Stress and anxiety in nursing students during the first wave of the COVID-19 pandemic / Estrés y ansiedad en estudiantes de enfermería durante la primera ola de la pandemia de COVID-19

Objetivo: Comparar los niveles de ansiedad y estrés agudo entre los/las estudiantes de enfermería que se incorporaron al trabajo durante la primera ola de la pandemia de COVID-19 y aquellos que no lo hicieron. Métodos: Estudio descriptivo transversal multicéntrico realizado en tres universidades públicas españolas. Un total de 216 estudiantes de enfermería participaron en nuestro estudio. La recopilación de datos se realizó mediante un formulario en línea. Se recopilaron variables relacionadas con las condiciones para ingresar al mercado laboral y se incluyó la Escala de Autoevaluación de Ansiedad de Zung y el Cuestionario de Reacción Aguda al Estrés de Stanford. Se llevaron a cabo análisis univariados y multivariados. Resultados: El 42,6% de los estudiantes ingresaron al mercado laboral. La puntuación global de ansiedad fue x?=36,31 (DE=5,71) y la puntuación de estrés fue x?=82,39 (DE=30,84). Los niveles más bajos de ansiedad se encontraron en aquellos que se incorporaron al mercado laboral (x?=35,67; DE=5,78), en comparación con aquellos que no lo hicieron (x?=36,73; DE=5,67). El 92,4% del total de alumnos presentaron estrés agudo. El estrés agudo fue mayor en aquellos que no trabajaron (x?=84,35; DE=32,38), y significativamente en mujeres. Conclusiones: Los estudiantes de enfermería mostraron ser capaces de hacer frente al estrés en situaciones como la pandemia de COVID-19. No se puede descartar un efecto del trabajador sano. El estrés y ansiedad de los estudiantes de enfermería deben tenerse en cuenta por los tutores de prácticas clínicas y cuando se incorporan al mercado laboral por primera vez (AU)

Objective: To compare anxiety and acute stress levels among nursing students who joined the labour market during the first wave of the COVID-19 pandemic and those who did not.Methods: A cross-sectional, multicentre descriptive study across three Spanish public universities. A total of 216 nursing students participated in our study. Data collection was carried through an online questionnaire, that included variables on conditions for entering the labour market, the Zung Anxiety Self-Assessment Scale and the Stanford Acute Stress Reaction Questionnaire. We performed univariate and multivariate analyses. Results: Overall, 42.6% (n=92) of the students entered the labour market during the first wave of the COVID-19 pandemic. The global anxiety score was x̄=36.31 (SD=5.71) and the stress score was x̄=82.39 (SD=30.84). Lower anxiety levels were observed among those who joined the labour market (x̄=35.67; SD=5.78) as compared to those who did not (x̄=36.73; SD=5.67). Overall 92.4% of the students were acutely stressed. Acute stress was higher among those who did not work (x̄=84.35; SD=32.38) and significantly in women. Conclusions: Nursing students were able to cope with stress in situations such as the COVID-19 pandemic. A healthy worker effect could not be ruled out. Stress and anxiety among nursing students should be considered by clinical practice preceptors and at the time students first enter the labour market (AU)

Percepciones de matronas de Atención Primaria sobre el uso de la telemedicina durante la pandemia COVID-19 en España / Primary health care midwives’ perceptions on the use of telemedicine during the COVID-19 pandemic in Spain

Objetivo: Explorar las experiencias de matronas/es de atención primaria de salud (APS) con la implementación de la telemedicina en la atención al embarazo y al puerperio durante la pandemia por COVID-19. Método: Estudio cualitativo exploratorio basado en análisis de contenido inductivo de 15 entrevistas semiestructuradas realizadas a matronas/es de APS en 2021-2022, seleccionadas intencionalmente en cuatro comunidades autónomas españolas. Resultados Se identificaron cinco categorías: 1)cambios en la modalidad de atención en el embarazo y puerperio: priorización de mujeres embarazadas, puerperio desprotegido, aumento de visitas domiciliarias y declive de los grupos de educación parental; 2)implementación de la telemedicina en un escenario cambiante: el lado positivo y negativo de la telemedicina; 3)reacción de las mujeres ante la telemedicina; 4)estrategias implementadas por las matronas para un cuidado humanizado, y 5)aprendizajes para el futuro. Conclusiones: El uso de la telemedicina por parte de matronas de atención primaria posibilitó la atención de mujeres embarazadas y puérperas durante la pandemia en España. Los aspectos positivos de la puesta en marcha de este tipo de atención plantean posibilidades de cambio hacia un formato híbrido de atención sanitaria.(AU)

Objective: To explore the experiences of primary healthcare (PHC) midwives with the implementation of telemedicine in pregnancy and puerperium care during the COVID-19 pandemic. Method: Exploratory qualitative study based on an inductive content analysis of 15 semi-structured interviews with intentionally selected PHC midwives in four Spanish Autonomous Regions, during 2021-2022. Results: Five categories were identified: (1)changes in the modality of care in pregnancy and puerperium: prioritization of pregnant women, unprotected puerperium, an increase of home visits and decline of parental education groups; (2)implementation of telemedicine in a changing scenario: the positive and negative side of telemedicine; (3)reaction of women to telemedicine; (4)strategies implemented by midwives for a humanized care, and (5)learning for the future. Conclusions: The use of telemedicine by primary healthcare midwives enabled the care of pregnant and postpartum women during the pandemic in Spain. The positive aspects of the implementation of this type of care raise possibilities for change towards a hybrid format of healthcare.(AU)

Nivel competencial adquirido en el abordaje de la violencia de género en estudiantes de Enfermería / Competence level achieved by Nursing students for addressing gender-based violence

Objetivo: conocer el nivel competencial en violencia de género de los estudiantes de 4º de Grado de Enfermería y comparar su nivel competencial con el adquirido por estudiantes de 1º.Método: estudio descriptivo transversal. Población de estudio: estudiantado de 1º y 4º curso del Grado en Enfermería de la Universidad Autónoma de Madrid. Recogida de datos: cuestionario validado Physician Readiness To Manage Intimate Partner Violence Survey (PREMIS).Resultados: participaron 47 estudiantes; el 96,1% en 1º y el 85,7% en 4º eran mujeres. Un 80,8% (n= 21) del estudiantado de 1º y un 57,1% (n= 12) de 4º señalaron no haber recibido ninguna formación sobre la violencia sobre la mujer infligida por su pareja (VMIP) antes de iniciar el grado. El 52,4% (n= 11) de 4º afirmó haber recibido formación teórica frente al 34,6% (n= 9) de 1º; y formación práctica el 23,8% (n= 5) de 4º frente al 3,8% (n= 1) de 1º. El alumnado de 4º obtuvo puntuaciones más elevadas en los ítems referidos a la autopercepción sobre su capacidad de actuación ante la víctima y conocimiento sobre violencia de compañero íntimo. Tanto en 1º como en 4º se identificó ser mujer como principal factor de riesgo para sufrir maltrato, y se sintieron con menos capacitación en la cumplimentación de los requisitos legales asociados a la notificación del maltrato.Conclusión: la implantación de la guía docente mejora la capacidad del estudiantado para la detección de los casos de VMIP, mostrando dificultades para aplicar el conocimiento adquirido a situaciones concretas. (AU)

Objective: to understand the competence level achieved by Nursing Degree students in their fourth year for addressing gender-based violence, and to compare their competence level with that acquired by first year students.Method: a descriptive cross-sectional study. Study population: 1st and 4th students of Nursing Degree at the Universidad Autónoma de Madrid (Madrid, Spain). Data collection: validated questionnaire Physician Readiness to Manage Intimate Partner Violence Survey (PREMIS).Results: 47 Nursing students; 96.1% in first year and 85.7% in fourth year were female. 80.8% (n= 21) of first year students and 57.1% (n= 12) of fourth year claimed that they had never received any training on Intimate Partner Violence against Women (IPVAW) before starting their degree. 52.4% (n= 11) of fourth year students stated that they had received theoretical training vs. 34.6% (n= 9) of first year students; and 23.8% (n= 5) of fourth year students had received practical training vs. 3.8% (n= 1) of first year students. Students in their fourth year achieved higher scores in those items related to self-perception of their skills of action towards the victim, and knowledge about the IPVAW. In first and fourth year, they identified that being a woman was a top factor of risk for suffering abuse. Students from both years felt less qualified to complete the legal requirements associated with abuse reporting.Conclusion: the implementation of a teaching guide improved the ability of students to detect cases of IPVAW, showing the difficulties to apply the knowledge acquired into specific scenarios. (AU)

Primary health care midwives' perceptions on the use of telemedicine during the COVID-19 pandemic in Spain.

OBJECTIVE: To explore the experiences of primary healthcare (PHC) midwives with the implementation of telemedicine in pregnancy and puerperium care during the Covid-19 pandemic. METHOD: Exploratory qualitative study based on an inductive content analysis of 15 semi-structured interviews with intentionally selected PHC midwives in four Spanish Autonomous Regions, during 2021-22. RESULTS: Five categories were identified: (1) changes in the modality of care in pregnancy and puerperium: prioritization of pregnant women, unprotected puerperium, an increase of home visits and decline of parental education groups, (2) implementation of telemedicine in a changing scenario: the positive and negative side of telemedicine (3) reaction of women to telemedicine (4) strategies implemented by midwives for a humanized care, (5) learning for the future. CONCLUSIONS: The use of telemedicine by primary healthcare midwives enabled the care of pregnant and postpartum women during the pandemic in Spain. The positive aspects of the implementation of this type of care raise possibilities for change towards a hybrid format of healthcare.

From students to nurses under pressure: Nursing students' entry into employment during the first COVID-19 wave.

AIMS AND OBJECTIVE: To describe the experiences of nursing students and their mental health as they entered employment during the first wave of the COVID-19 pandemic (May-June 2020). BACKGROUND: As other healthcare professionals, nursing students who worked during the first COVID-19 wave suffered from dysfunctional mental health symptoms. DESIGN: Sequential, mixed-method, multicentre study. METHODS: The study population comprised 92 students in the third and fourth year of the Nursing degree at three Spanish universities, who entered employment during the pandemic. Data were collected between May and June 2020. In the quantitative phase, data were collected using an online questionnaire containing both validated anxiety and stress scales. In the qualitative phase, semi-structured interviews were conducted with 18 participants. A descriptive analysis of the quantitative data and a reflexive thematic analysis of the qualitative data were carried out, and analyses were combined. COREQ checklist was used for reporting. RESULTS: The combined quantitative and qualitative results were organised into five thematic areas: (1) Interruption of clinical placements, (2) Entering employment on a healthcare assistant contract, (3) Preventing contagion, (4) Adapting to the situation and managing emotions, and (5) Lessons learned. CONCLUSION: The students had a positive overall experience of entering employment, as they were able to develop their nursing skills. However, they had an emotional impact in form of stress caused by excessive responsibility, academic uncertainty, lack of personal protective equipment and training in its use, and the possibility of spreading disease to their family members. RELEVANCE TO CLINICAL PRACTICE: In the current context, changes must be made in study programmes to instruct nursing students to be able to cope with extreme clinical situations, such as pandemics. The programmes should include a more extensive coverage of epidemics and pandemics and management of emotional aspects such as resilience.

A mixed methods study using case studies prepared by nursing students as a clinical practice evaluation tool.

AIM: To identify the presence of variability in the evaluation of case studies prepared by nursing students during their primary care rotations based on the existing evaluation rubric. To explore the difficulties experienced by link lecturers and students in preparing and evaluating case studies. DESIGN: A mixed methods study. METHODS: The scores for the rubric items and the final grades for the case studies were collected from a sample of 132 cases. Qualitative information was collected by conducting open-ended interviews with lecturers and a focus group session with students. RESULTS: Statistically significant differences were identified between the lecturers' mean final grades [F(5.136) = 3.984, p = 0.002] and a variety of items in the evaluation rubric (p < 0.05). In addition, effect sizes [η2 (≈0.14)] of considerable magnitude were found. Two themes emerged from the qualitative data: (1). the challenge of preparing the case studies and (2). the variable nature of the evaluations.

Case study: School-based care for a girl and her primary caregiver experiencing difficulties in managing diabetes treatment.

PURPOSE: To describe the use of the nursing process and standardized nursing language by the school nurse to facilitate the monitoring of the therapeutic regimen of a girl with type 1 diabetes mellitus and her caregiver. METHODS: Data were collected through clinical reports, observation, and physical examination of the girl and through interviews with her and her caregiver in accordance with Virginia Henderson's conceptual model. FINDINGS: Clinical reasoning informed the selection of NANDA-I nursing diagnoses. NIC nursing interventions were selected taking into consideration the available scientific evidence related to the care of children with type 1 diabetes mellitus. CONCLUSIONS: The school nurse is a key figure in improving and supporting the monitoring of the prescribed therapeutic regimen for children with chronic disease. IMPLICATIONS FOR NURSING PRACTICE: This case demonstrates the importance of adopting a conceptual model to guide the nursing process, as well as showing that standardized nursing languages are suitable for school nursing practice.

La violencia de género durante la pandemia por COVID-19 / Gender-based violence during the covid-19 pandemic

Objetivo: describir la situación de la violencia de género (VG) durante la pandemia por la COVID-19 en países de la Unión Europea y Estados Unidos: describir la incidencia de VG, identificar factores de riesgo agravados, detectar consecuencias de la pandemia en las mujeres, conocer planes de acción y detección de VG, y entender la visión del personal sanitario. Método: revisión narrativa mediante búsqueda en las bases de datos PubMed, Cinhal, Cuiden y Cochrane. Se incluyeron resultados sobre violencia contra las mujeres relacionados con la pandemia por COVID-19, y cuya población a estudio pertenezca a Europa o Estados Unidos. También se incluyeron datos del portal estadístico del Ministerio de Igualdad del Gobierno de España. Se excluyeron artículos de opinión. Resultados: se obtuvieron 179 resultados, de los cuales se analizaron finalmente 24. La incidencia de VG aumentó un 10,2-59% incrementándose el número de consultas telefónicas y online hasta un 182,93% en España. El confinamiento domiciliario ha agravado factores de riesgo de VG como el aislamiento y el control, y ha impactado de manera negativa en la salud mental de las mujeres, así como en su tasa de empleo. Se han llevado a cabo intervenciones de detección de VG en numerosos países, aunque los profesionales sanitarios afirman encontrar dificultades de trato con las víctimas tanto presencialmente por los equipos de protección, como por vídeo-consulta o llamada, por falta de trato no-verbal. Conclusiones: la pandemia por COVID-19 favorece el incremento de la VG al aumentar el control constante por parte del agresor y la escasez de recursos comunitarios.(AU)

Objectives: to describe the gender-based violence (GBV) scenario during the COVID-19 pandemic in European Union countries and the United States: describing the incidence of GBV, identifying the risk factors exacerbated, detecting the consequences of the pandemic in women, learning about plans of action and detection for GBV, and understanding the view by the healthcare staff. Method: a narrative review through search in the PubMed, Cinahl, Cuiden and Cochrane databases. The study included results regarding violence against women associated with the COVID-19 pandemic, and with study populations from Europe or the United States. Data from the statistical website of the Ministry for Equality of the Government of Spain were also included. Opinion articles were excluded. Results: in total, 179 results were retrieved, and 24 of these were finally analysed. The incidence of GBV increased by 10.2-59%, and there was an increase in the number of telephone and online consultations up to 182.93% in Spain. Lockdown at home has exacerbated the risk factors for GBV such as isolation and control, and there has been a negative impact on the mental health of women, as well as on their employment rate. Interventions for detecting GBV have been implemented in many countries, although healthcare professionals state that they find it difficult to deal with the victims both personally, due to the protection equipment, as by video-consultation or phone call, due to the lack of non-verbal treatment. Conclusions: the COVID-19 pandemic facilitated an increase in GBV by increasing the constant control by the aggressor and the lack of community resources.(AU)

Effectiveness of an Intervention Programme on Adherence to the Mediterranean Diet in a Preschool Child: A Randomised Controlled Trial.

BACKGROUND: The Mediterranean diet is considered one of the dietary patterns with the most accumulated scientific evidence on health benefits. In children, it has positive effects in the prevention of obesity and cardiovascular diseases, as well as in the prevention of diabetes. We aimed to evaluate the medium-term efficacy of an intervention programme, targeting adherence to the Mediterranean diet among preschool children. METHODS: In a randomised, parallel trial of participants aged 3-5 years, a school garden was attended in the experimental group, and in the control group, the usual content on the human body and health were taught. Adherence to the Mediterranean diet was assessed using the KIDMED questionnaire, controlling for weight, height, body mass index (BMI) and socio-demographic variables. RESULTS: A reduction in BMI was found in the experimental group after one year and at the end of the follow-up period. In the overall score obtained in the KIDMED survey, a statistical trend was found between the two groups (p = 0.076). In multivariate analysis, consumption of pulses more than once a week' was predictive of improved diet quality, with an Odds Ratio (OR) in the experimental group of 1.382 (95% CI 1.126-1.695; p = 0.009). CONCLUSIONS: The experimental approach improved the quality of the participants' diet, increasing adherence to the Mediterranean diet due to increased consumption of plant-based protein.

Propuesta de organización de la investigación en enfermería en la comunidad de madrid: un giro hacia la discriminación positiva / Organization proposal for nursing research in the Community of Madrid: a turn towards positive discrimination

Está demostrado que para mejorar la calidad de la atención sanitariaque se presta es necesario que las actuaciones realizadas se realicen sobre la base de unos conocimientos sólidos y científicamente demostradosque permitan garantizar e impulsar la excelencia en el sistema sanitario.En lo que a la investigación enfermera se re f i e re, estudios recientesseñalan la escasez de enfermeras/os dedicadas a tiempo completo op a rcial a la investigación, lo que supone una pérdida importante de recursoshumanos en investigación pues ya hay un buen número de profesionalesenfermeros en vías de capacitación o capacitados para llevara cabo estudios que puedan aportar evidencias sobre los mejores cuidadosenfermeros para implantar en la práctica.El objetivo de este trabajo es describir una propuesta organizativa quefomente la investigación enfermera en la Comunidad de Madrid, dadoque el marco legislativo actual permite sustentar una organización diferentetanto en el contexto nacional como en el autonómico

It has been shown that in order to improve the quality of the healthcareattention given, it is necessary for the actions taken to be performed onthe basis of solid and scientifically proven knowledge that enable guaranteedexcellence in the healthcare system. As far as nursing research isconcerned, recent studies make reference to the shortage of full-time orpart-time nurses dedicated to research. This represents an important lossof human resources in research as there are a number of nursing professionalsgetting their training or already trained to work in researchdoing trials, who can bring their experience on nursing care to integrateinto the practice.The objective of this study is to describe an organization proposal thatfosters nursing research in the Community of Madrid, given that the currentlegislative framework allows the existence of a different organization,both at national and state level

Los cuidadores familiares. Su evolución en el ámbito rural en el último siglo / The family carers: evolution in rural regions during the last century

FUNDAMENTO: Analizarlos cambios que han sufrido los cuidados familiares realizados por las mujeres en el ámbito rural en el siglo XX. MÉTODOS: Mediante una metodología cualitativa basada en la observación participante y entrevistas a informantes se realizó una comparación retrospectiva de la situación. Se utilizó una muestra diacrónica para comparar la situación actual con la de las primeras décadas del siglo. RESULTADOS: El estudio muestra que durante el siglo XX ha habido transformaciones como: nuclearización de la familia, desaparición de la red de mujeres, mayor acceso a la educación por parte de ellas y aumento de los cuidados institucionalizados, que marcan la diferencia entre el presente y el pasado. CONCLUSIONES: Los cambios estructurales que se producen tanto en la vida de estas mujeres como en su entorno producen variaciones en uno de sus principales roles asignados: el de cuidadoras (AU)