Mapping health promotion practices across key sectors and its intersectoral approach at the local level: Study protocol.

AIMS: This study outlines a protocol aimed at identifying and mapping health promotion practices in need of development from the perspectives of key sectors responsible for it at the local level and from an intersectoral perspective across four Spanish regions. DESIGN: A complementary multi-method study combining survey methods and qualitative interviews will be adopted. METHODS: Purposive snowball sampling will be employed to select potentially rich informants from city councils, primary care centres, primary and secondary schools, and public health and civil society organizations in 12 municipalities sensitive to local health. Data on the degree of execution of health promotion activities, the level of intersectorality in their implementation, and their origins will be collected using PromoACTIVA questionnaires, an intersectoral typology model and an interview protocol. A parallel mixed analysis encompassing descriptive statistics and a 'framework analysis' will be performed. DISCUSSION: This study is expected to yield thorough and reliable insights into health promotion practices and omissions at the local level by focusing on key stakeholders, both individually and collaboratively. This information can enhance health promotion planning and improve its effectiveness, efficiency and contextual relevance. The development and testing of a methodology for the integration and interpretation of these data will ensure sustainable capacity building. IMPACT: Managers and practitioners interested in health promotion planning in the researched settings can benefit from a comprehensive map of the current state of their practices and insights into the starting points of collaboration. In addition, planners from other local settings will gain access to tools and methodologies to replicate and expand these maps to their own contexts. STAKEHOLDER ENGAGEMENT: Engaging key stakeholders with experience working in or with primary care centres, public health organizations, primary and secondary schools, civil society organizations, and city councils was vital to ensure the study's relevance and feasibility.

Kaleidoscope of emotions in hospital childbirth: A phenomenological study.

The childbirth process represents a moment of transition in the life of each woman, and is a source of complex and dynamic emotions. The aim of this study was to describe the emotions women experience during hospital childbirth and to determine the conditioning factors. A qualitative prospective study with a phenomenological approach was conducted using semi-structured interviews with 42 women. The negative emotions the women highlighted were fear, anguish, suffering, concern and nervousness, and they were related to factors such as: the evolution of childbirth, the appearance of complications, pain, the doubt about the ability to give birth and poor communication. The positive emotions highlighted were joy, satisfaction, security, confidence and tranquillity, and they were related to the first skin-to-skin contact, effective communication, partner support and participation in decisions. The findings may contribute to the development of policies aimed at achieving the women and newborns' maximum health and life potential.

Environmental health knowledge and competences in Basque health workers. A comparison of different professional profiles.

Environmental exposures are responsible for a quarter of morbidity and mortality rates globally. Primary care professionals work in a privileged position to detect and intervene on environmental health matters. Nevertheless, due to lack of specific training, international literature shows that primary care health professionals have limited skills to deal with those. The objectives of this study were to assess the levels of environmental health (EH) knowledge and competence of a sample of 446 health professionals and students in the Basque Country and explore the presence that EH has on their daily practice. Only a very small proportion of participants had received training and took environmental clinical history regularly. Participants were confident to deal, and actually dealt, with tobacco, pollen and sun exposures but less able to address topics like biomarkers, pesticides and endocrine disruptors. Finally, and in accordance to previous works, we found moderate levels of EH knowledge and skills in our sample, and observed that nurses and nursing students reported higher EH skills than other professional profiles but scored lower in knowledge. Despite the manifold impacts of environmental exposures on health, interventions to strengthen health professionals' EH competence are required.

Intervenciones de la matrona ante el miedo al parto / Midwife Interventions to Reduce Fear of Childbirth

Objetivo: Analizar los factores de riesgo que influyen en el desarrollo del miedo y las diferentes intervenciones que puede ofrecer la matrona, e identificar instrumentos de medición del miedo al parto. Metodología: Revisión bibliográfica en PubMed, Biblioteca Virtual de la Salud, Cochrane Library, Dialnet, Cuiden y Medes de los estudios publicados en los últimos 5 años, mediante combinaciones booleanas de palabras clave: «miedo», «parto» y «matrona». Resultados: Han sido seleccionadas 33 referencias bibliográficas basándose en criterios de selección preestablecidos: 9 estudios secundarios, 17 cuantitativos, 4 cualitativos y 3 protocolos. Los resultados se presentan en tres categorías de acuerdo con el objetivo establecido. La nuliparidad, la depresión y el escaso apoyo social son factores de riesgo de la tocofobia, entre otros. Se ha demostrado la eficacia de varias intervenciones para el manejo del miedo al parto: asesoramiento presencial, psicoeducación, educación prenatal, terapia artística, y técnica de libertad emocional (TLE) y técnica de la conciencia respiratoria (TCR). El instrumento más utilizado para medir el miedo al parto es el Wijma Delivery Expectancy Questionnaire (W-DEQ). Conclusiones: Se asocian con la tocofobia factores socieconómicos y obstétricos de la mujer, así como las experiencias previas. Existe una gran variedad de intervenciones para el manejo del miedo al parto que han obtenido resultados positivos en la reducción de este. Además, se ha visto que la continuidad asistencial es el mejor modelo asistencial para reducirlo. La disponibilidad de herramientas que permiten detectar situaciones problemáticas relacionadas con el miedo al parto, las importantes repercusiones que este supone y la existencia de intervenciones que pueden ayudar a su reducción, reclaman la necesidad de valorar sistemáticamente la tocofobia. (AU)

Objectives: Analyze the risk factors that influence the development of fear, the different interventions that the midwife can offer and identify instruments for measuring the fear of childbirth. Methodology: Literature review in PubMed, Virtual Health Library, Cochrane Library, Dialnet, Cuiden and Medes of studies published in the last 5 years using Boolean combinations of keywords: “fear”, “parturition” and “midwife”. Results: Thirty-three bibliographic references were included based on selection criteria. Nulliparity, depression and poor social support are risk factors for tocophobia, among others . Several interventions have been found to be effective in managing fear of childbirth: face-to-face counselling, psychoeducation, prenatal education, art therapy, and Technique of Emotional Freedom (TEF) and Breathing Awareness Technique (BAT). The most widely used instrument to measure fear of childbirth is the Wijma Delivery Expectancy Questionnaire (W-DEQ). Conclusions: Socioeconomic and obstetric factors of women, as well as previous experiences, are associated with tocophobia. There is a wide variety of interventions for the management of fear of delivery that have obtained positive results in the reduction of this. In addition, continuity of care is the best care model to reduce it. The availability of tools to detect problematic situations related to fear of childbirth, the important repercussions that this implies and the existence of interventions that can help to reduce it demand the need to systematically assess tocophobia. (AU)

[Chlorhexidine bathing in intensive care units for the prevention of nosocomial infections. A systematic review].

The aim of this study was to determine the effectiveness of chlorhexidine use patients in adult intensive care units for preventing nosocomial infections. We carried out a systematic review of randomized clinical trials published over the past 10 years. We collected the following data: type of infection, mortality, isolated microorganisms, and multidrug-resistant microorganisms. In two out of the five studies included in the review, bathing with chlorhexidine was ineffective due to low cross-infection rates at baseline and Gram-negative bacteria being the most prevalent type of microorganism, against which chlorhexidine is not as effective. No decline in death rates was either observed. Chlorhexidine bathing was mainly effective in preventing bloodstream infections and those caused by Gram-positive bacteria. Thus, its use may be effective in intensive care units with high prevalence of infections by this type of microorganisms.

Higiene con clorhexidina en unidades de cuidados intensivos para prevenir infecciones nosocomiales. Revisión sistemática / Chlorhexidine bathing in intensive care units for the prevention of nosocomial infections. A systematic review

El objetivo de este estudio fue conocer la efectividad de la higiene con clorhexidina para prevenir infecciones nosocomiales en pacientes adultos ingresados en unidades de cuidados intensivos (UCI). Se realizó una revisión sistemática de los ensayos clínicos aleatorizados publicados en los últimos 10 años en diferentes bases de datos. Se extrajo información sobre distintos tipos de infecciones, mortalidad, microorganismos implicados y microorganismos multirresistentes. Se incluyeron cinco estudios. La intervención no fue efectiva en dos estudios debido a una baja frecuencia de infecciones y a una alta prevalencia de bacterias gramnegativas, frente a las que la clorhexidina no es tan eficaz. La intervención tampoco redujo las tasas de mortalidad. La intervención fue efectiva principalmente para prevenir bacteriemias e infecciones por bacterias grampositivas, por lo que podría ser útil en las UCI con altas prevalencias de infecciones de esas características.(AU)

The aim of this study was to determine the effectiveness of chlorhexidine use patients in adult intensive care units for preventing nosocomial infections. We carried out a systematic review of randomized clinical trials published over the past 10 years. We collected the following data: type of infection, mortality, isolated microorganisms, and multi-drug-resistant microorganisms. In two out of the five studies included in the review, bathing with chlorhexidine was ineffective due to low cross-infection rates at baseline and Gram-negative bacteria being the most prevalent type of microorganism, against which chlorhexidine is not as effective. No decline in death rates was either observed. Chlorhexidine bathing was mainly effective in preventing bloodstream infections and those caused by Gram-positive bacteria. Thus, its use may be effective in intensive care units with high prevalence of infections by this type of microorganisms.(AU)

Theory-based capacity building intervention for intersectoral action for health at local governments: An exploratory pilot study.

AIM: To design, implement and evaluate a nurse-led capacity building intervention (PromoGOB) for intersectoral action for health at local governments. DESIGN: The programme was based on theories of the policy process and organizational change and facilitated by a nurse developing a health broker role. A complex intervention perspective was adopted in carrying out the study. The intervention was evaluated using a mixed method embedded design. METHODS: Quantitative component relied on a specific questionnaire. This tool, designed and piloted ad hoc, measured the capacity in terms of knowledge, awareness, resources, skills, and commitment, both at sectoral and government levels. For the qualitative component, semi-structured interviews were conducted. These explored the perceived capacity and feasibility and acceptability issues. The programme was initiated at the end of October 2019, and it lasted a total of 5 weeks. Nineteen individuals representing various sectors at a local government in northern Spain participated in the study. The data analysis was concluded by the end of March 2020. FINDINGS: PromoGOB positively influenced participants' capacity for addressing health promotion. Awareness component, intersectoral work and the nurse as health broker were essential in the programme. The necessity of political participation was identified as an issue to be prioritized in future studies. CONCLUSION: This study highlights the relevance of capacity building at local governments and the role that nurses can play in it. Further work should be undertaken to continue developing Health in All Policies approach at local level. IMPACT: This study offers a starting point for nurses to get involved in the policy process of health promotion, performing a specific role as health brokers, building capacity at local governments for addressing social determinants of health, and delving into theories and concepts of the Health in All Policies field.

Placing myself in a new normalized life: The process of becoming a first-time father. A grounded theory study.

Becoming a first-time father is an important transition period in men's lives that is frequently accompanied by joy and happiness. Engaging fathers has a broader impact on family and community and on fathers' own well-being. This study explores the process of men becoming first-time fathers and the experiences and challenges involved. Seventeen interviews with men in different stages of pregnancy, childbirth, and the postpartum period were conducted. Through a grounded theory design, a novel four-stage theoretical model emerged that represents the journey to first-time fatherhood. These stages are beginning the journey, fatherhood in limbo, facing reality, and settling down. Participants suggested that achieving a new normality was the final stage where they finally felt located with a sense of mastery in their journey to fatherhood. The novel theoretical approach of addressing the process of men's transition allowed more complete access to their perspectives. Men's needs are different at every phase of the transition to fatherhood, and the use of these findings can help care providers in caring for every man according to the stage he is facing.

Development of a taxonomy of activities in health prevention and promotion for primary care.

AIM: To develop a taxonomy of activities in health prevention and promotion for primary care. BACKGROUND: Despite health promotion being considered a keystone for population health and health care sustainability, its implementation remains insufficient. Customized evaluation tools are needed to address prevention and promotion omissions in primary care. METHOD: A taxonomy was designed using documentary analysis. Documents describing frontline primary care professionals' health prevention and promotion activities or omissions were identified and analysed using framework analysis. RESULTS: The 'Taxonomy of Activities in Health Prevention and Promotion for Primary Care' (TaxoPromo) includes 43 activities grouped into eight categories: planification, situational analysis, capacity building, development of awareness/public opinion, advocacy, development of networks, development of partnerships and intervention strategies. CONCLUSION: By contrasting the usual practices with the activities collected in the TaxoPromo, opportunities for improvement can be unveiled. IMPLICATIONS FOR NURSING MANAGEMENT: The TaxoPromo can be used at organisational and system levels to identify actions to integrate health prevention and promotion activities into a systematic, data-driven process; design implementation plans and tailor-made strategies for capacity building; enable benchmarking; and address omissions. The TaxoPromo can serve as a catalyst tool for the clarification and expansion of the nursing role in health prevention and promotion.

Building capacity for health promotion by addressing nurses' role confusion: Study protocol of a pilot clustered randomised controlled trial.

AIM: To describe the protocol for the pilot phase of a complex intervention, designed to address primary care nurses' role confusion in health promotion. DESIGN: A pilot clustered randomized controlled trial, with control and intervention groups. METHODS: The study will be conducted in a primary care setting. Participants will be nurses from the primary care health service working in a primary care team (PCT, 15 control group; 15 intervention group). Nurses in the experimental group will receive the ROLE-AP programme over a 3-week period. The control group will continue with the normal routine. The pilot will help determine the intervention's feasibility, acceptability, fidelity and quality of the programme components. Data collected preintervention, postintervention and 3 months after intervention will provide estimates of the intervention's preliminary effects on the main variable, nurses' degree of agreement concerning their expected role in health promotion. The study received funding from the local government in December 2019. DISCUSSION: Role confusion is promoting primary care nurses' omissions in their health-promoting practice, which is far from the ideal portrayed by the Ottawa Charter. Interventions are needed that reveal the most appropriate mechanisms for addressing role confusion, which requires reaching an intraprofessional agreement about the expectations for role activities. Healthcare organisations could benefit from the incorporation of a programme of these characteristics into standard practice. IMPACT: This study will produce a novel and comprehensive complex intervention that is expected to build nurses' capacity in primary healthcare organizations for health promotion, which is key to increasing the quality, efficiency and sustainability of the National Health System. The programme evaluation and feasibility study will reveal how to better use existing resources in a full-scale clinical trial. TRIAL REGISTRATION: ClinicalTrials.gov (ID: NCT04726696).

Parental Self-Efficacy to Promote Children's Healthy Lifestyles: A Pilot and Feasibility Study.

Positive parenting programs are a key strategy to promote the development of parental competence. We designed a pilot study based on parental self-efficacy to promote healthy lifestyles in their children aged between 2 to 5 years old. In this pilot study, we aimed to assess the effects of a parenting program on parental self-efficacy and parenting styles. Twenty-five parents were allocated into intervention (N = 15) and control group (N = 10). Parents from the intervention group received four group sessions (120 mi per session) to develop a positive parenting, parenting styles and parenting skills regarding to children's diet, exercise, and screen time, and two additional sessions about child development and family games. Parents from the control group received these two latter sessions. Parental self-efficacy, parenting styles, and meal-related parenting practices were measured before and after the intervention and at 3-month follow-up. Acceptability and feasibility of the program was also measured. Quantitative data were analyzed using the repeat measures ANOVA and ANCOVA tests and the effect size calculation. Content analysis was used to analyse open questions. Positive trends were found regarding parental self-efficacy and the use of authoritative parenting style. Parents also reported a great acceptability of the program getting high satisfaction. According to the feasibility barriers and facilitators aspects were identified. The positive trends founded in this study support the development of parenting programs to promote healthy lifestyle in children.

Six-month breastfeeding maintenance after a self-efficacy promoting programme: an exploratory trial.

BACKGROUND: Breastfeeding care plays a fundamental role in establishing breastfeeding and longer duration after discharge. Practices though vary among professionals involved and are often inconsistent with good practices recommended, being a threat to women's breastfeeding self-efficacy. Breastfeeding self-efficacy is considered a predictor for successful breastfeeding and a significant variable amenable to intervention for promoting lactation AIM: To evaluate the efficacy, feasibility and acceptability of a new breastfeeding self-efficacy promoting programme (SIALAC) on 6-month breastfeeding maintenance. METHODS: In this exploratory multi-centre controlled trial, participants were allocated into control and intervention groups sequentially. Professionals in charge of the treatment groups were trained in between, with an especial focus on reducing practice variability. Control and intervention group women received usual care, and the intervention group received in addition SIALAC, a three-stage breastfeeding self-efficacy promoting programme. Primary outcome was breastfeeding maintenance up to 6 months analysed by Kaplan-Meier and Cox proportional hazard regression analysis. Student's t-test or chi-square tests were also used for continuous and categorical variables. Data on breastfeeding status and breastfeeding self-efficacy were collected at baseline, and 4, 8 and 24 weeks after birth. RESULTS: From May 2014 through November 2015, participants were enrolled. The sample consisted of 112 women. No relevant socio-demographic or obstetric difference was found between groups. The intervention achieved a significant difference between groups in breastfeeding survival (X2  = 4.94, p = 0.026). Six-month breastfeeding maintenance was significantly higher in the intervention group (67% vs. 55%; X2  = 5.384, p = 0.020). Breastfeeding dropout in the control group was 3.3 (CI 1.1, 10.1) times higher than that of the intervention group at 6 months. Breastfeeding self-efficacy scores were higher in the intervention group although without significant statistical difference. The programme showed good acceptability. CONCLUSION: Breastfeeding self-efficacy promoting programme SIALAC was beneficial in fostering 6-month breastfeeding survival. Full-scale trial should consider feasibility-related issues identified.

A Reliable and Valid Parent Self-Report Tool to Assess Children's Global Health Needs.

PURPOSE: This study aimed to develop and validate a parent self-report questionnaire to explore global health needs in 2- to 6-year-old children. DESIGN AND METHODS: The development of the tool started with a conceptualization phase, followed by the design, pilot testing and psychometric validation of the questionnaire. The construct validity was assessed. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were carried out to explore the construct validity of the questionnaire. The normed fit index (NFI), root mean square error of approximation (RMSEA), chi square test and comparative fit index (CFI) were used to test the goodness-of-fit. Reliability was explored through Cronbach's alpha for internal consistency. RESULTS: A total of 973 parents completed the 119 items of the Necesidades de salud de la Población Infantil (NPI) questionnaire for the psychometric validation stage. The EFA identified seven factors: Lifestyles, Promotion of healthy lifestyles and influence of significant persons, Children's socioemotional aspects, Parents' socioemotional aspects, Parental self-efficacy, Situational influences, Professional advice. All the factors showed good internal consistency (Cronbach's alpha >0.7). The CFA showed good adjustment to the model (RMSEA = 0.048). The values of NFI and CFI were 0.741 and 0.779 respectively. CONCLUSIONS: The NPI questionnaire is a reliable and valid instrument. PRACTICE IMPLICATIONS: The seven-factor questionnaire will be useful for analyzing children's global health needs, designing health promotion programs according to identified needs and assessing related interventions.

Nurses' role in health promotion and prevention: A critical interpretive synthesis.

BACKGROUND: Role confusion is hampering the development of nurses' capacity for health promotion and prevention. Addressing this requires discussion to reach agreement among nurses, managers, co-workers, professional associations, academics and organisations about the nursing activities in this field. Forming a sound basis for this discussion is essential. AIMS AND OBJECTIVES: To provide a description of the state of nursing health promotion and prevention practice expressed in terms of activities classifiable under the Ottawa Charter and to reveal the misalignments between this portrayal and the ideal one proposed by the Ottawa Charter. METHODS: A critical interpretive synthesis was conducted between December 2018 and May 2019. The PubMed, CINAHL, Scopus, PsychINFO, Web of Science and Dialnet databases were searched. Sixty-two papers were identified. The relevant data were extracted using a pro-forma, and the reviewers performed an integrative synthesis. The ENTREQ reporting guidelines were used for this review. RESULTS: Thirty synthetic constructs were developed into the following synthesising arguments: (a) addressing individuals' lifestyles versus developing their personal skills; (b) focusing on environmental hazards versus creating supportive environments; (c) action on families versus strengthening communities; (d) promoting community partnerships versus strengthening community action; and (e) influencing policies versus building healthy public policy. CONCLUSIONS: There are notable misalignments between nurses' current practice in health promotion and prevention and the Ottawa Charter's actions and strategies. This may be explained by the nurses' lack of understanding of health promotion and prevention and political will, research methodological flaws, the predominance of a biomedical perspective within organisations and the lack of organisational prioritisation for health promotion and prevention.

Design, implementation and evaluation of an education course to promote professional self-efficacy for breastfeeding care.

The objective of this study was to determine the effect of an education short course on professional' self-efficacy in the area of breastfeeding care. The intervention had a pre-post design. A total of 43 healthcare professionals attended the course. The Kirkpatrick model for the development, implementation and evaluation of education actions was used for a 4.5-h course. The aspects evaluated included professionals' satisfaction and learning regarding confidence to support lactating mothers, perceived transfer of knowledge to the workplace and organizational changes. Data were collected using self-administered questionnaires (participants, unit managers, and education planners), before and after the intervention. Participants' satisfaction with the education action was high in all of the aspects measured (greater than 3.9 in scores of 0-5). Professionals showed a significant increase in self-efficacy levels for supporting breastfeeding (Wilcoxon test p-value = < 0.05, before intervention: median = 55, [IQR] = 11; after intervention: median = 60, [IQR] = 14). Participants, managers and organizers of the course identified changes in the way that professionals cared for breastfeeding mothers. In conclusion, this educational intervention enhanced professional self-efficacy and performance in breastfeeding care.

"Missed nursing care" in health promotion: Raising awareness.

AIM(S): This commentary aims to raise awareness of the possible causes of "missed nursing care" in health promotion and to propose possible solutions. BACKGROUND: Although health promotion is an essential function of nursing practice, "missed nursing care" has been scarcely studied in this area. It is crucial to know both its causes and possible strategies to prevent it. EVALUATION: We used evidence to identify possible causes of "missed nursing care" in health promotion, and we classified them into categories. We suggested the concept of capacity building to address its underlying causes. KEY ISSUE(S): Four main factors are involved in "missed nursing care" in health promotion, that is intrapersonal, interpersonal, organisational and cultural. Capacity building, including the development of knowledge, skills, commitment, structures, systems and leadership, could reduce missed care. CONCLUSION(S): "Missed nursing care" in health promotion is complex and is multifactorial in its origins. Capacity building could be a way to address its causes. IMPLICATIONS FOR NURSING MANAGEMENT: Nursing care in health promotion is paramount and a long-term investment that can contribute to the sustainability of the health system. Organisations and managers could view capacity building processes as a tool to prevent "missed nursing care" in health promotion.

Volunteerism as adolescent health promotion asset: a scoping review.

The Aim of this scoping review was to explore the available literature on volunteerism in adolescence and the benefits that this activity may report in their healthy development, from a salutogenic perspective. Searches were conducted in Pubmed, Cinahl, PsycINFO and Cochrane Library home databases; 15 articles were selected. Almost all of the studies were conducted in the United States between 1990 and 2000, primarily developed by psychologists and sociologists. The impact of volunteering was reflected in aspects that can be classified based on Lerner's dimensions of the PYD model. Volunteer activities promote an Improved academic, social, cognitive, and vocational competence in adolescents. An increase in conflict resolution capacity, leadership and personal agency, as well as improved pro-social attitudes and relationships with adults and peers, all of which contributed to their self-identification with the community. Moreover, increased positive development of adolescents reduces the rates of risky behaviors. Volunteerism may represent an opportunity for health promotion in adolescence. The concept of volunteering as an asset for health promotion during adolescence evokes the need to adopt and favor this view with regard to key areas of study associated with this stage such as education and health. Teams that work in community health, especially those in primary care, should recognize and value existing volunteer groups as an asset to promote the healthy development of adolescents. Friendlier health services should be encouraged that include comprehensive services from within educational institutions to community actions.

Social and emotional competence as key element to improve healthy lifestyles in children: A randomized controlled trial.

AIM: To show the results of an exploratory trial based on social and emotional learning to promote healthy lifestyles in 5-6 aged children. DESIGN: A randomized controlled trial. METHOD: The study was conducted from 2015-2016. Thirty-seven children were allocated to the intervention group (N = 19) and control group (N = 18). A multi-method and multi-component evaluation approach was used to capture the preliminary efficacy, acceptability, and feasibility of the programme. Repeat measures ANOVA followed by an ANCOVA tests were applied for the inferential analysis and for qualitative data, a content analysis was used. RESULTS: Positive effects on emotional perception and resilience were found in children's intervention group. Children and families showed high programme's acceptability and a wide range of barriers and facilitators were identified during the implementation process. CONCLUSION: Predicted mechanisms to improve healthy lifestyles in children throughout social and emotional competence seem to be supported by some of the study's results. However more research is needed to replicate such results and confirm these mechanisms. ClinicalTrials.gov Identifier: NCT02975544.

Explorando el papel de la autoeficacia parental en el uso de los servicios sanitarios: revisión de la literatura / xploring the relationship between parental self-efficacy and the use of health services: a literature review

INTRODUCCIÓN: El número de consultas de urgencias pediátricas en los últimos años han experimentado un aumento notable. Muchos son los factores que influyen en el uso de los servicios sanitarios y en el uso que los padres hacen de estos servicios. Se ha demostrado que la autoeficacia parental juega un papel fundamental en el manejo de la salud y la enfermedad de los niños, y puede que también lo esté haciendo en el uso de los servicios de salud. OBJETIVO: Se plantea esta revisión narrativa de la literatura, con el propósito de explorar el papel que la autoeficacia parental tiene en el cuidado de los niños y el uso de los servicios sanitarios. MÉTODO: Se realizó una búsqueda bibliográfica en Pubmed, Cinhal y Psyc-Info. RESULTADOS: No se encontraron estudios que explorasen de manera directa la autoeficacia parental y el uso de los servicios sanitarios. Sin embargo, la relación existente entre el concepto de autoeficacia y el manejo de la salud infantil y las enfermedades menores conduce a pensar que la autoeficacia parental puede estar jugando un papel importante en el uso de los servicios sanitarios. CONCLUSIÓN: Es necesario llevar a cabo estudios que ayuden a explorar la relación entre la autoeficacia parental y el uso de los servicios. Esta información puede ser de gran ayuda para planificar acciones de educación para la salud acordes con las necesidades de esta población y contribuir a la sostenibilidad del sistema, reduciendo las visitas innecesarias a los servicios de urgencias.

INTRODUCTION: The number of visits to emergency departments in recent years has increased significantly. There are many factors that influence the use of health services and the use that parents make of these services. It has been shown that parental self-efficacy plays a fundamental role in the management of children's health and illness and may also be the case in the use of health services. OBJECTIVE: The purpose of this narrative review was to explore the role that parental self-efficacy plays in the care of children and the use of health services. METHODS: To this end, a bibliographic search was carried out in Pubmed, Cinhal and PsycINFO. RESULTS: No studies were found that directly explored parental self-efficacy and the use of health services. However, the relationship between the concept of self-efficacy and the management of children's health and minor illnesses shown in the literature points out towards the idea that parental self-efficacy may be playing an important role in the use of health services. CONCLUSION: Future observational studies are necessary to explore the relationship between parental-self-efficacy and use of service. This information can be of great help in planning health education actions according to the needs of this population and contributing to the sustainability of the system, decreasing unnecessary visits to the emergency departments.

Parental competence programs to promote positive parenting and healthy lifestyles in children: a systematic review / Programas de competência dos pais para promover parentalidade positiva e estilos de vida saudáveis em crianças: uma análise sistemática

Abstract Objective To analyze the available evidence regarding the efficacy of interventions on parents whose children were aged 2-5 years to promote parental competence and skills for children's healthy lifestyles. Source Articles published in English and Spanish, available at PubMed, Psycinfo, CINAHL, Web of Science, Eric, and Cochrane Library were reviewed. Summary of the findings The literature search yielded 2282 articles. Forty-one full texts were retrieved and assessed for inclusion using the PRISMA flow diagram. Twenty-six articles were excluded, as they did not meet the inclusion criteria. In the end, 15 studies were included. The studies were conducted between 2003 and 2016, nine in North America, four in Europe, and two in Asia. Extracted data were synthesized in a tabular format. CASPe guide was used to assess the quality of studies that was moderate overall. Parental self-efficacy was the main construct assessed in most studies. Four studies reported an increase in parental self-efficacy, although most of them were studies without control groups. Conclusions Outcomes of interventions to improve parental competence in order to promote children's lifestyles are promising, but inconsistent. Additional studies with higher methodological and conceptual quality are needed.

Resumo Objetivo Analisar as evidências disponíveis com relação à eficácia de intervenções em pais de filhos entre dois e cinco anos para promover a competência e as habilidades dos pais a respeito de estilos de vida saudáveis para as crianças. Fonte Foram analisados artigos publicados em PubMed, Psycinfo, CINAHL, Web of Science, Eric e Biblioteca Cochrane. Inglês e espanhol. Resumo dos achados A pesquisa da literatura encontrou 2.282 artigos; 41 textos completos foram selecionados e avaliados para inclusão com o fluxograma Prisma; 26 artigos foram excluídos, pois não atendiam aos critérios de inclusão. Por fim, 15 estudos foram incluídos. Os estudos foram feitos entre 2003 e 2016. Nove estudos foram conduzidos na América do Norte, quatro eram de origem europeia e dois de origem asiática. Os dados extraídos foram sintetizados em formato de tabela. O guia CASPe foi usado para avaliar a qualidade dos estudos, que, em geral, foi moderada. A autoeficácia dos pais foi o principal dado avaliado na maioria dos estudos. Quatro estudos relataram um aumento na autoeficácia dos pais, apesar de que a maioria era de estudos sem grupo de controle. Conclusões Os resultados de intervenções para melhorar a competência dos pais para promover os estilos de vida das crianças são promissores, porém incoerentes. São necessários estudos adicionais com melhor qualidade metodológica e conceitual.