Physiotherapists' Evidence-Based Practice profiles by HS-EBP questionnaire in Spain: A cross-sectional normative study.

Evidence-Based Practice (EBP) is a cost-effective approach for improving the quality of clinical care and implementing only well-tested evidence. Health professions, especially physiotherapy, must embrace EBP principles. This paper presents normative data from the Spanish physiotherapist population using the Health-Sciences Evidence-Based Practice questionnaire and explores EBP clusters/profiles of professionals in practice. An intentional sample of 419 practicing physiotherapists was recruited from the Spanish Professional Council of Physiotherapy. Participants completed a cross-sectional online survey with 60 Likert items (scale 1-10) measuring 5 dimensions: 1) Beliefs and attitudes, 2) Results from literature, 3) Professional practice, 4) Assessment of results, and 5) Barriers and Facilitators. The protocol also included sociodemographic, training, and practice-related contrast variables. Normative data were estimated and tabulated for each dimension and then a K-means clustering procedure was implemented using the contrast variables. Results for normative data showed, in descending order, the following 50th percentile values for the five EBP factors: Beliefs and attitudes (8.25), Professional practice (8.00), Assessment of results (7.42), Results from literature (6.71), and EBP Barriers and Facilitators (5.17); all expressed on a scale of 1 to 10. Academic degree, EBP training level, and work time shared in healthcare activity, research, or teaching activity were all statistically significant for discriminating EBP dimension scores. Finally, six different clusters showed that when EBP level is low, the scores in all dimensions are equally low, and vice-versa. The EBP dimensions "Beliefs and attitudes", "Professional practice", and "Evaluation of results" obtained better normative scores overall than "Search for bibliographic evidence and its inclusion in practice" and especially "Perception of EBP barriers", which had the worst score. Normative data are useful for comparing individual scores and the reference population, and information about clusters will enable appropriate global EBP intervention programs to be designed and implemented.

Concurrent Validity and Reliability of a Low-Cost Dynamometer to Assess Maximal Isometric Strength in Neck Movements.

OBJECTIVE: This study aimed to evaluate the concurrent validity and reliability of a low-cost digital dynamometer to assess maximal isometric strength in neck movements. METHODS: Twelve recreationally active participants (6 women, 6 men; age: 24.1 ± 3.4 years; height: 1.71 ± 0.06 m; weight: 64.6 ± 11.7 kg) performed neck flexion, extension, and lateral flexion, and maximal isometric strength was simultaneously measured using an isokinetic dynamometer (gold standard) and a digital dynamometer to evaluate the concurrent validity of the latter. One week later, all the participants repeated 3 trials of each neck movement (3 minutes apart) registered only with the digital dynamometer. The first and second trial were guided by tester 1 and the third trial was guided by tester 2. RESULTS: The concurrent validity of the digital dynamometer showed a nearly perfect correlation between both devices (r > 0.986, P < .001), with Bland-Altman plots showing absolute agreement. Intertester and intratester reliability were nearly perfect for all neck movements (intraclass correlation coefficient > 0.86). CONCLUSION: The low-cost digital dynamometer showed valid and reliable measurements of maximal isometric strength in neck movements.

Validity and reliability of a low-cost dynamometer to assess maximal isometric strength of upper limb.

Muscle imbalance and deficit are key parameters for guiding rehabilitation and sports sessions and avoiding injuries. However, the high cost and non-portable nature of most instruments employed for muscle strength assessment frequently hamper an affordable evaluation in field conditions. This study evaluated the validity and reliability of a low-cost digital dynamometer to assess the maximal isometric strength of upper limb muscles. Fourteen physically active volunteers performed the main movements of the upper limb at maximal isometric strength: flexion-extension, internal-external rotation and abduction-adduction of the shoulder; and flexion-extension of both elbow and wrist. Validity was examined by comparing the strength values from the low-cost digital dynamometer and those measured by an isokinetic dynamometer, assumed as the gold standard. The correlation between both devices was perfect (r > 0.913), while Bland-Altman plots showed absolute agreement between both devices, the maximum range of the values of bias was -0.99-1.00 N in wrist extension. Inter-tester and intra-tester reliability were excellent for all movements (ICC ≥ 0.855). The low-cost digital dynamometer showed strong validity and excellent reliability in assessing maximal isometric strength during the main movements of the upper limb. Professionals may use it for an affordable isometric muscle strength assessment in field situations.

Consenso sobre competencias para la enfermería de práctica avanzada en España / Consensus on competencies for advanced nursing practice in Spain

INTRODUCCIÓN: Existe falta de consenso internacional sobre la definición exacta y las competencias asociadas a los roles de enfermería de práctica avanzada (EPA), caso que resulta más acuciante en nuestro entorno nacional dada la corta trayectoria de la misma en nuestro país. El objetivo del trabajo consistió en delinear el marco competencial para enfermeras de práctica avanzada en nuestro contexto nacional mediante el proceso de consenso de expertos a través del método Delphi. MÉTODO: Basándonos en un proceso de revisión bibliográfica previo, se identificó un conglomerado de 17 dominios competenciales (clusters de competencias relacionadas). Este conjunto inicial fue revisado, refinado y validado por un conjunto de panelistas expertos en la materia (tanto clínicos como investigadores, gestores y docentes) a través de sucesivas rondas en busca del adecuado consenso sobre cada una de las diferentes competencias propuestas. RESULTADOS: Los resultados permitieron establecer una sólida base en forma de mapa de competencias que permitiera identificar aquellos conjuntos de competencias más específicos para roles de práctica avanzada, independientemente del contexto de regulación y práctica profesional, identificando dominios como investigación y práctica basada en la evidencia, liderazgo clínico y profesional o gestión de cuidados. DISCUSIÓN: Este conjunto de competencias relacionadas con roles de práctica avanzada en nuestro entorno permite delinear los estándares competenciales propios de este nivel de práctica enfermera, y servir de referencia tanto para el desarrollo normativo, la revisión de roles o el planteamiento de perfiles formativos

INTRODUCTION: There is a lack of international consensus on the exact definition and core competencies of advanced practice nursing (APN) roles, a problem particularly acute in our national context due to the lack of APN role development, which has a significantly short history in our country. The main objective of this paper was the delineation of the competence framework for Advanced Practice Nurses in our national context based on expert consensus through the Delphi method Method: Based on a preliminary literature review process, a conglomerate of 17 domains of competence (clusters of related competencies) were identified. This initial set was revised, refined and validated by a group of expert panellists on the subject (clinicians, researchers, managers, and teachers) through successive rounds in search of a suitable consensus on each of the various proposed items RESULTS: The results helped to establish a solid foundation in the form of a skills map that could identify those sets of more specific competencies for advanced practice roles, regardless of regulatory and professional practice context, identifying domains such as Research and Evidence Based Practice, Clinical and Professional Leadership, or Care Management DISCUSSION: This set of skills related to advanced practice roles in our environment can delineate competency standards common to this level of nursing practice, and serve as a reference for policy development, a review of roles, or the establishment of academic profiles

[Consensus on competencies for advanced nursing practice in Spain]. / Consenso sobre competencias para la enfermería de práctica avanzada en España.

INTRODUCTION: There is a lack of international consensus on the exact definition and core competencies of advanced practice nursing (APN) roles, a problem particularly acute in our national context due to the lack of APN role development, which has a significantly short history in our country. The main objective of this paper was the delineation of the competence framework for Advanced Practice Nurses in our national context based on expert consensus through the Delphi method METHOD: Based on a preliminary literature review process, a conglomerate of 17 domains of competence (clusters of related competencies) were identified. This initial set was revised, refined and validated by a group of expert panellists on the subject (clinicians, researchers, managers, and teachers) through successive rounds in search of a suitable consensus on each of the various proposed items RESULTS: The results helped to establish a solid foundation in the form of a skills map that could identify those sets of more specific competencies for advanced practice roles, regardless of regulatory and professional practice context, identifying domains such as Research and Evidence Based Practice, Clinical and Professional Leadership, or Care Management DISCUSSION: This set of skills related to advanced practice roles in our environment can delineate competency standards common to this level of nursing practice, and serve as a reference for policy development, a review of roles, or the establishment of academic profiles.

A multisample model validation of the evidence-based practice questionnaire.

Evidence-based practice may be implemented more successfully if the barriers to its implementation have been previously identified. Many of the available instruments to measure these barriers have been validated in single samples or without confirmatory analyses. The objective of the study was to contrast the goodness of fit of two measurement models (24 items and 19 items) for the Spanish version of the Evidence-Based Practice Questionnaire (EBPQ) in a sample of 1,673 full-time registered nurses in 10 hospitals and 57 primary health care centers in the Spanish Public Health Service. The 19-item model performed better in all four subsamples. A hypothesis of strict invariance, with equal factor loadings, intercepts, and error variance in all contexts in which it was evaluated, was supported. Goodness-of-fit indices provided strong evidence of good fit according to standard cut-off criteria in a multisample confirmatory factor analysis.