Exploring How Evidence-Based Practice, Communication, and Clinical Simulation Outcomes Interact in Nursing Education: A Cross-Sectional Study.

(1) Background: Clinical simulation is an educational approach that aims to replicate real-life scenarios. Its primary goal is to help nursing students acquire the necessary knowledge and skills to perform effectively in clinical settings. This study focuses on the relationship between communication skills, evidence-based practice (EBP), and clinical simulation. We aimed to assess how communication skills and EBP competencies affect nursing students' performance in simulated clinical scenarios. (2) Methods: We conducted an observational, cross-sectional study with 180 third-year nursing students at the University of Murcia. We used validated instruments to evaluate the students' EBP competencies, communication skills, non-technical skills, and nursing interventions in simulated scenarios. (3) Results: The results showed that the students had varying competencies in EBP and communication skills. However, there was a positive and statistically significant correlation (p < 0.001) between these variables, non-technical skills, and the simulated clinical scenario nursing interventions. Our regression models revealed that communication skills and EBP competence significantly influenced the performance of the student nurses regarding their clinical and non-technical skills in the simulated scenarios. (4) Conclusions: Communication skills and EBP competencies predict performance in simulated scenarios for nursing students.

Cross-Cultural Validation of the Healthcare Provider's Practices, Attitudes, Self-Confidence, and Knowledge Regarding Bullying Questionnaire.

How can we know the reality of the context of bullying in the field of primary health care? The aim of this study is to obtain a validated and reliable tool that allows measurement of the involvement of primary care professionals in addressing bullying through a systematic content validation process. A cross-cultural validation of the Healthcare Provider's Practices, Attitudes, Self-Confidence, and Knowledge Regarding Bullying Questionnaire was conducted for the Spanish perspective. This involved linguistic adaptation through translation-back-translation, content validity index (CVI) analysis, construct validity using confirmatory factor analysis (CFA), and internal consistency (Cronbach's α). The total CVI was 0.95, with individual item scores ≥ 0.78. CFA revealed a good fit for the three subscales, with discrimination indices (item-total correlation within the dimension) > 0.30. Cronbach's α for each dimension indicated a high level of reliability, with values of 0.735 for attitudes, 0.940 for self-confidence, and 0.895 for knowledge. The questionnaire is valid and reliable for evaluating the knowledge, attitudes, and self-confidence of primary care professionals in Spain regarding bullying. Its validity and reliability guarantee its potential use in other health settings and may lead to better training of professionals and school biopsychosocial health.

Including audience response systems in debriefing. A mixed study during nursing simulation-based learning.

BACKGROUND: The audience response systems are being implemented to support active learning in nursing degree programs. The benefits of audience response systems have been studied in lecture-based classes and seminars, but their advantages or inconveniences when included in the debriefing phase of a high-fidelity clinical simulation have not been explored. The study aim was to discover student´s experience about using of interactive questions during debriefing, and the self-perceived effects on attention, participation and motivation. METHODS: A Mixed-methods study was used exploratory sequential design in a university. The participants were 4th-year students enrolled in the Nursing Degree in a university in Southern Spain. (1) Qualitative phase: a phenomenological approach was utilized, and focus groups were used for data-collection. (2) Quantitative phase: cross-sectional descriptive study using a questionnaire designed "ad hoc", on the experiences on the use of interactive questions in the debriefing phase and the Debriefing Experience Scale. RESULTS: (1) Qualitative phase: the students highlighted the facilitating role of the interactive questions during the reflection part of the debriefing, and mentioned that the interactive questions helped with stimulating attention, participation, and motivation during the analytical part of the debriefing; (2) Quantitative phase: it was observed that the best evaluated dimension was "Motivation", with a mean of 4.7 (SD = 0.480), followed by the dimension "Participation", with a mean of 4.66 (SD = 0.461), and lastly, the dimension "Attention", with a mean of 4.64 (SD = 0.418). CONCLUSIONS: The use of interactive questions contributed the attention, participation, and motivation of the students during the debriefing, contributing towards a highly satisfactory experience of high-fidelity clinical simulation.

High-power motorcycle accidents in Spain: a descriptive study.

PURPOSE: In modern societies, motorcycle accidents have become a great problem for health systems worldwide. In Spain, the size and the power of the engine of 2-wheel vehicles determine the type of driving license and the age at which these vehicles can be used (mopeds and motorcycles, which at the same time can have a small or large engine capacity). The objective of the present study was to analyze and characterize low- and high-power motorcycle accidents in Spain, between 2014 and 2020, both included and compared these categories with each other. METHODS: Retrospective, descriptive, and observational study of motorcycle and moped accidents in Spain between 2014 and 2020, both included. RESULTS: The mortality of motorcycle accident riders in Spain is associated with males aged between 30 and 40 years old, with a high-power motorcycle, and an A or A1 driver's license, who is 6.7 times more likely to die in crossings and highways than a moped, while wearing a helmet, and if not, this increases to 4.89 times. During the COVID-19 pandemic, an increase in death at 24 h after a high-power motorcycle accident was observed, as compared with a large reduction in the total medical assistance provided in 2019-2020. CONCLUSIONS: High-power motorcycles had higher scores in mortality and morbity rates than low-power ones, with a significant increase in mortality during the pandemic, even though number of accidents and medical assistance provided were drastically reduced.

Effects of a Clinical Simulation-Based Training Program for Nursing Students to Address Social Isolation and Loneliness in the Elderly: A Quasi-Experimental Study.

INTRODUCTION: The population of older adults is rapidly increasing worldwide, presenting both prospects and complexities for society and healthcare professionals to maximize the functional capacity of this age group. Social isolation and loneliness significantly affect this population. The objective was to determine the effectiveness, satisfaction, and perceptions of the simulation-based education practices of a training program for nursing students, which was created to palliate the social isolation and loneliness of older adults. METHOD: A quasi-experimental study was conducted with nursing students who participated in an online training program using teleservice based on high-fidelity clinical simulation. The program included asynchronous theoretical training and synchronous practical training using an online platform. Five scenarios were designed using simulated phone calls to address the social isolation and loneliness of older adults. RESULTS: Twenty-five nursing students participated in the program, and they had a mean age of 27.44, with 76% of them being women. After the training program, the participants showed statistically significant improvements (p < 0.05) with respect to their knowledge and attitudes towards older adults, and the program was adapted to the best educational practices in simulations. CONCLUSIONS: Simulation-based online training efficiently improved the knowledge and attitudes of nursing students towards older adults, improving their ability to address social isolation and loneliness. The high satisfaction and adhesion to the best educational practices underline the usefulness of high-fidelity online simulations, especially in situations in which face-to-face training is not feasible, and accessibility and equilibrium could be guaranteed between work and personal life.

Telephone-Cardiopulmonary Resuscitation Guided by a Telecommunicator: Design of a Guiding Algorithm for Telecommunicators.

BACKGROUND: Out-of-hospital cardiac arrest is considered a global problem. In the last few years, there has been a growing interest in telephone-cardiopulmonary resuscitation guided by a telecommunicator. Indeed, several studies have demonstrated that it increases the chances of survival rate. This study focuses on the key points the operator should follow when performing telephone-cardiopulmonary resuscitation. The main objective of this paper is to design an algorithm to improve the telephone-cardiopulmonary resuscitation response protocol. METHODS: The available evidence and the areas of uncertainty that have not been previously mentioned in the literature are discussed. All the information has been analyzed by two discussion groups. Later, a consensus was reached among all members. Finally, a response algorithm was designed and implemented in clinical simulation. RESULTS: All the witnesses were able to recognize the OHCA, call for emergency assistance, follow all the operator's instructions, move the victim, and place their hands in the correct position to perform CPR. DISCUSSION: The results of the pilot study provide us a basis for further experimental studies using randomization and experimental and control groups. CONCLUSIONS: No standardized recommendations exist for the operator to perform telephone-guided CPR. For this reason, a response algorithm was designed.

The Chinese version of the Health Professional Communication Skills Scale: Psychometric evaluation.

Objective: This study aims to translate the Health Professional Communication Skills Scale (HP-CSS) into Chinese and assess its psychometric properties. Methods: A total of 836 healthcare professionals were recruited. The demographic characteristics form and HP-CSS were used for data collection. The psychometric properties of HP-CSS were evaluated by examining item analysis, construct validity, known-group discriminant validity, internal consistency, and split-half reliability. Results: In terms of item analysis, the critical ratio (CR) of 18 items was both >3 (CR ranging from 9.937 to 28.816), and the score of each item was positively correlated with the total score (r ranging from 0.357 to 0.778, P < 0.001). The fit indices showed that the original correlated four-factor model of HP-CSS was adequate: χ2 =722.801; df = 126; χ2/df = 5.737; RMSEA = 0.075; CFI = 0.923; NNFI = 0.908; TLI = 0.906; IFI = 0.923. In terms of known-group discriminant validity, the HP-CSS total score was related to gender, occupation, work years, and communication skill training. Cronbach's α coefficient was 0.922, and the split-half reliability was 0.865 for the total scale. Conclusion: The Chinese version of the HP-CSS is a reliable and valid instrument to evaluate communication skills among healthcare professionals in China.

Effectiveness of the flipped classroom methodology on the learning of evidence-based practice of nursing students: Quasi-experimental design.

BACKGROUND: International organizations recognize the importance of evidence-based practice (EBP) for nurses. The objective of teaching EBP in the Nursing degree is to train future nurses on this subject. Different teaching models exist for this, from less active traditional models to more active ones such as the flipped classroom. OBJECTIVE: To compare the degree of EBP competence of undergraduate nursing students after an EBP course, through the application of a traditional methodology versus a flipped classroom methodology. DESIGN: Quasi-experimental study of non-equivalent groups. SETTING: The study was composed by a group of students who received training on EBP with the traditional model (face-to-face), and another intervention group with whom the flipped classroom model was utilized, using the online teaching platform EBP-eToolkit. PARTICIPANTS: The study was conducted with 4th-year Nursing degree students enrolled in the course evidence-based practice, in academic years 2019/20 and 2021/2022. METHODS: Before and after the course, the students completed a questionnaire about EBP competence (EBP-COQ), and an objective test was given at the end of the year. RESULTS: A sample of 152 students in the face-to-face group (control), and 143 students in the flipped classroom group (intervention) participated. The intervention group significantly improved its competence on attitude (p = 0.01, η2 = 0.022), skills (p = 0.019, η2 = 0.018), and global competence in EBP (p = 0.003, η2 = 0.030), with respect to those who were taught using the traditional method. However, there were no significant differences in the impact on knowledge, neither through the self-report dimension of the EBP-COQ (p = 0.188) nor the final test score, control group 6.89 (SD: 1.35) and flipped classroom group 7.12 (SD: 1.53) (p = 0.206). CONCLUSIONS: The flipped classroom model is adequate for the teaching of EBP to undergraduate nursing students. It produced a slight increase in attitude, as well as in skills and global competence in EBP. Nevertheless, this increase was not significantly different from face-to-face learning in terms of impact on EBP knowledge.

Subjective mental workload in Spanish emergency nurses. A study on predictive factors.

INTRODUCTION: Mental workload refers to the cognitive or intellectual requirements that a worker is subjected to in a workday. The objective of the present work was to discover the subjective mental workload of nursing staff at Hospital Emergency Units, and its relationship with sociodemographic, work, environmental factors at the workplace, and personality variables. METHOD: A quantitative, descriptive, observational, and crosssectional study was conducted with 201 emergency nurses from 13 different provinces in Spain. Each participant completed 5 questionnaires (sociodemographic, work conditions, environmental conditions, personality, and subjective mental workload). Descriptive statistics were obtained, and Pearson's correlations and multivariate models (multiple linear regression) were performed. RESULTS: The nurses had medium to high levels of mental workload. The environmental conditions had a direct relationship with the mental workload, especially with respect to noise and lighting. The participants obtained high scores in kindness, responsibility, openness/intellect, and extraversion. Positive and statistically significant relations were found between neuroticism and mental workload. Being female, older, and having stable employment or a permanent contract were associated with a greater mental workload of emergency nurses. CONCLUSION: The domain of neuroticism personality, and the hygienic conditions in the workplace were the predictors with the most weight in the model. This study could be useful for defining aspects that need to be considered for the well-being of emergency nurses, such as lighting conditions or environmental noise in the workplace. It also invites reflection on the influence of personal factors (age, gender, personality) and work factors (type of contract, professional experience) on the mental workload of emergency nurses.

Nursing Interventions against Bullying: A Systematic Review.

(1) Background: Bullying is a worldwide public health problem, with short- and long-term physical, mental, and socio-economic implications for all involved, including consequences as serious as suicide. (2) Objective: The aim of this study is to compile data on nursing interventions for preventing and addressing bullying at the international level. (3) Methods: A systematic review was conducted in accordance with the guidelines laid out in the PRISMA statement. The search included papers written in Spanish, English, and Portuguese over the previous five years from the following databases: Web of Science, CUIDEN, CINHAL, BDENF, Cochrane, Lilacs, and PubMed. The following descriptors were used: "Acoso escolar AND Enfermería", "Bullying AND Nursing" and "Intimidação AND Enferma-gem". Due to the heterogeneity in the methodology of the studies, a narrative synthesis of the results is provided. (4) The synthesis of results shows nurses' involvement in tackling and preventing bullying. Interventions are categorised into awareness raising; coping mechanisms; and approach/care, nursing skills in the face of bullying, and the role of the family in the face of bullying. (5) Conclusions: It is clear that at the international level, nursing is involved in planning and developing autonomous and interdisciplinary interventions to address and prevent bullying. The evidence paves the way for school nurses and family and community nurses to take steps to tackle this phenomenon.

Development and psychometric testing of the non-technical skills scale in medical and surgical hospital units for nursing students.

OBJECTIVE: To develop and validate a tool to assess the non-technical skills of medical and surgical hospital units undergraduate nursing students. BACKGROUND: In the area of healthcare, non-technical skills complement technical ones, and contribute to patient safety. High-fidelity simulation is an ideal resource for working on these skills. Thus, evaluation instruments are needed to understand the efficiency of this methodology. Although many evaluation instruments already exist, none measure non-technical skills of undergraduate nursing students in medical and surgical hospital units. DESIGN: An instrumental study design was employed. METHODS: Two-phases were used to develop and validate the scale: 1) Scale development. A group of experts defined the dimensions and components. Afterwards, the content was validated by experts, and a pilot study was conducted with undergraduate Nursing students. 2) Analysis of the psychometric properties of the scale. A total of 393 students were evaluated in high-fidelity simulation scenarios by three evaluators, through the use of the Non-Technical Skills in Medical and Surgical Hospital Units (NTS-Nursing) Scale. RESULTS: The content validity indexes were adequate for the total of the items and the total of the scale. The statistical descriptors of the items, the internal structure, and the reliability (internal consistency and inter-evaluator reliability) were analyzed, as well as the external evidence of validity, with adequate values obtained. CONCLUSION: The NTS-Nursing scale is a valid and reliable instrument. Its structure of 10 items makes its use fast and easy.

To Clap or Not to Clap: Relevance of "Applause" in Simulation-Based Learning Sessions.

INTRODUCTION: Applause is a common behavior during simulation case learning sessions. Some simulation facilitators believe that this should not be allowed, arguing that it can mislead students when they make mistakes during simulation. This study was conducted to explore the opinions of students about spontaneous applause (initiated by the participants), as a habitual behavior in the simulation sessions, in the undergraduate and postgraduate nursing degrees. METHODS: A qualitative research study was conducted based on the content analysis of 7 focus groups composed of simulation students (N = 101, both undergraduate and graduate students). The participants were asked to conduct a debate about the following question: What is your opinion about the spontaneous applause given to participants by their peers at the completion of the scenario as they go to the debriefing, and why? An inductive method of content analysis was used to interpret the data. RESULTS: The majority considered applause as a sign of support; one student disapproved of the practice. For most participants, receiving spontaneous applause from their peers after finishing the simulation represented a spontaneous example of moral support that reduced the participants' stress. CONCLUSIONS: Applause within the context of clinical simulation is a motivational act, which should not be repressed by the facilitator, as long as it is a spontaneous and genuine act by the participants once the simulation experience ends.

Consequences of the Covid-19 pandemic on complex multimorbid elderly: Follow-up of a community-based cohort. SAMAC3 Study.

BACKGROUND: The restrictions imposed during the management of the pandemic led to lack of care of other health problems. PURPOSE: To assess changes in the health status of complex multimorbidity elderly, functional and cognitive capacities, perception of the social surroundings, care provided by the nurses, including nursing diagnosis and interventions, use of health services, adverse events, and use of devices and technical help during the first 6 months of the Covid-19 pandemic. DESIGN: A 1-year longitudinal cohort study was conducted. METHODS: Ninety-seven complex multimorbid elderly attended in primary care were evaluated every 3 months in a health area of the Spanish National Health System (SNHS). The research was called "SAMAC3 study". RESULTS: Significant negative changes were observed in the functional and cognitive capacity of the elderly, and in several nursing diagnoses. A decrease was observed in the frequency of visit to the nurses, hospital admittance, length of hospital stays, and falls. CONCLUSIONS: The functional and cognitive capacities of the cohort became worse. However, a significant decrease in the frequency of use of health services was observed. The nurses detected significant changes in activity-exercise, cognitive-perception, and roles-relationships, but their interventions were mostly centered on resolving clinical matters that required immediate attention. CLINICAL RELEVANCE: The present study allowed us to observe that a situation of social and health stress has worsened the health indicators of multimorbid elderly, and the clinical care of community nurses was insufficient to providing care for the deterioration of the physical and cognitive domains.

Validity and reliability of the measurement instrument of the nursing outcome health-related Physical Fitness (2004), proposed and transculturally adapted to the Spanish context.

BACKGROUND: Presently, physical inactivity is the main public health problem in many countries worldwide. Physical activity promotes the maintenance or improvement of one's physical condition. Physical fitness has been established as the main biological marker of the state of health of an individual, and therefore, there is a clear need to measure health-related physical fitness through the use of a reliable and valid instrument. This study is a continuation of the transcultural adaptation process and a new proposal of the nursing outcome Physical Fitness (2004), found in the 5th Edition of the Nursing Outcomes Classification. The objective of this study was to examine the validity and reliability of the nursing outcome Health-Related Physical Fitness survey, proposed and transculturally adapted to the Spanish context. METHODS: An instrumental study to validate the nursing outcome Physical Fitness (2004), from the 5th Edition of the Nursing Outcome Classification was carried out. It took place between the months of May, 2016 to May, 2017. On the first stage, the instrument proposed Health-Related Physical Fitness survey was administered to 160 adults who used the Health Services of Murcia, Spain by three independent evaluators. After 4 weeks, it was administered again to 33 participants to calculate the intra-rater reliability. Lastly, the SF-12v2 Health Survey was administered to obtain external evidence of validity. RESULTS: The inter-rater reliability of the nursing outcome proposed obtained high values (between 0.91-0.99) in the evaluations performed by the three evaluators. As for the intra-rater reliability, high values were obtained (0.94-1), except for the item "balance", which was moderate (0.56). Lastly, a positive and statistically significant correlation (p < 0.05) was obtained between the Physical Component Summary, and the dimensions Physical Functioning and General Health from the SF-12v2 Health Survey, and the global score of the Health-Related Physical Fitness proposed instrument. CONCLUSIONS: The validity and reliability results of the nursing outcome Health-Related Physical Fitness survey, proposed and transculturally adapted to the Spanish context, were adequate for its use by nurses with adults who use the Health Services of Murcia. However, this instrument must be analyzed with more diverse samples of health services users.

Analysis of Healthcare Costs Incurred in Regional Hospitals in Andalusia (Spain) during the COVID-19 Pandemic.

(1) Background: The global health crisis caused by the coronavirus disease (COVID-19) pandemic has led to extreme overloading of different public healthcare systems worldwide. The Spanish Public Healthcare System is one of them. This study aimed to conduct a comparative cost analysis to assess the impact of the COVID-19 pandemic on small- and medium-sized regional hospitals in Andalusia (Spain). (2) Methods: This comparative, multicentre, observational, and retrospective study was designed to perform a comparative cost analysis between the Alto Guadalquivir Health Agency (AGHA) and Poniente University Hospital (PUH), both of which belong to the Spanish Public Health System (PHS). The data included in this study corresponds to the total costs by area and year incurred by the 61,335 patients from both healthcare institutions (AGHA = 36,110; PUH = 25,225) in the areas of hospital emergency service (HES), hospitalisation, and intensive care unit (ICU), during the 24 months of the study period (from 1 January 2019 to 31 December 2020). (3) Results: The analysis results showed a significant increase in costs incurred in 2020 for HES relative to those incurred in 2019 for both AGHA (+14%; p < 0.003) and PUH (+36%; p = 0.002). Additionally, costs incurred for ICU increased significantly in 2020 relative to those incurred in 2019 for both AGHA (+30%; p = 0.003) and PUH (+46%; p = 0.002). Hospitalisation costs for AGHA also increased significantly (+9%; p < 0.012) in 2020 versus those obtained in 2019; however, no significant differences were found for PUH (+6%; p = 1) in the same period analysed. However, the number of patients treated in the areas of HES, hospitalisation, and ICU was significantly reduced throughout 2020 compared to 2019. (4) Conclusions: Our findings show that the costs incurred during 2020 in the regional hospitals of Andalusia (Spain) increased significantly in most of the parameters analysed relative to those incurred in the year before the pandemic (i.e., 2019).

Adaptación y validación de un instrumento de evaluación de la competencia del consejo breve para dejar de fumar. BTI-Prof© / Adaptation and validation of an instrument to evaluate the competence on a Brief Tobacco Intervention. BTI-Prof©

Objetivo: Adaptación y validación del BTI-St© para evaluar el nivel de competencia en consejo breve para dejar de fumar en profesionales de medicina y enfermería de Atención Primaria. Diseño: estudio transversal, de adaptación y validación psicométrica de un test referido a criterio. Emplazamiento: Atención Primaria. Participantes: Ciento cincuenta y cinco profesionales de medicina y enfermería de Atención Primaria en activo. Intervenciones: Se diseñaron 3 escenarios clínicos. A través de una plataforma online, los participantes en primer lugar visualizaban cada escenario donde se desarrollaba un consejo breve para dejar de fumar y posteriormente debían valorar si se había realizado de acuerdo con el modelo de las 5A+5R. Mediciones principales: Competencia en el consejo breve para dejar de fumar medida a través del BTI-Prof©. Resultados: Los resultados vinculados a la fiabilidad se obtuvieron mediante el coeficiente Kuder-Richardson y fueron para el escenario 1: 0,880, para el escenario 2: 0,829 y para el escenario 3: 0,826. El test-retest muestra una adecuada estabilidad temporal, con unos coeficientes de correlación intraclase de 0,857 (IC 95%: 0,734-0,923), p<0,0001 para el escenario 1, 0,829 (IC 95%: 0,676-0,909), p<0,001 para el escenario 2 y 0,869 (IC 95%: 0,76-0,928), p<0,0001 para el escenario 3. Conclusiones: El BTI-Prof© es una herramienta robusta, con adecuadas propiedades psicométricas para evaluar la competencia en consejo breve para dejar de fumar en profesionales de medicina y enfermería de Atención Primaria.(AU)

Objective: Adaptation and validation of the BTI-St© to assess the level of competence in brief tobacco intervention in general practitioners and nurses in Primary Health Care. Design: Cross-sectional study of adaptation and psychometric validation of a criterion-referenced test. Setting:Primary Health Care. Participants: One hundred fifty-five general practitioners and nurses working at Primary Health Care. Interventions: Three clinical scenarios were designed. Using an online platform, participants first viewed each scenario in which brief tobacco intervention was given. Health professional had to assess whether or not the scenarios were carried out in accordance with the 5A+5R model. Main measures: Competence in brief tobacco intervention measured by the BTI-Prof©. Results: Results related to reliability were obtained through Kuder-Richardson coefficient, being for scenario 1, 0.880, for scenario 2, 0.829, and for scenario 3, 0.826. The test–retest shows adequate temporal stability: intraclass correlation coefficient for scenario 1 0.857 (95% CI 0.734–0.923), p<0.0001, for scenario 2 0.829 (95% CI 0.676–0.909), p<0.001, and for scenario 3 0.869 (95% CI 0.76–0.928), p<0.0001. Conclusions: The BTI-Prof© is a robust tool with adequate psychometric properties to assess competence in brief tobacco intervention in Primary Health Care general practitioners and nurses.(AU)

[Adaptation and validation of an instrument to evaluate the competence on a Brief Tobacco Intervention. BTI-Prof©]. / Adaptación y validación de un instrumento de evaluación de la competencia del consejo breve para dejar de fumar. BTI-Prof©.

OBJECTIVE: Adaptation and validation of the BTI-St© to assess the level of competence in brief tobacco intervention in general practitioners and nurses in Primary Health Care. DESIGN: Cross-sectional study of adaptation and psychometric validation of a criterion-referenced test. SETTING: Primary Health Care. PARTICIPANTS: One hundred fifty-five general practitioners and nurses working at Primary Health Care. INTERVENTIONS: Three clinical scenarios were designed. Using an online platform, participants first viewed each scenario in which brief tobacco intervention was given. Health professional had to assess whether or not the scenarios were carried out in accordance with the 5A+5R model. MAIN MEASURES: Competence in brief tobacco intervention measured by the BTI-Prof©. RESULTS: Results related to reliability were obtained through Kuder-Richardson coefficient, being for scenario 1, 0.880, for scenario 2, 0.829, and for scenario 3, 0.826. The test-retest shows adequate temporal stability: intraclass correlation coefficient for scenario 1 0.857 (95% CI 0.734-0.923), p<0.0001, for scenario 2 0.829 (95% CI 0.676-0.909), p<0.001, and for scenario 3 0.869 (95% CI 0.76-0.928), p<0.0001. CONCLUSIONS: The BTI-Prof© is a robust tool with adequate psychometric properties to assess competence in brief tobacco intervention in Primary Health Care general practitioners and nurses.

Comparative Analysis of Quality of Life of Patients with Dermatological Problems: Teledermatology Versus Face-to-Face Dermatology.

The health-related quality of life (HRQoL) of the patients cared for with teledermatology (TD) services was analyzed as compared with face-to-face dermatology (F-F/D) at the hospital. This study was a controlled, non-blinded, intra-level, and multicenter randomized clinical trial, with a 6-month follow-up. A total of 450 patients were randomly assigned to two different groups. The Spanish version of the generic EuroQol-5-dimensions-5-Levels (EQ-5D-5L) questionnaire and the specific Skindex-29 questionnaire were used at 0 and 6 months. The number of primary care visits (2.24 TD; 1.68 F-F/D) and number of hospital visits (0.01 TD; 1.48 F-F/D) were statistically significant. It was observed that from month 0 onwards, the users included in the F-F/D group self-perceived a lower HRQoL than the users included in the TD group (Skindex-29 total: p ≤ 0.00; EQ-5D-5L VAS = p ≤ 0.00; EQ-5D-5L utilities = p ≤ 0.00). At the end of the study, the patients included in the F-F/D group still obtained lower scores in their perception of HRQoL, as compared to those included in the other type of follow-up (Skindex-29 total: p ≤ 0.00; EQ-5D-5L VAS = p ≤ 0.00; EQ-5D-5L utilities = p ≤ 0.00). TD was an effective diagnosis and follow-up tool. At the end of the study period, the HRQoL of the patients in both groups was significantly higher as compared to their baseline levels. Additionally, both the general and specific HRQoL perceived by the TD patients was higher than the F-F/D group from the start of the study.

What can be improved in learning to care for people with autism? A qualitative study based on clinical nursing simulation.

AIM/OBJECTIVE: The aim of this study was to identify the main patterns of errors that 4th year nursing students made in simulated clinical practice with scenarios of care for people with Autism Spectrum Disorder (ASD). BACKGROUND: Clinical simulation currently plays a major role in the training of nursing students and provides the participants with the opportunity to practice and develop their clinical sills with a pediatric patient diagnosed with ASD. DESIGN: A retrospective longitudinal qualitative study was performed. METHODS: Content analysis of the existing debriefing records from a period of 7 academic years (2016-2022) was carried out. The scenario was simulated by a standardized patient diagnosed with ASD, with 23 groups of nursing students. RESULTS: The results showed different patterns of errors. These patterns were grouped into 1 main category (weaknesses) and 5 major subcategories: clinical, communication, knowledge about ASD, emotions, and behavior towards parents. The most repeated errors were excessive use of verbal communication, abundant stimuli, low demand for information from primary caregivers, low demand for information about the child's emotions and interests, and a lack of knowledge of the profile of the child with ASD. CONCLUSION: From the findings of this study, we can highlight the lack of training that students received on the practical approach for providing care to these individuals. It has also been inferred in this study that clinical simulation is a tool that favors reflection and experiential learning for students when they are faced with caring for people with ASD.

Cross-Cultural Adaptation of the Instrument "Nurse-Physician Relationship Survey: Impact of Disruptive Behavior in Patient Care" to the Spanish Context.

Disruptive behavior in the healthcare context has an impact on patient care, healthcare personnel, and the health organization, and it also influences the therapeutic relationship, communication process, and adverse events. However, there is a lack of instruments that could be used for its analysis in the hospital care environment in the Spanish context. The objective of the study was to culturally adapt and perform a content validation of the tool "Nurse−Physician Relationship Survey: Impact of Disruptive Behavior on Patient Care", to the Spanish content (Spain). An instrumental study was conducted, which included an analysis of conceptual and semantic equivalence. A panel of experts analyzed the translations, by analyzing the Content Validity Index (CVI) of the group of items in the scale through the Relevance Index (RI) and the Pertinence Index (PI). Only a single item obtained an RI value of 0.72, although with PI value of 0.81, with consensus reached for not deleting this item. The CVI of all the items was >0.80 for the mean value of the RI, as well as the PI. The instrument was adapted to the Spanish context and is adequate for evaluating the disruptive behaviors on nurse−physician relationships and its impact on patient care. However, the importance of continuing the analysis of the rest of the psychometric properties in future studies is underlined.