Mental health during ecological crisis: translating and validating the Hogg Eco-anxiety Scale for Argentinian and Spanish populations.

BACKGROUND: Eco-anxiety is increasingly recognized as a shared experience by many people internationally, encompassing fear of environmental catastrophe and anxiety about ecological crises. Despite its importance in the context of the changing climate, measures for this construct are still being developed in languages other than English. METHODS: To contribute to global eco-anxiety research, we translated the Hogg Eco-Anxiety Scale (HEAS) into Spanish, creating the HEAS-SP. We validated this measure in samples from both Argentina (n = 990) and Spain (n = 548), performing measurement invariance and confirmatory factor analyses. Internal consistency of the scale and score stability over time were investigated through reliability analyses. Differences in eco-anxiety across sociodemographic variables were explored through Student's t-tests and Pearson's r tests. RESULTS: The four-factor model of the HEAS-SP comprising affective and behavioural symptoms, rumination, and anxiety about personal impact demonstrated excellent model fit. We found good internal consistency for each subscale, and established measurement invariance between Spanish and Argentine samples, as well as across genders and participants' age. Spanish participants reported higher scores on the affective symptoms and personal impact anxiety factors compared to the Argentinian sample. Also, men reported lower levels than women on the subscales of affective symptoms, rumination, and personal impact anxiety. It was found that the relationship between both age and personal impact anxiety and age and affective symptoms varies significantly depending on the gender of the individuals. Younger participants tended to report higher scores on most dimensions of eco-anxiety. CONCLUSIONS: These findings enhance the global initiative to investigate, explore and therefore comprehend eco-anxiety by introducing the first valid and reliable Spanish-language version of this psychometric instrument for its use within Spanish and Argentinian populations. This study augments the body of evidence supporting the robust psychometric properties of the HEAS, as demonstrated in prior validations for Australian, Turkish, Portuguese, German, French, and Italian populations.

Perspectives of adult patients with mental health disorders on the relationship with nurses: a focus group study.

BACKGROUND: The relationship between the nurse and the patient with mental health disorder is crucial to the recovery process. Thus, patients with mental health disorders should be active subjects in this relationship by having autonomy and self-determination. METHODS: This study aimed to explore the perspectives of adult patients with mental health disorders on the relationship with nurses. A qualitative, descriptive, and exploratory study was conducted in March 2023, using focus group meetings in an association to support patients with severe mental health disorders in the Northern region of Portugal. The study followed the Consolidated Criteria for Reporting Qualitative Research (COREQ). A total of 8 patients participated in the study. Two focus group meetings were conducted. The inductive method was used, and content analysis of the transcripts was performed. The QDA Miner Lite 4.0 and Microsoft Excel were used for content analysis. RESULTS: Participants considered the relationship with nurses important for their recovery and expected nurses to provide support and help, being able to identify their needs, thus personalising their care. Attitudinal and communication aspects were also considered crucial for establishing a solid, trusting, and meaningful relationship. CONCLUSION: According to the findings nursing care is expected to focus on the patient, his/her preferences, expectations, and the uniqueness of each individual. The results of this study may be useful for the reflection and improvement of nurses in their relational and communication skills and the driving force for nursing students' awareness of the perspective of the relationship with patients with mental health disorder and its relevance.

The therapeutic relationship from the perspective of patients and nurses in the first days of admission: A cross-sectional study in acute mental health units.

The therapeutic relationship (TR) is essential in mental health nursing care and plays a fundamental role in the understanding and treatment of the patient's health status. Despite being a bidirectional construct, limited evidence is available to shed light on this issue in mental health units and even less so in the first days of admission. This study aimed to examine the association and differences between nurses' and patients' perspectives on the establishment of the therapeutic relationship in acute mental health units during the first days of hospitalization. A cross-sectional study was carried out in 12 Spanish mental health units. Data were collected from patients and nurses using the Working Alliance Inventory-Short (WAI-S) questionnaire. A total of 234 cases were analysed, including 234 patients and 58 nurses. The results showed a positive association between nurses' and patients' perspectives on the therapeutic relationship, but also revealed significant differences on each WAI-S dimension. Nurses assigned higher scores compared to patients on the perception of the quality of the therapeutic relationship. The dimensions with the greatest weight from the patients' perspective regarding the quality of the therapeutic relationship were the perception of greater agreement on goals and tasks among nurses. This study demonstrates the importance of establishing shared goals and tasks with nurses from the first days of hospitalization to improve the quality of the therapeutic relationship as perceived by patients. These findings underline the need to consider the different perspectives of both parties to promote a high-quality therapeutic relationship.

The experiences of family members of persons with intellectual disabilities who used residential care homes during the COVID-19 pandemic.

BACKGROUND: The global COVID-19 pandemic has shown the vulnerability of some population groups, including persons with intellectual and developmental disabilities (IDD). AIM: The present paper will provide more clarity and understanding of the experiences of family members of persons with IDD housed in residential facilities in Catalonia within the period of maximum restrictions during the COVID-19 pandemic. METHODS AND PROCEDURES: Semi-structured interviews were conducted using an interpretive phenomenological qualitative approach. Study participants consisted of 14 relatives of IDD individuals who were institutionalized in residence facilities or homes. The guiding questions emerged from group discussions with relatives of those with IDD who did not participate in the subsequent interviews. Drawing from this group, the factors that were identified to have had the greatest impact on their lives were later used to guide the interviews. Data collection was carried out in face-to-face individual interviews that were recorded together with the observations of two researchers between February and October 2022. RESULTS: Our analysis identified 4 main themes that developed into additional factors: the decision to stay at home or in the residence, fear, illness, and protocol. Individuals with IDD lost their daily routines, suffered from social isolation, and did not understand the situation. CONCLUSION: The results of this study allow for a better understanding of the experiences of families of persons with IDD in residential centres during the lockdown by identifying their needs and how to better support them in the future. OUTCOMES AND RESULTS: Knowledge and understanding of these events should allow for better management of similar situations in the future.

This study contributes to a growing body of research that examines the experiences of IDD individuals and their families during the early months of the COVID-19 pandemic. A qualitative phenomenological interpretative approach was used following the recommendations of qualitative research practices in health care. Our findings reveal that relatives of persons with IDD who lived in residential care homes felt that the residents were not adequately cared for by the staff, who applied measures for containment and contagion prevention that were disproportionate, resulting in their needs not being considered; these recommended measures had been developed for elderly care homes. Individuals with IDD lost their daily routines, suffered from social isolation, and did not understand the situation. The present findings show that residential care homes for persons with IDD require specific action protocols in crisis situations that are adapted to the needs and characteristics of each centre,thus adopting a model of care based on human rights.

Validating a measure for eco-anxiety in Portuguese young adults and exploring its associations with environmental action.

BACKGROUND: Worsening environmental conditions may amplify people's emotional responses to an environmental crisis (eco-anxiety). In Portugal, young people seem to be especially concerned about climate change. However, this phenomenon needs to be interpreted using accurate instruments. Thus, this study aimed to validate the Portuguese version of the Hogg Eco-Anxiety Scale (HEAS) in young adults and examine the associations among eco-anxiety, sociodemographic characteristics, and pro-environmental behaviours. METHODS: A survey was administered to 623 Portuguese university students aged between 18 and 25 years. The survey included our Portuguese translation of the HEAS (obtained through a back-translation and pretesting process), a sociodemographic assessment, and questions related to pro-environmental behaviours. Confirmatory factor analysis was conducted to assess the construct validity of the Portuguese version of the HEAS, and global fit indices were used to assess whether the original four-dimensional structure of the scale was reproduced. The reliability of the Portuguese version of the HEAS was evaluated by Cronbach's alpha and the intraclass correlation coefficient. Measurement invariance examined sex differences in scale interpretation. Linear regressions were used to detect whether sociodemographic variables predict eco-anxiety and whether eco-anxiety predicts pro-environmental behaviours. RESULTS: The factorial structure of the original scale was replicated in the Portuguese version of the HEAS, showing good internal consistency, reliability over time and strict invariance between men and women. A higher paternal education level predicted greater eco-anxiety in children. Two dimensions of eco-anxiety-namely, rumination and anxiety about personal impacts on the environment-predicted higher engagement in pro-environmental behaviours. CONCLUSIONS: The translated scale is an appropriate tool to measure eco-anxiety in the Portuguese context and should be used to collect evidence to drive environmental and health policies. An individual's education level should be considered a determinant of their emotional response to environmental conditions. Importantly, eco-anxiety can act as a protective emotional response to preserving the planet.

Transcultural adaptation and psychometric properties of the spanish version of the therapeutic relationship Assessment Scale-Nurse.

BACKGROUND: The nurse-patient therapeutic relationship is considered a pillar of mental health nursing, contributing to improved person-centered care and shared decision making with the patient. Given the importance of the nurse-patient therapeutic relationship, appropriate evaluation instruments are required to assess its quality. The aim of this study was to adapt and validate the Spanish version of the Therapeutic Relationship Assessment Scale-Nurse. METHODS: A translation and back-translation of the scale was carried out. To analyze the psychometric properties, the scale was administered to 213 nurses working in the field of mental health care. Temporal stability or test-retest was examined by means of the intraclass correlation coefficient (ICC) in a sample of 100 nurses. RESULTS: Confirmatory Factor Analysis revealed a four-factor structure identical to the original version, with some poor model fit indices. The ordinal alpha values for the total scale and the four factors were 0.939, 0.654, 0.798, 0.801, and 0.866, respectively. The intraclass correlation coefficient was 0.928 (95% CI: 0.893-0.952). CONCLUSIONS: The results show that the Spanish version of the Therapeutic Relationship Assessment Scale-Nurse is reliable for determining the quality of the therapeutic relationship that mental health nurses can establish with their patients. However, more studies are needed to analyse the model fit of the instrument's factor structure in the Spanish population.

Impact of the 'reserved therapeutic space' nursing intervention on patient health outcomes: An intervention study in acute mental health units.

AIMS: To evaluate the effectiveness of the 'reserved therapeutic space' intervention for improving the nurse-patient therapeutic relationship in acute mental health units in Spain. DESIGN: Multicentre intervention study with control group. METHODS: The study will be carried out in 12 mental health units. The 'reserved therapeutic space' intervention to be tested has been co-designed and validated by both nurses and patients. The quality of the therapeutic relationship, the care received and perceived coercion among patients will be assessed. An estimated 131 patients per group are expected to participate. Funding was granted by the Instituto de Salud Carlos III. Co-financed by the European Union (European Regional Development Fund (ERDF) (PI21/00605)) and College of Nurses of Barcelona (PR-487/2021). The proposal was approved by all the Research Ethics Committees of participating centres. RESULTS: This project will lead to changes in clinical practice, transforming the current models of organization and care management in mental health hospitalization units. No patient or public contribution.

Adaptation of the person centered therapeutic relationship patient version (PCTR-PT) to a version for physiotherapists (PCTR-PHYS) and evaluation of its psychometric properties.

BACKGROUND AND PURPOSE: The therapeutic relationship is a central component for developing person-centered care within physiotherapy services. However, it is necessary to understand how this relationship is perceived by both parties involved. The Person Centered Therapeutic Relationship-Patient scale (PCTR-PT) was constructed to identify patients' perceptions. No instruments are currently available to correlate patients' and physiotherapists' perceptions of the therapeutic relationship. This study sought to adapt the PCTR-PT to develop a version for physiotherapists, the Person Centered Therapeutic Relationship Scale for Physiotherapists (PCTR-PHYS) and to determine its psychometric properties. METHODS: A three-stage study was performed: (1) item generation, (2) pretesting of the questionnaire, (3) analysis of psychometric properties. Factor validity and psychometric properties were analyzed by confirmatory factor analysis (CFA). Convergent validity was calculated. Internal consistency was verified using the Cronbach's alpha coefficient. The intraclass correlation coefficient (ICC) was used to examine temporal stability. RESULTS: Thirty-three physiotherapists participated in two rounds of cognitive interviews and 343 participated in the analysis of psychometric properties. The CFA confirmed the four-structure model. Reliability of the tool was confirmed by Cronbach's alpha (α = 0.863) for all four dimensions, as all were above 0.70, ranging from 0.704 (relational bond) and 0.898 (therapeutic communication). Test-retest was performed with 2-week intervals, indicating an appropriate stability for the scale (ICC = 0.908). DISCUSSION: The Person Centered Therapeutic Relationship Scale for Physiotherapists is a useful, valid and applicable instrument to evaluate the person-centered therapeutic relationship during physiotherapy interventions. It will enable the comparison of patients' and physiotherapists' perceptions. To provide person-centered care in physiotherapy services, there is a clear need to incorporate specific resources into clinical practice to evaluate the quality of the therapeutic relationship from the perspective of both the persons being treated and the professionals providing care.

Nurses' promotion of Mental Health First Aid Training Programmes for upper secondary students: a modified Delphi approach.

BACKGROUND: Mental Health First Aid Training Programmes can be carried out by nurses in schools. Adolescents have reported the importance of these interventions, the contents to be addressed, and intervention strategies that should be used. Mental health nurses have also discussed the characteristics of these training programmes. This study sought to create a consensus on the features of Mental Health First Aid Training Programmes promoted by nurses aimed at upper secondary students. METHODS: A descriptive mixed method study was developed using the modified e-Delphi technique. Original statements on the topic were drawn from the results section of previous studies with nurses and adolescents. The statements were included in a structured online questionnaire. An expert panel of 78 mental health nurses participated in the two-rounds online survey from October to December 2021. Absolute and relative frequencies of responses were analysed. The experts' comments were also considered. RESULTS: In the first round, experts suggested 4 new ideas about training programmes. Experts took a position on a total of 59 declarations. At least 75% of participants agreed with 58 statements about training programmes, namely about facilitators, intervention foci, evaluation methodology, participants, the implementation context, period and regularity, intervention strategies and content. The experts' opinions differed only in one statement that expressed the impaired sexual behaviour as a mental health problem to be addressed in the training programmes. CONCLUSIONS: Mental health nurses can lead the delivery of training programmes in upper secondary schools, improving adolescent competencies in mental health. Several educational approaches can be used to teach about mental health, related problems and actions underlying these conditions. Valid and appropriate assessment methods must be used. Our findings guide the planning, implementation and evaluation of these interventions in upper secondary schools and encourage nurses to explore these programmes and include them in their educational curricula.

Quality in Psychiatric Care in the Community Mental Health Setting from the Perspective of Patients and Staff.

The current paradigm of mental health care focuses on care provided in the community, increasingly moving away from hospital care models that involve considerable economic burden. Patient and staff perspectives on the quality of psychiatric care can highlight strengths and areas for improvement to ensure better care provision. The aim of this study was to describe and compare perceptions of quality of care among patients and staff in community mental health services and to determine possible relationships between these perceptions and other study variables. A comparative cross-sectional descriptive study was conducted in a sample of 200 patients and 260 staff from community psychiatric care services in the area of Barcelona (Spain). The results showed high overall levels of quality of care from patient (m = 104.35 ± 13.57) and staff (m =102.06 ± 8.80) perspectives. Patients and staff both gave high scores to Encounter and Support factors, while factors concerning patient Participation and Environment received the lowest scores. Continuous assessment of the quality of psychiatric care in the community setting is essential to ensure the highest quality of care, taking the perspectives of those involved into account.

Transcultural adaptation and assessment of psychometric properties of the Spanish version of the Scale for the Evaluation of Staff-Patient Interactions in Progress Notes.

PURPOSE: To adapt the Scale for the Evaluation of Staff Patient Interactions in Progress Notes to Spanish and to test the psychometric properties. DESIGN AND METHODS: The study was conducted in two phases: (1) Adaptation of the instrument to Spanish following the Standards for Educational and Psychological Testing. (2) Psychometric study in a sample of mental health nurses. FINDINGS: The Cronbach's alpha values were 0.97 for the total scale and 0.83 to 0.81 for each dimension. The inter-rater reliability values were between 0.94 and 0.97. PRACTICE IMPLICATIONS: The scale is a reliable tool for assessing nurses' clinical notes in relation to the quality of nurse-patient interactions.

The therapeutic relationship at the heart of nursing care: A participatory action research in acute mental health units.

AIMS AND OBJECTIVES: To explore the process of change within the clinical practice of nurses in mental health inpatient units in the context of a participatory process to improve the nurse-patient therapeutic relationship. DESIGN: Participatory Action Research. METHODS: Ninety-six nurses from 18 mental health units participated. Data were collected through focus groups and reflective diaries between March 2018 and January 2020. Data were analysed using inductive content analysis. The COREQ guidelines were used. RESULTS: The research process was carried out through two cycles of four stages each in which the nurses were able to identify the facilitating and limiting elements of their practice in relation to the therapeutic relationship. They then proposed two consensual improvement strategies for all the units, which they called reserved therapeutic space and postincident analysis. Finally, they implemented and evaluated the two strategies for change. CONCLUSIONS: This study has shown that, despite the different cultural and structural realities of the participating units, it is possible to implement a collaborative process of change, provided the needs and expectations of both the participants and the organisations are similar. RELEVANCE TO CLINICAL PRACTICE: The results obtained through Participatory Action Research were directly transferred to clinical practice, thus having an impact on individual nurses and patients, as well as on the collective dynamics of the teams and aspects related to the management of the units. NO PATIENT OR PUBLIC CONTRIBUTION: Patient or public input is not directly applicable to this study. Patients were recipients of the changes that were occurring in the nurses as part of their daily clinical practice.

A systematic review on the use of action research methods in mental health nursing care.

AIMS: To identify and synthesize evidence on the use of action research methods in mental health nursing care. DESIGN: Systematic review. DATA SOURCES: CINAHL, Web of Science, PubMed and Scopus databases were searched in January 2021. REVIEW METHODS: Data were selected using the updated Preferred Reporting Items for Systematic Reviews and Meta-Analysis framework. Two reviewers independently conducted the study selection, and quality appraisal using Joanna Briggs Institute Critical Appraisal Checklist for Qualitative Research, data extraction and data analysis procedures. RESULTS: Sixteen studies, half of which used participatory action research, were included in this review. Nurses, along with other stakeholders, were an active part of the action research process. The main topics of interest addressed were categorized as improving the adoption of a person-centred approach to care and improving decision-making procedures. The use of action research helped the participants to identify the meaning they attached to the topic of interest to be improved. Moreover, this method helped to identify needs and strategies for improving care. The studies concurred that the use of action research enabled participants to gain awareness, improve attitudes and acquire knowledge. In addition, it enabled participants to gain confidence and security in the group context, as key aspects of their empowerment. CONCLUSION: This review shows the usefulness of action research in any mental health nursing context, contributing to the improvement of care at both the individual and collective levels. IMPACT: This paper demonstrates the use of the action research method in the field of mental health nursing. Its use has improved the clinical practice of nurses as well as that of teams in both community and hospital settings, addressing issues of the person-centred approach to care and decision-making procedures.

Exploring the therapeutic relationship through the reflective practice of nurses in acute mental health units: A qualitative study.

AIMS AND OBJECTIVES: To explore the therapeutic relationship through the reflective practice of nurses in acute mental health units. BACKGROUND: In mental health units, the therapeutic relationship is especially relevant for increasing the effectiveness of nursing interventions. Reflective practice is considered an essential aspect for improving nursing care. DESIGN: Action and observation stages of a participatory action research project. METHODS: Data were collected through reflective diaries designed for the guided description and reflection of practice interactions related to the therapeutic relationship and content analysis was applied. A total of 152 nurses from 18 acute mental health units participated. The COREQ guidelines were used. RESULTS: The results were classified into three categories as follows: (i) Nursing attitude as a core of the therapeutic relationship. For the nurses, the attitudinal component was key in the therapeutic relationship. (ii) Nursing practices that are essential to the therapeutic relationship. Nurses identified practices such as creating a conducive environment, using an appropriate verbal approach, offering help and working together with the patient as essential for establishing a therapeutic relationship in practice. (iii) Contextual factors affecting the therapeutic relationship. The nurses considered the patient's condition, the care dynamics of the unit and its regulations, as well as the structure and environment of the unit, as contextual factors involved the establishment of an adequate therapeutic relationship in daily clinical practice. CONCLUSIONS: This study has provided knowledge of the importance and role of the nurses' attitude in the context of the nurse-patient therapeutic relationship based on the reflections of nurses in mental health units regarding their own practice. RELEVANCE TO CLINICAL PRACTICE: These findings help nurses to increase awareness and develop improvement strategies based on their own knowledge and day-to-day difficulties. Moreover, managers can evaluate strategies that promote motivation and facilitate the involvement of nurses to improve the therapeutic relationship with patients.

Actitudes y percepciones de las enfermeras hacia la conducta suicida: Revisión sistemática de estudios cualitativos / Nurses' attitudes and perceptions towards suicidal behaviour: Systematic review of qualitative studies

Objetivo principal: Conocer las percepciones y actitudes hacia la conducta suicida por parte de las enfermeras, así como su influencia en la evaluación y abordaje de esta. Metodología: Revisión sistemática de estudios cualitativos que sigue el modelo de metasíntesis para el análisis de los resultados. Resultados: El total de artículos incluidos en el trabajo han sido trece, a través de los cuales, se han obtenido cuatro categorías temáticas que sintetizan los resultados de los estudios evaluados. Conclusiones: El trabajo aporta una visión del camino que se está recorriendo, desde una postura moralista hacia la conducta suicida, a la comprensión de la patología que se ha de evaluar, tratar y prevenir.(AU)

Main objective: To know the perceptions and attitudes towards suicidal behaviour by nurses, as well as their influence on its evaluation and approach to it. Methodology: Systematic review of qualitative studies that follows the metasynthesis model for the analysis of results. Results: The total number of articles included in this paper has been thirteen, through which, four thematic categories that summarise the results of the evaluated studies have been obtained. Conclusions: The paper provides a vision of the path that is being followed, from a moralistic stance towards suicidal behaviour, to the understanding of the pathology that has to be assessed, treated and prevented.(AU)

Spanish adaptation of the quality in psychiatric care-outpatient (QPC-OP) instrument community mental health patients' version: psychometric properties and factor structure.

BACKGROUND: Health systems in the field of mental health are strongly committed to community models that allow patients to be attended in their own environment. This helps them to maintain their family and social ties while trying to avoid costly hospital admissions. The patients' perspective is a key component in the assessment of the quality of psychiatric care and can even determine their adherence to the devices where they are treated. However, there are few instruments with adequate psychometric properties for the evaluation of the quality of psychiatric care in community mental health. The Quality in Psychiatric Care - Outpatient (QPC-OP) instrument has adequate psychometric properties to assess the quality of psychiatric care from the patients' perspective. The aim of this study was to adapt and validate the Spanish version of the QPC-OP instrument. METHODS: A translation and back-translation of the instrument was carried out. To examine its psychometric properties, the instrument was administered to 200 patients attending various community mental health services. To assess test-retest reliability, the instrument was readministered after 7-14 days (n = 98). RESULTS: The Confirmatory Factor Analysis revealed a structure of 8 factors identical to the original version, with an adequate model fit. The internal consistency coefficient (Cronbach's alpha) was 0.951. The intraclass correlation coefficient was 0.764 (95% IC: 0.649 - 0.842), and higher than 0.70 in 5 of the 8 factors. Additionally, an EFA was performed and revealed that the instrument could behave in a unifactorial or four factor manner in the sample analyzed. CONCLUSIONS: Results show that the Spanish version of the QPC-OP instrument is valid and reliable for the assessment of quality of psychiatric care in the community setting.

Relationship between competency for evidence-based practice and level of burnout of physical therapists with the establishment of the therapeutic relationship.

BACKGROUND: Evidence-based practice (EBP) interventions and effective therapeutic alliance (TA) are associated with greater treatment success. Furthermore, burnout syndrome could be detrimental to the development of such TA. OBJECTIVE: To examine the association between EBP competencies and burnout level with the quality of TA among Spanish physiotherapists. METHODS: Cross-sectional research with an electronic survey including the EBP Questionnaire-19, Maslach Burnout Inventory and Working Alliance Inventory-Short (WAI-S) and administered to 471 physiotherapists. RESULTS: Regarding the EBP Questionnaire-19, physiotherapists scored highest on attitude and lowest on knowledge. For WAIS which achieved appropriate results of internal consistency and validity in the sample analyzed, bond scored the highest and goals the lowest. Years of experience was significantly associated with the task (r = 0.5; p = .003) and bond (r = 0.7; p = .002) and the WAIS total score (r = 0.8; p < .001), and all burnout subscales (-0.7 < r > 0.7; p < .001 for all). CONCLUSION: Lower levels of burnout and improved EBP competencies are associated with a TA of greater quality. The association between attitudes toward EBP, a higher level of self-confidence and a lower perception of depersonalization appear to be determinant factors for improving TA.

Cross-cultural adaptation and psychometric properties of the Spanish Quality in Psychiatric Care Forensic Inpatient Staff (QPC-FIPS) instrument.

"Quality in Psychiatric Care-Forensic Inpatient Staff (QPC-FIPS) is an instrument of Swedish origin validated to measure the perception of the quality of mental health care provided by forensic psychiatry professionals. The aim of this study was to cross-culturally adapt the QPC-FIPS instrument and to evaluate the psychometric properties of the Spanish version of the instrument. A psychometric study was carried out. For validity, content validity, convergent validity and construct validity were included. For reliability, the analysis of internal consistency and temporal stability was included. The sample consisted of 153 mental health professionals from four Forensic Psychiatry units. The adapted Spanish version of the QPC-FIPS scale was configured with the same number of items and dimensions as the original. The psychometric properties, in terms of temporal stability and internal consistency, were adequate and the factor structure, such as the homogeneity of the dimensions of the Spanish version of the QPC-FIPS, was equivalent to the original Swedish version. We found that the QPC_FIPS-Spanish is a valid, reliable and easy-to-apply instrument for assessing the self-perception of professionals regarding the care they provide.

Spanish mental health nurses' experiences of mechanical restraint: A qualitative descriptive study.

WHAT IS KNOWN ON THE SUBJECT?: Mechanical restraint is a common practice in mental healthcare settings in Spain, despite controversy. Mechanical restraint is perceived as a negative experience for nurses and service users. Mechanical restraint damages the nurse-patient therapeutic relationship, which is essential in providing quality care and promoting recovery. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: The negative experiences of service users and mental health nurses arising from use of mechanical restraint affects both parties involved and results in trauma. Using mechanical restraint can provoke a moral injury in mental health nurses which can negatively impact on the establishment of trust within the therapeutic nurse-patient relationship. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Nurses must be aware of the negative effects that mechanical restraint use has on both their practice and their day-to-day lives. Post-mechanical restraint debriefing is required to repair the damage to the trust aspect of the nurse-patient relationship. Involving service users in co-producing a debriefing framework may be a way to rebuild trust through constructive dialogue. ABSTRACT: INTRODUCTION: Mechanical restraint is an intervention that causes harm to service users and nurses, yet continues to be used in many countries, including Spain. However, there is a lack of research exploring Spanish mental health nurses' experiences of using mechanical restraint. AIM: To describe the experiences of mental health nurses who have used mechanical restraint in practice. METHODS: A qualitative descriptive methodology was used and a purposive sample of 10 Spanish mental health nurses were interviewed about their experiences of using mechanical restraint. Thematic analysis was then employed to analyse interview data. RESULTS: Participants' experiences of using mechanical restraint were mostly negative. Three main themes arose from the analysis of interview transcripts, (i) symmetrical trauma, (ii) moral injury and (iii) broken trust. DISCUSSION: The use of restrictive practices, which can be perceived as counter-therapeutic, exposes nurses to risks such as moral injury and service users to broken trust in the therapeutic nurse patient relationship. Avoiding empathy in order to use mechanical restraint is counterproductive, in the understanding that empathy is key to reducing this intervention. IMPLICATIONS FOR PRACTICE: Reducing or eliminating use of mechanical restraints should be a policy and practice priority due to the symmetrical harms it causes both nurses and service users. The trust aspect of the therapeutic nurse-patient relationship is a significant casualty when mechanical restraint is used, therefore involving service users in co-production of post-mechanical restraint debriefing can be an avenue for restoring this trust through dialogue.

The association between empathy and the physiotherapy-patient therapeutic alliance: A cross-sectional study.

BACKGROUND: The central component of person-centred care is in having a therapeutic realtionship. Furthermore, the empathy of the physiotherapist is one of the most important attributes in achieving a successful therapeutic alliance. OBJECTIVE: The aim of the research was to determine the association between the constructs of empathy and therapeutic alliance in Spanish physical therapists and the possible influence of socio-professional variables on them. DESIGN: Cross-sectional research. METHODS: An electronic survey including the Working Alliance Inventory-Short Form, the Interpersonal Reactivity Index and sociodemographic data with 473 Spanish physiotherapists. A descriptive, bivariate and simple lineal regression analysis was carried out. RESULTS: Work experience has a positive influence on bonding and the agreement on objectives and tasks (0.04 < B > 0.06; p < 0.01). The perspective taking dimensions and empathic concern positively influence the agreement on achievement (0.14 < B > 0.19; p < 0.001). Personal distress inversely influences bonding and the agreement on achievements and tasks (-0.13 < B > -0.09; p < 0.01). CONCLUSIONS: The dimensions of perspective taking and empathic concern seem to facilitate successful shared decision making in terms of treating objectives. Furthermore, the physiotherapist's personal distress acts as an obstacle to the development of the three subcomponents of the therapeutic alliance analysed.