Cost-effectiveness and cost-utility study of a psychoeducational group intervention for people with depression and physical comorbidity in primary care.

OBJECTIVE: To evaluate the cost-effectiveness and cost-utility of a psychoeducational group intervention led by primary care (PC) nurses in relation to customary care to prevent the depression and improve quality of life in patients with physical comorbidity. DESIGN: Economic evaluation based on data from randomized, multicenter clinical trial with blind response variables and a one-year follow-up, carried in the context of the PSICODEP study. LOCATION: 27 PC teams from Catalonia. PARTICIPANTS: >50 year-old patients with depression and some physical comorbidity: diabetes mellitus type 2, ischemic heart disease, chronic obstructive pulmonary disease, and/or asthma. INTERVENTION: 12 psychoeducational group sessions, 1 per week, led by 2 PC nurses with prior training. MEASUREMENTS: Effectiveness: depression-free days (DFD) calculated from the BDI-II and quality-adjusted life years (QALYs) from the Euroqol-5D. Direct costs: PC visits, mental health, emergencies and hospitalizations, drugs. Indirect costs: days of temporary disability (TD). The incremental cost-effectiveness ratios (ICER), cost-effectiveness (ΔCost/ΔDLD) and cost-utility (ΔCost/ΔQALY) were estimated. RESULTS: The study includes 380 patients (intervention group [IG] = 204; control group [CG] = 176). 81.6% women; mean age 68.4 (SD = 8.8). The IG had a higher mean cost of visits, less of hospitalizations and less TD than the CG. The difference in costs between the IG and the CG was -357.95€ (95% CI: -2026.96 to 1311.06) at one year of follow-up. There was a mean of 11.95 (95% CI: -15.98 to 39.88) more DFD in the IG than in the CG. QALYs were similar (difference -0.01, 95% CI -0.04 to 0.05). The ICERs were 29.95€/DLD and 35,795€/QALY. CONCLUSIONS: Psychoeducational intervention is associated with an improvement in DFD, as well as a reduction in costs at 12 months, although not significantly. QALYs were very similar between groups.

Competencias enfermeras y grado de seguridad de estudiantes y profesionales en el cuidado del paciente crítico / Level of nursing skills and confidence among students and professionals regarding critical patient care

Objetivo: describir el nivel competencial y el grado de seguridad percibido en el cuidado al paciente crítico de estudiantes de Enfermería, y de profesionales de Enfermería de nueva contratación; analizar la influencia del sexo sobre ambas capacidades; y analizar las diferencias entre el nivel competencial calculado por los estudiantes/profesionales y sus responsables (tutores/supervisores).Método: estudio descriptivo transversal con estudiantes de cuarto año de Grado Universitario de Enfermería y profesionales de Enfermería con experiencia < 2 años. Se recogieron variables sociodemográficas, el grado de seguridad autopercibido en una escala Likert de 0 a 10, y para la evaluación de competencias se administró el cuestionario validado COM-VA©. Las competencias de cada participante fueron evaluadas por ellos mismos y por sus responsables (tutores/supervisores).Resultados: participaron 54 estudiantes, 22 profesionales y cuatro responsables. La autopercepción del grado de seguridad de los alumnos tutorizados fue superior al de los nuevos profesionales (p= 0,001), el nivel competencial autopercibido fue similar: 22,2% de los estudiantes y 18,2% de los profesionales se autopercibían como competentes. Aunque el nivel competencial fue similar según el cuestionario COM-VA© autocumplimentado (media de 7,2 y 7,8 sobre 10 para estudiantes y profesionales respectivamente), el nivel competencial de los profesionales fue superior según lo valorado por sus supervisores y tutores (p< 0,001). No se dieron diferencias por sexo.Conclusión: los resultados obtenidos muestran que los estudiantes de Enfermería de último año presentan un mayor grado de seguridad que los nuevos profesionales, pero que el nivel competencial de los profesionales es mayor que el de los estudiantes según sus responsables.(AU)

Objective: to describe the level of skills and confidence perceived regarding care for critical patients among Nursing students and newly recruited Nursing professionals; to analyse the influence of gender on both skills, and to analyse the differences between the competence level estimated by students / professionals and their persons in charge (academic tutors / supervisors).Method: a descriptive cross-sectional study with students in the 4th year of their University Nursing Degree and Nursing professionals with <2 years of experience. Sociodemographic variables were collected, as well as the self-perceived confidence level in a Likert scale from 0 to 10; and the COM-VA© validated questionnaire was administered for skill assessment. The skills of each participant were evaluated by themselves and by their academic tutors / supervisors.Results: the study included 54 students, 22 professionals and four persons in charge. The self-perception of the level of confidence by tutored students was higher than that by new professionals (p= 0.001); their self-perceived level of skills was similar: 22.2% of the students and 18.2% of professionals perceived themselves as competent. Even though their competence level was similar according to the self-completed COM-VA© questionnaire (mean of 7.2 and 7.8 out of 10 for students and professionals, respectively), the competence level of professionals was higher according to the evaluation by their supervisors and tutors (p< 0.001). There were no differences by gender.Conclusion: the outcomes obtained showed that Nursing students in their last year presented a higher level of confidence than new professionals, but that the competence level of professionals was higher than that of students according to their tutors / supervisors.(AU)

Embracing diversity: measuring the impact of an international immersion learning experience on nursing students' cultural beliefs and values.

OBJECTIVES: An international Nursing Leadership Collaborative covened in Japan to hold a patient safety and quality workshop for nursing students from six countries. The purpose was to measure students' self reported beliefs reflecting sensitivity and openness to cultural diversity before and after the international experience. METHODS: A pre-post-test design was used and the Beliefs, Events, and Values Inventory was administered to international undergraduate and graduate nursing students. RESULTS: The group aggregate data analysis indicate that prior to the start of the workshop, the group presented itself as quite introspective and after the workshop the group reported being more sophisticated in making causal explanations about why the world works in the way it does. CONCLUSIONS: Nursing students experienced an expanded awareness of their beliefs and values that reflect a greater degree of intercultural sensitivity for acceptance of inclusivity and diversity after the experience.

Nursing students faced with organ donation: Multicenter stratified national study.

AIM: To analyze the attitude of university nursing students at Spanish universities toward organ donation and transplantation and the factors affecting to their attitude. BACKGROUND: The opinion of future nurses toward organ transplant donation could have an important influence on the population. Knowing that opinion and what factors influence it is important to improve the attitude towards organ donation and transplantation. DESIGN: A multicenter, sociological, interdisciplinary and observational study including university nursing diploma students in a complete academic year. METHODS: Selected and randomized sample was taken of students from 52 of the 111 faculties and nursing schools and faculties in Spain with teaching activity PARTICIPANTS: A sample of 10,566 students was selected stratified by geographical area and year. MEASUREMENT INSTRUMENT: The instrument used was a validated questionnaire of attitude toward organ donation and transplantation, self-administered and completed anonymously. RESULTS: Completion rate: 85 % (n = 9001). Of the students surveyed, 78 % (n = 7040) would donate their organs after dying. Variables related to a favourable attitude: (1) Interest in listening to a talk about organ donation and transplantation [Odds ratio 1.66, 95 % confidence interval 2.05-1.35]; (2) Family discussion [Odds ratio 2.30, 95 % confidence interval 2.79-1.90] or discussion with friends about organ donation and transplantation [Odds ratio 1.56, 95 % confidence interval 1.86-1.31]; (3) Knowing that one's father [Odds ratio 1.54, 95 % confidence interval 1.94-1.22], mother's [Odds ratio 1.44, 95 % confidence interval 1.82-1.13] or partner [Odds ratio 1.28, 95 % confidence interval 1.60-1.03] has a favourable opinion; (4) Having a good self-assessment of information about organ donation and transplantation [Odds ratio 2.94, 95 % confidence interval 4.90-1.78]; (5) Not being worried about possible mutilation of the body after donation [Odds ratio 2.73, 95 % confidence interval 3.36-1.72]. CONCLUSIONS: Nursing students in Spain tend to have a favourable attitude toward organ donation and transplantation although more than 20 % of those surveyed are not in favour. TWEETABLE ABSTRACT: To maintain a high rate of organ donation for organ transplantation, it is necessary to improve the social awareness of future generations of nurses towards organ donation.

Moral sensitivity of nursing students. Adaptation and validation of the moral sensitivity questionnaire in Spain.

Ethical sensitivity is a requirement for people care as well as for decision-making in everyday practice. The aim is to present an adaptation and transcultural validation -in Spanish- of the Moral Sensitivity Questionnaire by Lützén et al. in Spain. In addition to that, we provide a practical implementation analysing the degree of moral sensitivity of nursing students. The data used for data collection were moral Sensitivity Questionnaire, socio-demographic data and a self-report questionnaire. The psychometric properties of the questionnaire were assessed, including validity and reliability. Fit indices of the overall model were computed. The fit indices of the Confirmatory Factor Analysis (CFA) indicate a poor fit, although the Exploratory Factor Analysis (EFA) revealed two dimensions that show a better fit of its indices. Women and those women with more experience in the clinical setting have a higher mean score, as well as those who study in centers where the strategic lines are the humanization of care. Female nursing students with more experience in the clinical setting and with more educational training present higher sensitivity indexes, as well as those who study in centers where the strategic lines are the humanization of care. The findings confirm that the Lützén et al. questionnaire is multidimensional. In the Spanish sample, it was necessary to group the three initial factors into two: sense of moral burden and moral strength-grouping the moral responsibility items into the above items to make the instrument more resilient.

Effectiveness of a Psychoeducational Group Intervention Carried Out by Nurses for Patients with Depression and Physical Comorbidity in Primary Care: Randomized Clinical Trial.

The association between physical illness and depression implies a poorer management of chronic disease and a lower response to antidepressant treatments. Our study evaluates the effectiveness of a psychoeducational group intervention led by Primary Care (PC) nurses, aimed at patients of this kind. It is a randomized, multicenter clinical trial with intervention (IG) and control groups (CG), blind response variables, and a one year follow-up. The study included 380 patients ≥50 years of age from 18 PC teams. The participants presented depression (BDI-II > 12) and a physical comorbidity: diabetes mellitus type 2, ischemic heart disease, chronic obstructive pulmonary disease, and/or asthma. The IG (n = 204) received the psychoeducational intervention (12 weekly sessions of 90 min), and the CG (n = 176) had standard care. The patients were evaluated at baseline, and at 4 and 12 months. The main outcome measures were clinical remission of depressive symptoms (BDI-II ≤ 13) and therapeutic response (reduction of depressive symptoms by 50%). Remission was not significant at four months. At 12 months it was 53.9% in the IG and 41.5% in the CG. (OR = 0.61, 95% CI, 0.49-0.76). At 4 months the response in the IG (OR = 0.59, 95% CI, 0.44-0.78) was significant, but not at 12 months. The psychoeducational group intervention led by PC nurses for individuals with depression and physical comorbidity has been shown to be effective for remission at long-term and for therapeutic response at short-term.

Nursing student attitudes toward dying patient care: A European multicenter cross-sectional study.

Background and aim of the work Nursing education plays a key role in preparing future nurses to deal with dying patients, which represents one of the most emotionally involving aspect of nursing. The aims of the study were to explore nursing students' attitudes towards care of dying patients in three different European contexts and to analyze the variables that can influence them. Methods We conducted an international multicenter cross-sectional study. We administered the Frommelt Attitude Toward Care of the Dying Scale form B (FATCOD-B) and a demographic form to 569 students, enrolled in the Nursing Programmes in three different countries (Italy, Spain and the United Kingdom), who accepted to participate in the study. The data were analyzed using SPSS software version 26.0. Results Median total FATCOD-B scores indicated intermediate levels of students' attitudes towards care for dying patients, with a statistically significant difference among the three student groups. The median total FATCOD-B scores did not statistically significantly change in students with different age, gender, year of study, religious believes, nursing education on palliative care, previous experiences of dying patient care and personal grieving. Conclusions In our study, nursing students feel partially prepared in caring for dying patients and their attitudes do not change as the course of study progresses. No selected variables had an impact on students' attitudes towards palliative care. Since nurses play a vital role in ensuring the quality of care, education on end-of-life care should be offered as a core part of undergraduate nursing programs.

Experiencing communication related to knowing the cancer diagnosis and prognosis: A multi-perspective interpretative phenomenological study.

PURPOSE: To understand the phenomenon of communication related to knowing the diagnosis and prognosis, by exploring the perspectives of patients with advanced cancer and those of their caregivers, physicians and nurses. METHODS: Drawing upon a multi-perspective design, a total of 27 semi-structured interviews involving four different groups of stakeholders (7 patients, 7 caregivers, 6 physicians, and 7 nurses) -who were linked by a carer-cared relationship-were conducted in two Oncology Departments of two Italian hospitals. Interpretative Phenomenological Analysis was used to interpret the participants' narratives. RESULTS: Two overarching themes were identified: The first theme "the «what is it?¼ and the «what will happen to me?¼" illustrates the two different paths of communication of diagnosis and prognosis. The second theme "Matching and mismatching in identifying the others as speakers" shows that not each of the four parties recognizes the others as reciprocal speakers on topics related to diagnosis and prognosis, although all of them display reciprocal communication interactions. CONCLUSIONS: Communication related to diagnosis and prognosis is often handled by health professionals without a comprehensive and integrated understanding of the communication approach. There is a correspondence between the nurses' perception of their extraneousness to the diagnosis and the prognosis related communication, and the descriptions and perceptions of the nurse's role reported by the other participants. Understanding how the different groups of stakeholders reciprocally interact and influence each other, can help to identify potential positive resources and detect hindrance in the implementation of an effective patient-centered approach, while avoiding silo cultures.

Calidad de vida en personas con depresión y comorbilidad física desde una perspectiva de género / Quality of life in people with depression and physical comorbidity from a gender perspective

OBJETIVO: El objetivo del estudio es describir la percepción de la calidad de vida relacionada con la salud de personas con depresión y comorbilidad física bajo una perspectiva de género. Se incluyeron 380 individuos mayores de 49 años con, al menos, una patología de las siguientes: diabetes, enfermedad obstructiva pulmonar crónica y cardiopatía isquémica, reclutadas en 31 equipos de atención primaria de Cataluña. La calidad de vida se midió con la escala EuroQol (EQ-5D). Además, se recogieron variables sociodemográficas, gravedad de depresión, índice de privación económica y ámbito de residencia. Se evaluó la relación ajustada entre el sexo y las dimensiones de calidad de vida, mediante una regresión logística multivariante. RESULTADOS: El 81,3% fueron mujeres; la media de edad fue de 68,4 años (DE: 8,8), La media de la escala visual analógica fue de 57,8 (DE: 17,4) en hombres y 55,8 (DE: 18,6) en mujeres. La media del EQ-Health Index fue de 0,74 (DE: 0,17) en hombres y 0,65 (DE: 0,21) en mujeres (p = 0,001). La probabilidad de presentar problemas en las dimensiones del EQ-5D mostró el sexo como factor de más peso (mujer = 1/hombre = 0) en: autocuidado OR: 2,29 (IC 95% 1,04 a 5,07) y actividades cotidianas OR: 3,09 (IC 95% 1,67 a 5,71). La movilidad se asoció con la edad OR: 1,87 (IC 95% 1,22 a 2,86), el ámbito de residencia con el dolor OR: 2,51 (IC 95% 1,18 a 5,34) y el Beck Depression Inventory (BDI) con la ansiedad/depresión OR: 4,77 (IC 95% 1,77 a 12,88). CONCLUSIÓN: La percepción en la calidad de vida de las mujeres con depresión y comorbilidad física es inferior a la de los hombres, siendo en ambos casos inferior a la de población general

OBJECTIVE: The aim of the study is to describe from a gender perspective how people with depression and physical comorbidity perceive their quality of life. The study included 380 people over 49 years of age with at least one of the following pathologies: diabetes, chronic obstructive pulmonary disease and ischemic heart disease. Participants were recruited from 31 teams the primary care of in Catalonia. Quality of life was measured using the EuroQol Scale. In addition, sociodemographic variables were collected, as well as the severity of depression, the index of economic deprivation and area of residence. The adjusted relationship between sex and dimensions of quality of life was assessed by means of multivariate logistic regression. RESULTS: 81.3% were women; the mean age was 68.4 years (SD: 8.8). The mean on the Visual Analogue Scale was 57.8 (SD: 17.4) in men and 55.8 (SD: 18.6) in women. The mean of the EQ-Health Index was 0.74 (SD: 0.17) in men and 0.65 (SD: 0.2) in women (p = 0.001). The probability of having problems of the EQ-5D showed sex as the most important factor (woman = 1/man = 0) in: self-care OR: 2.29 (95% CI 1.04-5.07) and daily activities OR: 3.09 (95% CI 1.67-5.71). Mobility was associated with age OR: 1.87 (95% CI 1.22-2.86), pain with area of residence OR: 2.51 (95% CI 1.18-5,34) and the BDI with anxiety/depression OR: 4,77 (95% CI 1.77-12,88). CONCLUSION: The perception quality of life of women with depression and physical comorbidity is lower than that of men and, in both cases, it is lower than that of the general population

[Quality of life in people with depression and physical comorbidity from a gender perspective]. / Calidad de vida en personas con depresión y comorbilidad física desde una perspectiva de género.

OBJECTIVE: The aim of the study is to describe from a gender perspective how people with depression and physical comorbidity perceive their quality of life. The study included 380 people over 49 years of age with at least one of the following pathologies: diabetes, chronic obstructive pulmonary disease and ischemic heart disease. Participants were recruited from 31 teams the primary care of in Catalonia. Quality of life was measured using the EuroQol Scale. In addition, sociodemographic variables were collected, as well as the severity of depression, the index of economic deprivation and area of residence. The adjusted relationship between sex and dimensions of quality of life was assessed by means of multivariate logistic regression. RESULTS: 81.3% were women; the mean age was 68.4 years (SD: 8.8). The mean on the Visual Analogue Scale was 57.8 (SD: 17.4) in men and 55.8 (SD: 18.6) in women. The mean of the EQ-Health Index was 0.74 (SD: 0.17) in men and 0.65 (SD: 0.2) in women (p = 0.001). The probability of having problems of the EQ-5D showed sex as the most important factor (woman = 1/man = 0) in: self-care OR: 2.29 (95% CI 1.04-5.07) and daily activities OR: 3.09 (95% CI 1.67-5.71). Mobility was associated with age OR: 1.87 (95% CI 1.22-2.86), pain with area of residence OR: 2.51 (95% CI 1.18-5,34) and the BDI with anxiety/depression OR: 4,77 (95% CI 1.77-12,88). CONCLUSION: The perception quality of life of women with depression and physical comorbidity is lower than that of men and, in both cases, it is lower than that of the general population.

Exploring Health Science Students' Notions on Organ Donation and Transplantation: A Multicenter Study.

The knowledge acquired during university education about organ donation and transplantation (ODT) decisively influences the information future health professionals transmit. This is important in ODT where the participation of the general public is essential to obtain organs. OBJECTIVE: To determine notions of Spanish medicine and nursing students on ODT and its relationship with attitude toward ODT. METHODS AND DESIGN: and design. We conducted a sociologic, multicenter, and observational study. The population for our study consisted of medical and nursing students in Spanish universities. Our database was the Collaborative International Donor Project, stratified by geographic area and academic course. A validated questionnaire (PCID-DTO-RIOS) was self-administered and completed anonymously. Our sample consisted of 9598 medical and 10,566 nursing students (99% confidence interval; precision of ±1%), stratified by geographic area and year of study. RESULTS: The completion rate for our study was 90%. Only 20% (n=3640) of students thought their notions on ODT were good; 41% (n=7531) thought their notions were normal; 36% (n=6550) thought their notions were scarce. Comparing groups, there were differences between those who believed that their notions on ODT were good (44% nursing vs 56% medical students; P < .000), and those who believed it scarce (54% nursing vs 46% medical students; P < .000). Notions on ODT were related with attitude toward the donation of one's own organs: those who considered their notions were good were more in favor then those who considered it scarce (88% vs 72%; P < .000). CONCLUSION: Only 20% of Spanish medical and nursing students thought their notions on ODT were good. Having good knowledge is related to a favorable attitude towards ODT. Receiving specific information on the subject could improve their knowledge about ODT during their training.

Organ Donation Related With Attitude Toward the Law of Presumed Consent: Spanish University Medical and Nursing Students Study.

INTRODUCTION: Information provided by health care professionals is crucial to create a climate of social opinion. This is important in organ donation and transplantation (ODT), where the participation of the general public is essential to obtain organs. OBJECTIVE: To determine the attitude toward the Law of Presumed Consent (LPC) among Spanish university students and to analyze their relation with attitude toward ODT. METHODS: and design. The type of study was a sociologic, multicenter, observational study. The population included medical and nursing students in Spanish universities. Database of Collaborative International Donor Project was used stratified by geographic area and academic course. A validated questionnaire (Collaborative International Donor Project, organ donation and transplantation questionnaire in Spanish [PCID-DTO-RIOS]) was self-administered and completed anonymously. A sample of 9598 medical and 10,566 nursing students was analyzed (99% confidence and precision of ±1%) and stratified by geographic area and year of study. RESULTS: Completion rate was 90%. Regarding attitude toward LPC, 66% of the students were against the law, whereas 34% accepted it. Of the students surveyed, 9% considered the law as a gesture of solidarity, 25% as an effective way of not wasting organs, 48% as an abuse of power, and 18% as offenses against the family. Those students who were in favor of LPC also had a more favorable attitude toward ODT (86% vs 76%; P < .001). Comparing groups, nursing students were less in favor of LPC than medical students (32% vs 36%; P < .000). CONCLUSION: Sixty-six percent of Spanish university medical and nursing students were against the LPC. The favorable attitude toward ODT is associated with considering the law as a gesture of solidarity or as an effective way of not wasting organs.

Confident Perception of Primary Care Physicians Correlates to the Attitude Toward Donation and Organ Transplantation: A Multicenter Study of Medical And Nursing Spanish Students.

A primary care physician (PCP) not only accompanies the patient in the process of an illness, but throughout his or her life. The confidence we have in these health professionals is fundamental, and their favorable attitude toward organ donation and transplantation (ODT) has a significant influence on the population. OBJECTIVE: To analyze trust in PCPs among Spanish medical and nursing students, the relationship with their attitude toward ODT, and the factors that condition it. METHODS AND DESIGN: A sociologic, multicenter, and observational study. POPULATION: medical and nursing students in Spanish universities. DATABASE: Collaborative International Donor Project, stratified by geographic area and academic course. A validated questionnaire (PCID-DTO-RIOS) was self-administered and completed anonymously. A sample of 9598 medical and 10,566 nursing students (99% confidence and precision of ±1%), stratified by geographic area and year of study. RESULTS: Completion rate: 90%. With respect to students' trust in their physician, 18% (n = 3267) of them totally trust (completely), 45% (n = 8101) trust enough, 30% (n = 5478) of them have not enough trust, and 7% not at all. Comparing groups, medical students totally trust more in PCPs than nursing students (55% vs 45%; P < .000), however, nursing students have less than enough trust in their PCP than medical students (53% vs 47%; P < .000). Students that totally trust in their PCP were more in favor toward ODT than students with not enough trust (83% vs 77%; P < .000). CONCLUSION: Only 18% of Spanish medical and nursing students totally trust in their PCP. Attitude toward ODT is related to a higher level of trust in PCPs among these students.

Caring efficacy: nurses' perceptions and relationships with work-related factors.

BACKGROUND AND AIM OF THE WORK: Caring nursing practice is central aspect of quality of services. It is important to assess nurses' caring experience in terms of perceived caring efficacy to make them aware of their outcomes and improve their strategies. The aims of the study was to analyze: (1) the caring efficacy level, (2) differences between the caring efficacy levels concerning  positive and negative work attitudes, (3) individual and organizational predictors of perceived caring efficacy. METHODS: 200 nurses were recruited from a University Hospital in Southern Italy. A self-reported questionnaire was administered. T-test was performed to analyze differences between caring efficacy levels concerning outcomes variables. Regression analysis was carried out to examine how some work factors were related to perceived caring efficacy. RESULTS: Participants referred high confidence to care (CC) for 55%, and low doubts and concerns (DC) for 72.9%. Nurses who had low DC had lower emotional exhaustion than nurses with moderate DC. Nurses with low DC had higher job satisfaction than nurses with high DC. Regarding CC levels, there were no differences between mean values for both attitudes at work. The emotional dissonance significantly predicted DC and CC. The supervisor support had a negative link with emotional dissonance, which in turn was negatively related to CC. CONCLUSIONS: Education and training should be addressed to reduce doubts and concerns to care and improve the ability to manage emotions. A work environment that value caring and give support in managing emotions can reduce emotional dissonance and improve caring self-efficacy.

Nursing Students' Knowledge About Organ Donation and Transplantation: A Spanish Multicenter Study.

Health care professionals and the information that they provide to the public on organ donation and transplantation (ODT) influence attitudes toward this option. OBJECTIVE: The objective was to analyze the knowledge of university nursing students at Spanish universities toward ODT and the factors affecting it. METHODS AND DESIGN: The methods and design included a multicenter, sociologic, and observational study including university nursing diploma students in a complete academic year. PARTICIPANTS: A sample of 10,566 students was selected stratified by geographic area and year. INSTRUMENT: A validated questionnaire of knowledge toward ODT (PCID-DTO RIOS), self-administered and completed anonymously. RESULTS: Questionnaire completion rate: 85% (n = 9001). Only 18% (n = 1580) believed that their knowledge about ODT was good, 40% (n = 3578) believed that the information they had was normal, and 39% believed that their knowledge was sparse. Of the students, 96% believed that organ needs are not covered and 79% that they might need a transplant in the future. Only 39% (n = 3493) had attended a talk about ODT. Furthermore, 83% (n = 7435) believed that attending a talk would be interesting. The following variables were associated with having a more adequate knowledge: gender (62% men vs 57% women; P < .001); academic year (P < .001); knowing a donor (P < .001); knowing a transplant patient (P < .001); believing the possibility of needing a transplant oneself in the future (P < .001); attitude toward deceased donation (P < .001); and interest in receiving an informative talk about ODT (P < .001). CONCLUSION: Only 18% of nursing students in Spain believed that their knowledge about ODT was adequate. These results must be considered for possible training plans for these future professionals.

Cultural adaptation and psychometric validation of the Caring Efficacy scale in a sample of Italian nurses.

Caring is the essence of nursing practice. Caring Efficacy scale was developed with the purpose of measuring nurses' perceived self-efficacy in orienting and maintaining caring relationships with patients. Since any instruments measuring caring self-efficacy have not been developed in Italy, the study aimed at culturally adapting and validating Caring Efficacy scale in a sample of Italian nurses. A total of 300 registered nurses were asked to fill a self-reported questionnaire; translation-back-translation procedure was carried out to maintain semantic, idiomatic and conceptual equivalence of the original scale. Then, factor analysis was performed in order to test appropriateness of the factor structure. Convergent and discriminant validity was also tested. A two-factor structure with 17 items was found. Results show that Cronbach's Alpha value was 0.84 for Confidence to Care, and 0.75 for Doubts and Concerns. Correlation analysis for convergent and discriminant validity showed that Confidence to Care was positively correlated with sense of coherence and no significant correlation with Doubts and Concerns was found. Caring efficacy scale can be used by nurse managers as a way of assessing nurses' self-efficacy and their caring orientation, thus improving quality of patient care.

Percepción del equipo de enfermería sobre sí mismo ante el cuidado espiritual / Nursing team's perception of themselves before spiritual care

Objetivo: Comprender la percepción de los integrantes del equipo de enfermería (EE) sobre sí mismos ante el cuidado espiritual ofrecido en el Hospital Universitari Germans Trias i Pujol, centro público con 638 camas, de Badalona. Antecedentes: El cuidado espiritual se ha considerado necesario para la provisión de cuidados holísticos, a fin de evitar la angustia espiritual y favorecer el afrontamiento de la enfermedad. Diseño: Estudio fenomenológico hermenéutico. Método: Se incluyó un total de 31 informantes: 16 profesionales del EE -8 enfermeras y 8 auxiliares de enfermería- de un servicio de Hospitalización General y 10 de la Unidad de Onco-Hematología. Tras un muestreo teórico, se realizaron entrevistas en profundidad y un grupo focal de cinco enfermeros de áreas diferentes a la de Hospitalización General. Resultados:La percepción ante el cuidado espiritual del EE se observa a nivel de sensación y a nivel de la propia capacitación para resolver la demanda de cuidado espiritual. Ambos niveles están mediatizados por el tipo de demanda, por el tiempo de relación terapéutica y el grado de confianza establecido entre el profesional y la persona atendida y por la sobrecarga laboral en relación con el tiempo de jornada. En dicho escenario, el profesional puede autopercibirse con temor o gratitud, y sentirse o no preparado para resolverla. Conclusiones: Para ofrecer cuidados espirituales efectivos, los profesionales del EE deben sentirse capacitados a nivel formativo y a nivel personal previo. Aplicabilidad para la práctica clínica: Los profesionales del EE deben estar preparados para proporcionar atención espiritual en el ámbito hospitalario, puesto que las competencias de enfermería están relacionadas con el cuidado espiritual, sin el cual el cuidado de la persona deja de ser holístico

Aim: To understand nursing team staff (NT) spiritual coping experience regarding the spiritual care at the Hospital Universitari Germans Trias i Pujol, a public health centre with 638 beds, located in Badalona. Background: Spiritual care has been considered necessary for the provision of holistic care, avoiding spiritual distress and coping with illness. Design: A phenomenological hermeneutic approach. Method: The total sample was 31 informants, included 16 NT -8 graduates and 8 assistants- from a general hospitalization service and 10 staff from the Onco-Hematology unit. After theoretical sampling, the data consisted of in-depth interviews and a focal group with five nurses from different units but general hospitalization. Results: The perception of spiritual care of NT occurs at the level of sensation and at the level of the training itself to resolve the demand for spiritual care. Both mediated by the type of demand; the time of therapeutic relationship and degree of trust established between professional and person served; and the work overload in relation to the time of day. In this scenario, the professional can self-perceive with fear or gratitude, feeling prepared to solve it or not prepared. Conclusions: NT Professionals should feel prepared -at a formative level, at their own previous level, and at the level of training- to offer an effective spiritual care. RELEVANCE TO CLINICAL PRACTICE. NTs should be prepared to provide spiritual care within the hospital environment as nursing competencies related to spiritual care

Scale for the study of nursing students' perception of intimate partner violence: Adaptation and validation.

BACKGROUND: Intimate partner violence (IPV) is one of the most important challenges facing today's society. Health professionals, and nurses in particular, play a leading role in addressing this problem. Having an instrument to study Nursing students' perception of this type of violence may enable appropriate and necessary educational strategies for their pre-service training and help them identify and address IPV in their future careers. OBJECTIVES: To adapt and validate the IPV scale of Beccaria et al. (2011) in order to study nursing students' perception of IPV. METHOD: The original instrument (63 items) underwent back-translation. Statistical and metrical analysis in a sample of 1064 students of the four-year Nursing degree program at four public universities in Catalonia (Spain) were based on their responses to the Spanish version. RESULTS: The results of the exploratory factorial analysis and subsequent confirmatory analysis showed that the data had an adequate fit for a four-factor model. The reliability analysis showed adequate internal consistency for each subscale in the instrument: Education (0.83); Identification of the Victim (0.72); Nursing Role and Values (0.78), and Identification of the Perpetrator (0.66). CONCLUSION: The translation, cultural adaptation and validation process of the original IPV scale resulted in a Spanish-language instrument (IPV scale Spanish version) with 32 items in four subscales. We concluded that the Spanish version of the instrument is reliable and valid, and that its implementation would enable the assessment of nursing students' perception of IPV situations.

Alzheimer: sentidos, significados y cuidados desde una perspectiva transcultural / Alzheimer: Significance, sense and care from a transcultural perspective

Objetivo principal: Explorar las vivencias, las representaciones y las prácticas sociales de los familiares de personas con Alzheimer en distintos contextos culturales. A la luz de tres casuísticas empíricas concretas, nuestro objetivo se centra en analizar cómo los cuidadores familiares identifican, denominan e interpretan el padecimiento y cómo establecen y desarrollan estrategias de cuidados. Con este fin, se comparan las experiencias de cuidadores familiares de la ciudad de Tarragona (España), de la Parroquia Santa Lucía, Municipio Maracaibo del Estado de Zulia (Venezuela) y de Cuernavaca (México).Metodología: En base a una metodología cualitativa, centrada en el punto de vista del actor, los encuentros con los familiares cuidadores han permitido captar el sentido y el significado que adquiere para ellos la enfermedad y el cuidado circunscrito al ámbito doméstico. Como estrategias básicas para la recogida de información se utilizó la observación participante y la entrevista en profundidad. Además, para los casos de Tarragona y Cuernavaca, se realizaron sesiones de grupo focal.Resultados principales: Del análisis comparativo de los resultados se desprende un dominio de la influencia que el discurso biomédico hegemónico ejerce sobre los saberes de los familiares. Se han encontrado variados puntos de encuentro entre las vivencias, las representaciones y las prácticas sociales de los familiares de los tres contextos culturales, con escasos matices que nos permitan hablar de diferencias socioculturales en torno a las manifestaciones y percepciones sobre la demencia.Conclusión principal: Las similitudes encontradas nos hacen pensar en (..) (AU)

Objective: In this paper, the interest for exploring the living experiences, representations and social practices of family members of persons who have Alzheimer disease within different cultural contexts is outlined. Seen from three concrete empiric polls, our objective is to analyze how family-member care takers identify, designate and interpret the disease and how they establish and develop care strategies. With this in mind, the care taking family member experience in the city of Tarragona (Spain), in the Parish of Santa Lucia, Municipality of Maracaibo of the State Zulia (Venezuela) and in Cuernavaca (Mexico) are compared.Methods: Based on a qualitative methodology, focused on the actor's point of view, the meetings with the care taking family, have allowed us grasp the sense and the significance that the disease and the care involved in the domestic field have upon them. The participating observation and in depth interviews were used as a basic strategy for gathering information. Also, in the Tarragona and Cuernavaca cases, focal group sessions were carried out.Results: The comparative analysis shows the influence that the hegemonic biomedical discourse has upon the family member's knowledge. In the three cultural contexts, we found several common grounds in the living experiences, representations and social practices of the family members, with few changes allowing us to speak of social-cultural differences with respect to the manifestations and (..) (AU)