Emergency Crisis Resource Management de la Sociedad Española de Medicina de Urgencias y Emergencias: curso de gestión en crisis basado en simulación para estudiantes de ciencias de la salud / Emergency crisis resource management: a simulation-based course developed by the Spanish Society of Emergency Medicine (SEMES) for health sciences students

Objetivo. Los programas educativos dirigidos a la adquisición de competencias no técnicas, tales como el Crisis Resource Management (CRM), basado en simulación de alta fidelidad, implican un aumento de las competencias del alumno en el manejo de situaciones de crisis. El objetivo del presente trabajo es evaluar la eficacia del programa Emergency CRM (E-CRM) de la Sociedad Española de Medicina de Urgencias y Emergencias, dirigido a estudiantes de último año de los grados de ciencias de la salud. Método. Se llevó a cabo un estudio cuasiexperimental con medidas pre y posintervención, que consistió en un programa de E-CRM con simulación de alta fidelidad, en un único grupo. Participaron un total de 209 estudiantes que completaron dos instrumentos autoadministrados sobre la autoeficacia hacia las competencias no técnicas y la resiliencia. Además, a través de observadores externos se evaluó sus competencias no técnicas con instrumentos de evaluación objetivos. Resultados. El alumnado mejoró las puntuaciones de resiliencia (F = 25,90; p < 0,001) y autoeficacia (F = 68,02; p < 0,001) tras la intervención, con diferencias estadísticamente significativas para la resiliencia en la línea basal en función del grupo de estudios (t = 2,67; p = 0,008). Por otro lado, se encontraron mejoras de las puntuaciones obtenidas tanto para el instrumento Mayo High Performance Teamwork Scale (F = 6,18; p < 0,001; eta2 = 0,20) como para el Ottawa Global Rating Scale Crisis Resource Management (F = 5,58; p < 0,005; eta2 = 0,19). Conclusión. El programa de E-CRM, basado en simulación de alta fidelidad, con un equipo interprofesional coordinado, mejora la autoeficacia en todas las competencias no técnicas medidas y aumenta la resiliencia. (AU)

Objetivo. Los programas educativos dirigidos a la adquisición de competencias no técnicas, tales como el Crisis Resource Management (CRM), basado en simulación de alta fidelidad, implican un aumento de las competencias del alumno en el manejo de situaciones de crisis. El objetivo del presente trabajo es evaluar la eficacia del programa Emergency CRM (E-CRM) de la Sociedad Española de Medicina de Urgencias y Emergencias, dirigido a estudiantes de último año de los grados de ciencias de la salud. Método. Se llevó a cabo un estudio cuasiexperimental con medidas pre y posintervención, que consistió en un programa de E-CRM con simulación de alta fidelidad, en un único grupo. Participaron un total de 209 estudiantes que completaron dos instrumentos autoadministrados sobre la autoeficacia hacia las competencias no técnicas y la resiliencia. Además, a través de observadores externos se evaluó sus competencias no técnicas con instrumentos de evaluación objetivos. Resultados. El alumnado mejoró las puntuaciones de resiliencia (F = 25,90; p < 0,001) y autoeficacia (F = 68,02; p < 0,001) tras la intervención, con diferencias estadísticamente significativas para la resiliencia en la línea basal en función del grupo de estudios (t = 2,67; p = 0,008). Por otro lado, se encontraron mejoras de las puntuaciones obtenidas tanto para el instrumento Mayo High Performance Teamwork Scale (F = 6,18; p < 0,001; eta2 = 0,20) como para el Ottawa Global Rating Scale Crisis Resource Management (F = 5,58; p < 0,005; eta2 = 0,19). Conclusión. El programa de E-CRM, basado en simulación de alta fidelidad, con un equipo interprofesional coordinado, mejora la autoeficacia en todas las competencias no técnicas medidas y aumenta la resiliencia. (AU)

Emergency crisis resource management: a simulation-based course developed by the Spanish Society of Emergency Medicine (SEMES) for health sciences students. / Emergency Crisis Resource Management de la Sociedad Española de Medicina de Urgencias y Emergencias: curso de gestión en crisis basado en simulación para estudiantes de ciencias de la salud.

OBJECTIVES: Educational programs based on high-fidelity simulation training aim to promote students' acquisition of nontechnical competencies such as understanding crisis resource management (CRM). This study evaluated the efficacy of a CRM course for students in their last year of university studies in health sciences. The course was developed by the Spanish Society of Emergency Medicine (SEMES). MATERIAL AND METHODS: Quasi-experimental study of a high-fidelity simulation course to teach emergency CRM (E-CRM) using preand postcourse measures of achievement in a single student cohort. A total of 209 students completed 2 selfadministered self-efficacy evaluations of their acquisition of nontechnical competencies and resilience. External observers also assessed the students' nontechnical competencies with objective measurement scales. RESULTS: Scores on resilience and self-efficacy assessments improved through the intervention (F = 25.90 and F = 68.02, respectively; P .001, for both pre-post comparisons). Statistically significant differences were found between students in different health sciences at baseline (t = 2.67; P = .008). Scores improved significantly on the Mayo High Performance Teamwork Scale (F = 6.18, P .001, eta2 = 0.20) and the Ottawa CRM Global Rating Scale (F = 5.58; P .005, eta2 = 0.19). CONCLUSION: The E-CRM course developed by a coordinated multiprofessional team based on high-fidelity simulations improved self-efficacy assessments of resilience and all nontechnical competencies.

OBJETIVO: Los programas educativos dirigidos a la adquisición de competencias no técnicas, tales como el Crisis Resource Management (CRM), basado en simulación de alta fidelidad, implican un aumento de las competencias del alumno en el manejo de situaciones de crisis. El objetivo del presente trabajo es evaluar la eficacia del programa Emergency CRM (E-CRM) de la Sociedad Española de Medicina de Urgencias y Emergencias, dirigido a estudiantes de último año de los grados de ciencias de la salud. METODO: Se llevó a cabo un estudio cuasiexperimental con medidas pre y posintervención, que consistió en un programa de E-CRM con simulación de alta fidelidad, en un único grupo. Participaron un total de 209 estudiantes que completaron dos instrumentos autoadministrados sobre la autoeficacia hacia las competencias no técnicas y la resiliencia. Además, a través de observadores externos se evaluó sus competencias no técnicas con instrumentos de evaluación objetivos. RESULTADOS: El alumnado mejoró las puntuaciones de resiliencia (F = 25,90; p < 0,001) y autoeficacia (F = 68,02; p 0,001) tras la intervención, con diferencias estadísticamente significativas para la resiliencia en la línea basal en función del grupo de estudios (t = 2,67; p = 0,008). Por otro lado, se encontraron mejoras de las puntuaciones obtenidas tanto para el instrumento Mayo High Performance Teamwork Scale (F = 6,18; p 0,001; eta2 = 0,20) como para el Ottawa Global Rating Scale Crisis Resource Management (F = 5,58; p 0,005; eta2 = 0,19). CONCLUSIONES: El programa de E-CRM, basado en simulación de alta fidelidad, con un equipo interprofesional coordinado, mejora la autoeficacia en todas las competencias no técnicas medidas y aumenta la resiliencia.

Spanish adaptation of the Stillbirth Stigma Scale (SSS).

The death of a baby in the perinatal period is considered a disenfranchized grief that can be a source of significant symptoms of guilt, shame, and stigma. There is a lack of validated instruments for assessing the stigma associated with perinatal grief. The aim of this study was to examine the psychometric properties (factor structure, reliability, and validity) of the Spanish version of the Stillbirth Stigma Scale (SSS) in parents who have experienced a perinatal loss. A total of 291 participants (mostly mothers) completed an online questionnaire that included the SSS and other measures. The best-fitting factor structure was a second-order model with four dimensions and adequate reliability values. In terms of validity, we found statistically significant relationships between the SSS scores and the variables of self-esteem, complicated grief, event centrality, depression, and anxiety. In conclusion, the Spanish adaptation of the SSS is deemed to have adequate psychometric properties.

Emergency Crisis Resource Management de la Sociedad Española de Medicina de Urgencias y Emergencias: curso de gestión en crisis basado en simulación para estudiantes de ciencias de la salud / Emergency crisis resource management: a simulation-based course developed by the Spanish Society of Emergency Medicine (SEMES) for health sciences students

Objetivo. Los programas educativos dirigidos a la adquisición de competencias no técnicas, tales como el Crisis Resource Management (CRM), basado en simulación de alta fidelidad, implican un aumento de las competencias del alumno en el manejo de situaciones de crisis. El objetivo del presente trabajo es evaluar la eficacia del programa Emergency CRM (E-CRM) de la Sociedad Española de Medicina de Urgencias y Emergencias, dirigido a estudiantes de último año de los grados de ciencias de la salud. Método. Se llevó a cabo un estudio cuasiexperimental con medidas pre y posintervención, que consistió en un programa de E-CRM con simulación de alta fidelidad, en un único grupo. Participaron un total de 209 estudiantes que completaron dos instrumentos autoadministrados sobre la autoeficacia hacia las competencias no técnicas y la resiliencia. Además, a través de observadores externos se evaluó sus competencias no técnicas con instrumentos de evaluación objetivos. Resultados. El alumnado mejoró las puntuaciones de resiliencia (F = 25,90; p < 0,001) y autoeficacia (F = 68,02; p < 0,001) tras la intervención, con diferencias estadísticamente significativas para la resiliencia en la línea basal en función del grupo de estudios (t = 2,67; p = 0,008). Por otro lado, se encontraron mejoras de las puntuaciones obtenidas tanto para el instrumento Mayo High Performance Teamwork Scale (F = 6,18; p < 0,001; eta2 = 0,20) como para el Ottawa Global Rating Scale Crisis Resource Management (F = 5,58; p < 0,005; eta2 = 0,19). Conclusión. El programa de E-CRM, basado en simulación de alta fidelidad, con un equipo interprofesional coordinado, mejora la autoeficacia en todas las competencias no técnicas medidas y aumenta la resiliencia. (AU)

Objetivo. Los programas educativos dirigidos a la adquisición de competencias no técnicas, tales como el Crisis Resource Management (CRM), basado en simulación de alta fidelidad, implican un aumento de las competencias del alumno en el manejo de situaciones de crisis. El objetivo del presente trabajo es evaluar la eficacia del programa Emergency CRM (E-CRM) de la Sociedad Española de Medicina de Urgencias y Emergencias, dirigido a estudiantes de último año de los grados de ciencias de la salud. Método. Se llevó a cabo un estudio cuasiexperimental con medidas pre y posintervención, que consistió en un programa de E-CRM con simulación de alta fidelidad, en un único grupo. Participaron un total de 209 estudiantes que completaron dos instrumentos autoadministrados sobre la autoeficacia hacia las competencias no técnicas y la resiliencia. Además, a través de observadores externos se evaluó sus competencias no técnicas con instrumentos de evaluación objetivos. Resultados. El alumnado mejoró las puntuaciones de resiliencia (F = 25,90; p < 0,001) y autoeficacia (F = 68,02; p < 0,001) tras la intervención, con diferencias estadísticamente significativas para la resiliencia en la línea basal en función del grupo de estudios (t = 2,67; p = 0,008). Por otro lado, se encontraron mejoras de las puntuaciones obtenidas tanto para el instrumento Mayo High Performance Teamwork Scale (F = 6,18; p < 0,001; eta2 = 0,20) como para el Ottawa Global Rating Scale Crisis Resource Management (F = 5,58; p < 0,005; eta2 = 0,19). Conclusión. El programa de E-CRM, basado en simulación de alta fidelidad, con un equipo interprofesional coordinado, mejora la autoeficacia en todas las competencias no técnicas medidas y aumenta la resiliencia. (AU)

Factors associated with non-urgent presentations in the paediatric emergency department using Andersen's behavioural model: A cross-sectional descriptive study.

OBJECTIVES: To explore the rate of NUPs and associated factors in the PED of the 'Hospital Universitario y Politécnico La Fe' in Valencia (Spain) using Andersen's Behavioural Model. METHODS: We conducted a descriptive cross-sectional study using Andersen's Behavioural Model in parents visiting the PED with their children at the 'Hospital Universitario y Politécnico La Fe' in Valencia (Spain). RESULTS: The study involved a total of 530 participants, of whom 419 (79%) had made an NUP. The predisposing factors identified were: (I) paediatric patients brought in by their fathers (OR = 0.460; p = 0.005), (II) lower educational attainment (OR = 3.841; p = 0.000), (III) first-time parenthood (OR = 2.335; p = 0.000) and (IV) higher parental stress (OR = 1.974; p = 0.023). The enabling factors included: (I) responsibility for a significant part of the childcare shared with others (OR = 0.348; p = 0.041) and (II) the perception that PEDs provide better care than primary care (PC) services (OR = 1.628; p = 0.005). The need factors were: (I) existing chronic illness in the child seeking care (OR = 0.343; p = 0.000) and (II) the perceived severity of the urgency (OR = 0.440; p = 0.031). CONCLUSIONS: The NUP rates found in this study are similar to those found internationally. In accordance with Andersen's Behavioural Model, we identify predisposing, enabling and need factors to explain the multifactorial nature of NUPs in PEDs. IMPLICATIONS FOR PRACTICE: Identifying the factors associated with NUPs enables interventions to be targeted at those groups most likely to engage in NUPs, thereby optimising the functioning of the PED and improving the well-being of children and families. These interventions should focus on improving parental health literacy, providing education on making appropriate decisions about accessing health services and recognising severe symptoms in children, as well as improving access to high-quality PC services. Providing support to parents during the transition to parenthood would also be beneficial. REPORTING METHOD: This paper adheres to the STROBE initiative guidelines. CONTRIBUTION FROM PATIENTS OR MEMBERS OF THE PUBLIC: Participants, who voluntarily agreed to take part, contributed to the study by completing a paper-based questionnaire containing all the study variables as prepared by the research team.

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

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

Factors associated with frequent users in hospital paediatric emergency departments: A single centre study in Spain.

BACKGROUND: Over the last decade, the demand for hospital paediatric emergency departments (PEDs) has been on the rise. Studies have been carried out in adults, but in paediatrics, and in Spain, they are few and far between. In order to develop interventions to alleviate this problem, it is necessary to understand the factors that predispose people to use these services. OBJECTIVE: The main objective of this study was to identify the factors associated with frequent users of PEDs in Spain. METHODS: A descriptive, cross-sectional study conducted between September 2021 and December 2022 in the PED of a referral hospital in Spain. RESULTS: There were 530 participants, 12.07% of whom were frequent users. There was an indirect association between frequent use and having a secondary level of education (OR = 0.282, p = 0.002). The factors which were directly associated included: perceived urgency (OR = 10.209, p = 0.002) and the perception that PEDs provide better care than primary care (PC) (OR = 2.664, p = 0.044). CONCLUSIONS: The percentage of frequent users is comparable with international levels. As a strategy to reduce the frequency of visits, health interventions are needed to ensure that parents know how to correctly interpret their children's symptoms and are well informed about the recommended flow of care.

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

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

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

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

Validation and cross-cultural adaptation of the Multiple Sclerosis Intimacy and Sexuality Questionnaire-15 (MSISQ-15) into Spanish.

Background: The Multiple Sclerosis Intimacy and Sexuality Questionnaire-15 (MSISQ-15) is a valid and reliable tool to assess the sexuality of people with multiple sclerosis. The objectives of this study were: 1) to cross-culturally adapt and examine the psychometric properties of the MSISQ-15 in the Spanish context and 2) to examine the association between sexual dysfunction and other related factors. Methods: We conducted a instrumental study. People diagnosed with multiple sclerosis and members of multiple sclerosis associations in Spain were included. The linguistic adaptation of the questionnaire was performed through a translation-back translation procedure. For the psychometric validation, the confirmatory factor analysis was used while the internal consistency was examined by the ordinal alpha test. The construct validity was examined by correlating the results with the Male Sexual Function (FSH), Female Sexual Function-2 (FSM-2), Dyadic Adjustment Scale-13 (EAD-13) and Multiple Sclerosis International Quality of Life Questionnaire (MusiQoL) questionnaires. Results: A total of 208 participants were included. Both the fit of the Spanish version of the MSISQ-15 to the original scale and the internal consistency were adequate (α = 0.89). The construct validity showed correlations with the FSH, FSM-2, and MusiQoL but not with the EAD-13. Conclusions: The Spanish version of the MSISQ-15 is a valid and reliable tool to assess the sexuality of people with multiple sclerosis in the Spanish context.

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

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

The Parental Stress Scale: Psychometric Properties in Pediatric Hospital Emergency Setting.

Parental psychological distress has been identified as a predisposing factor in attendance at and the inappropriate use of hospital pediatric emergency departments (PEDs). The aim of the study was to validate the Parental Stress Scale (PSS), a 12-item Spanish scale, in parents seeking care at PEDs. The study involved 270 participants with a mean age of 37.9 (SD = 6.76) years, of which 77.4% were women. The properties of the PSS were analyzed. The scale showed adequate internal consistency for the different factors (0.80 for the "Stressors" factor and 0.78 for the "Baby's Rewards" factor) and optimal model fit (chi-square = 107.686; df = 53; CFI = 0.99; TLI = 0.98; RMSEA = 0.028; 90% CI = 0.00-0.05). The 12-item Spanish version of the PSS is a valid and reliable instrument for assessing the stress levels of parents seeking care in PEDs.

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

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

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

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

Psychometric Properties of the Spanish Version of the Fatigue Assessment Scale in Caregivers of Palliative Care Patients.

Symptoms of fatigue and lack of energy are very common in caregivers of palliative care (PC) patients, traditionally associated with variables such as burden or depression. There are no Spanish-language instruments validated for assessing fatigue levels in this population. The Fatigue Assessment Scale (FAS) is a useful and simple instrument for assessing fatigue in this group. The aim of this study was to examine its psychometric properties (factor structure, reliability and validity) in a sample of caregivers of PC patients. Instrumental design for instrument validation was performed. One hundred and eight caregivers of PC patients participated and completed measures of fatigue, family functioning, life satisfaction, caregiver burden, anxiety, depression, resilience and quality of life. A confirmatory factor analysis was performed; non-linear reliability coefficient and Pearson correlations and t-tests were conducted to assess evidence of reliability and validity. The Spanish version of the FAS was found to have a one-dimensional structure. Reliability was 0.88. Validity evidence showed that FAS scores were positively associated with levels of burden, anxiety and depression. They were negatively associated with family functioning, life satisfaction, resilience and quality of life. The Spanish version of the FAS in caregivers of PC patients shows adequate psychometric properties.

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

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

Experience of women with multiple sclerosis about their sexuality.

PURPOSE: To understand how women with multiple sclerosis (MS) experience their sexuality. MATERIAL AND METHODS: This was a qualitative study in which eight women belonging to MS associations in Elche or Alicante (Spain) completed semi-structured interviews. We subsequently carried out a thematic analysis of this data. RESULTS: Four main themes and multiple sub-themes were identified. The first theme was the 'influence of stereotypes on sexual expression', which included social and gender perspectives; the second theme was 'physical and emotional causes of sexual dysfunction', which were classified as primary, secondary, and tertiary; the third theme was 'experiencing sexuality in a personalised way', which included relationships with a partner, the concept of sexuality, and resources for improving sexual function; and the final theme was 'external support', which included sexual assistance, professional care, and peer support. CONCLUSIONS: Sexual needs change in women with MS after diagnosis of the disease. However, this is not addressed routinely by health professionals. In their search for resources, women with MS highlighted that support from partners and from associations, could constitute a support network for the expression of their sexuality.IMPLICATIONS FOR REHABILITATIONWomen with MS refer changes in their sexual function, and these changes are not addressed routinely by healthcare providers.Inclusion of the sexual partners of women with MS in consultations regarding the treatment of sexual dysfunctions should be considered with previous consent.The positive experience of a woman with MS who used sexual assistant services may justify further research.MS associations can also play an important role in the sexual field as a meeting place for peers with shared experiences.

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

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

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

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

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

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