años analizados fue de 75,1, presentó unos niveles bajos durante los primeros años y no fue hasta 1981 cuando la producción aumentó de manera importante. El análisis de la productividad por autores revela que la mayor parte de los mismos solamente han publicado un artículo durante este periodo, y solo un 2,2% del total han producido más de diez artículos durante este periodo. El grupo de las diez revistas más productivas representa el 21,4% de la producción total de artículos incluidos en el estudio. El 68,1% proceden de revistas de Enfermería (AU)

Objective: to obtain data about the situation of research on burnout innursing professionals since 1952 and until 2011.Methodology: electronic bibliography search for relevant literature published on nurse burnout until December, 2011. The following databases were searched: PubMed (Medline), BVSalud (Virtual Library on Health), Complutense University Library, Madrid; Trip Database, DOAJ(Directory of Open Access Journals), ENFISPO, BioMed, Cochrane, Dialnet, Gopubmed; Psyke: catalog of Psychology articles in Spanish; Highwire Standford University, Science Direct, SciELO, Cinahl, Cuiden, Cuidatge and Wylley-Blackwell. Results and Conclusions: 4,506 articles were obtained. The median annual production during those 60 years analyzed was 75.1; there werelow levels during the first years, and the production did not show a major increase until 1981. The analysis of productivity by authors shows that the majority of them have only published one article during this period,and only 2.2% of them have published over ten articles during said period. The group of the ten most productive journals represents 21.4% of the total production of articles included in the study. 68.1% of these articles have appeared in Nursing Journals (AU)