Water insecurity among seasonal agriculture workers: perspectives from Spanish professionals.

BACKGROUND: Migrant seasonal agricultural workers face conditions of material vulnerability such as inadequate housing difficulties prevent access to running water supplies. The purpose of this study is to explore the perceptions of professionals involved in the care and support of seasonal migrant agricultural workers, as it relates to water access and water consumption and their impact on these workers' health, in a context of COVID-19 pandemic. METHODS: A qualitative exploratory and descriptive study was conducted in 2021 as part of a larger research project, based on 63 personal semi-structured interviews with professionals who provided support to seasonal migrant agricultural workers in three Spanish autonomous regions. COREQ checklist was used for reporting. The interviews were recorded, transcribed, and imported into ATLAS.ti-9 for an inductive thematic analysis. RESULTS: The results have been structured into two main themes: (1) Accessing and obtaining water; and (2) Health problems related to water consumption. Seasonal migrant agricultural workers experience barriers to obtaining safe water for hygiene, cleaning, food preparation and drinking. The implementation of regulations to reduce COVID-19 transmission resulted in improved hygiene levels in the migrants' quarters, including access to safe drinking water. CONCLUSION: This study suggests that water insecurity experienced by migrant seasonal agricultural workers in Spain results from their poor living conditions and causes health problems related to a lack of hygiene and the use of unsafe water. Sustainable solutions are needed beyond the pandemic in order to provide migrant workers with adequate living conditions and ensure their water needs are fulfilled.

Listening to stakeholders in the prevention of gender-based violence among young people in Spain: a qualitative study from the positivMasc project.

OBJECTIVE: This study seeks to deepen current knowledge of the phenomenon of gender-based violence (GVB) among young people in Spain, identifying the main challenges in terms of prevention from the perspective of key stakeholders in the field. METHODS: 23 semi-structured qualitative interviews were performed with professionals whose work involves youth and comes from different areas: social work, policy making, youth education, feminist and LGBTQ activism and anti-violence masculinities engagement (13 women and 10 men). RESULTS: Among the main challenges identified by stakeholders in relation to GBV preventive strategies in young populations there is a need to focus on transformative programmes within educational settings. The findings indicate that specific programs and interventions in this area may not be yielding the expected effectiveness. This outcome could be attributed less to a lack of resources and more to a failure to address the core issues and challenges adequately. Thus, the results underline that intervention programmes should emphasise equitable gender norms and gender relations and incorporate content on anti-violence masculinities. Finally, a pivotal aspect seen by professionals to facilitate GBV prevention is the design and development of interventions based on participatory and active approaches, close to young people's everyday situations. The results also draw attention to the need to analyse the impact of new forms of violence in greater depth, especially those that occur through information and communication technologies. CONCLUSION: Among other implications for policy and practice, the study points to the need to articulate interventions designed to work simultaneously at different levels of influence acting on people.

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 qualitative content analysis of nurses' perceptions about readiness to manage intimate partner violence.

AIMS: To explore the perceptions of nurses on the factors that influence their readiness to manage intimate partner violence (IPV) in Spain. DESIGN: Qualitative content analysis based on data from six different regions in Spain (Murcia, Region of Valencia, Castile and Leon, Cantabria, Catalonia, Aragon) collected between 2014 and 2016. METHODS: 37 personal interviews were carried out with nurses from 27 primary health care (PHC) centres and 10 hospitals. We followed the consolidated criteria for reporting qualitative research guidelines. Qualitative content analysis was supported by Atlas.ti and OpenCode. RESULTS: The results are organised into four categories corresponding to (1) acknowledging IPV as a health issue. An ongoing process; (2) the Spanish healthcare system and PHC service: a favourable space to address IPV although with some limitations; (3) nurses as a key figure for IPV in coordinated care and (4) factors involved in nurses' autonomy in their response to IPV, with their respective subcategories. CONCLUSION: In practice, nurses perceive responding to IPV as a personal choice, despite the institutional mandate to address IPV as a health issue. There is a need to increase continuous training and ensure IPV is included in the curriculum in university nursing undergraduate degrees, by disseminating the existing IPV protocols. Furthermore, coordination between healthcare professionals needs to be improved in terms of all levels of care and with other institutions.

Sleeping is a nightmare: A qualitative study on the experience and management of poor sleep quality in women with fibromyalgia.

AIM: This study aimed to explore the experience and management of poor sleep quality in Spanish women with fibromyalgia (FM). DESIGN: This was a qualitative study based on one-to-one interviews. METHODS: Twenty-one adult women diagnosed with FM were recruited from the community between January and March 2020. Data were collected through in-depth semistructured one-to-one interviews, using an interview guide of open questions about the experience and management of poor sleep quality, and were analyzed with thematic qualitative analysis. The symptom management theory was used as a biopsychosocial conceptual framework. RESULTS: The results were organized into two themes: (a) experience of poor sleep quality and (b) management strategies for poor sleep quality. Poor sleep quality was found to be a severe symptom of FM that negatively impacts pain, fatigue, stiffness, mental health, and quality of life. The participants perceived pharmacological treatment to be the main approach of health care professionals for improving sleep, and most did not want this form of treatment. Self-management strategies lack clear beneficial effects on sleep quality. CONCLUSION: Women with FM recognize that they need to receive more information from nurses and allied professions about sleep in the context of FM and how to effectively manage poor sleep quality. IMPACT: This study contributes to a better understanding of how women with FM experience and manage poor sleep quality. More information about management strategies for poor sleep quality from nurses and other health care professionals is needed in women with FM. The results of this study can be applied by nurses and health care professionals, including sleep educators, in the treatment of this patient group.

Burnout and job satisfaction among nurses in three Spanish regions.

AIMS: To determine the levels of job satisfaction and burnout syndrome and related factors among nurses in three Spanish regions. BACKGROUND: The nursing profession involves high work stress due to emotional involvement, workload and available resources. METHODS: Descriptive multicentric cross-sectional study. Sociodemographic and migration data were collected and participants completed the Job Satisfaction Questionnaire S20/23 and Maslach Burnout Inventory. The data were analysed using descriptive statistical methods using the program SPSS. RESULTS: The sample included 228 nurses (187 women and 41 men), with a mean age of 37.11 ± 10.87. Reported job satisfaction was medium to high. Overall, values were low in emotional fatigue and medium in depersonalization and personal fulfilment. In terms of migration, 21.59% of the participants had already moved to other Spanish regions or another country, while 18.58% had the intention of doing so. CONCLUSION: Nurses with a temporary contract showed a high burnout rate, and high levels of emotional fatigue, depersonalization and lack of personal fulfilment. IMPLICATIONS FOR NURSING MANAGEMENT: Strategies are needed to improve working and contractual conditions such as enhancing teamwork, management and leadership skills in nurses; achieving internal promotion; and having higher participation in decision-making and a better balance of power between health institution managers and health professionals.

Exploring primary health care professionals' perceptions about a patient feedback intervention to improve patient safety in Spanish primary health care centres: a qualitative study.

BACKGROUND: Patient feedback interventions are receiving increasing attention given their potential to improve health care provision. However, primary health care (PHC) professionals' acceptability and perceived utility of this type of interventions remain largely unexplored. OBJECTIVES: The aim of this study was to explore PHC professionals' perceptions, opinions and suggestions about a patient feedback intervention currently being designed to improve patient safety in Spanish PHC centres. METHODS: We conducted an exploratory qualitative study with 43 PHC professionals. Information was obtained from three semi-structured interviews and four focus groups. All data were audio-recorded, transcribed and analyzed using content analysis by three analysts. RESULTS: The patient feedback intervention was acceptable to health care professionals, who perceived it as a useful strategy to improve health care processes and activate patients. A number of factors potentially limiting the acceptability and perceived utility of the intervention were identified (low patient safety culture, low patient-centred care orientation and limited credibility of patient feedback data). Recommendations for designing and implementing the proposed intervention in the Spanish PHC centres were identified in relation to the following areas: 'collection and analysis of feedback data'; 'feedback display'; 'feedback delivery' and; 'implementation of safety improvement initiatives'. CONCLUSIONS: Although the proposed intervention was generally perceived as useful and acceptable, our study identified a number of tensions about the practical aspects of using the patient-reported data and the credibility of the data and what actions would arise from its use. The intervention has been adapted to address these tensions before its formal evaluation in a randomized clinical trial.

A qualitative study on primary health care responses to intimate partner violence during the economic crisis in Spain.

Background: The objective of this study was to explore how health professionals perceived the effect of the economic crisis and associated austerity measures on the detection of and cares for intimate partner violence (IPV) in primary care in Spain. Methods: Qualitative study designed using semi-structured interviews carried out with 145 health professionals in 16 primary health care centres in different regions of Spain. An inductive thematic analysis was made of the transcriptions. Results: Three main themes were identified: 'Women endure more violence during times of economic crisis', 'Fewer resources, fewer professionals and less time to respond to IPV' and 'Professionals' motivation as a requirement to respond to IPV'. Professionals perceived that economic precariousness triggered violence against women and made women more hesitant to put an end to violent relationships. They also reported that the austerity measures applied to primary health care negatively affected their ability to detect and adequately care for cases of IPV due to a heavy workload, reduced human resources, difficulties in training and the loss of resources to which women could be referred. To counteract these obstacles, health professionals' motivation played a vital role in the response to IPV. Conclusions: Institutional efforts to organize awareness programmes and training in order to improve and promote early diagnosis, care and rehabilitation of these women cannot stop during times of crisis and primary health care centres should facilitate health professionals' access to these programmes.

Health Providers' Narratives on Intimate Partner Violence Against Roma Women in Spain.

This qualitative study identifies health professionals' dominant, adaptive, and liberating narratives regarding inter-ethnic relations when talking about intimate partner violence (IPV) and the health system responses to the way it affects Roma women. Dominant narratives are oppressive internalized stories that shape social perceptions of members of both dominant and minority groups, adaptive narratives refer to those that acknowledge asymmetry and inequality, and liberating narratives directly challenge oppression with resistant views of stereotypes and negative interpretations. A total of 25 in-depth interviews were carried out with healthcare professionals in Spain in 2015. A discourse analysis of the interview transcriptions was conducted, showing the way in which different narratives about Roma people and IPV are combined among health providers. Dominant narratives were more salient: they were used by health providers to reflect prejudicial social perceptions in Spain that depict the Roma as a marginalized and traditional group, to construct Roma women in negative and prejudicial terms as patients, and to explain the existence of the cultural normalization of IPV among Roma women. Adaptive and liberating narratives showed a prevailing ideology in terms of the tendency to socially discriminate against Roma people. Using liberating narratives to train and raise awareness among health professionals about IPV among Roma women could facilitate a positive change in their treatment of Roma women who could be affected by IPV, helping to ameliorate the maintenance of existing prejudices.

A qualitative exploration of the impact of the economic recession in Spain on working, living and health conditions: reflections based on immigrant workers' experiences.

BACKGROUND: This study aimed to analyse how immigrant workers in Spain experienced changes in their working and employment conditions brought about Spain's economic recession and the impact of these changes on their living conditions and health status. METHOD: We conducted a grounded theory study. Data were obtained through six focus group discussions with immigrant workers (n = 44) from Colombia, Ecuador and Morocco, and two individual interviews with key informants from Romania living in Spain, selected by theoretical sample. RESULTS: Three categories related to the crisis emerged--previous labour experiences, employment consequences and individual consequences--that show how immigrant workers in Spain (i) understand the change in employment and working conditions conditioned by their experiences in the period prior to the crisis, and (ii) experienced the deterioration in their quality of life and health as consequences of the worsening of employment and working conditions during times of economic recession. CONCLUSION: The negative impact of the financial crisis on immigrant workers may increase their social vulnerability, potentially leading to the failure of their migratory project and a return to their home countries. Policy makers should take measures to minimize the negative impact of economic crisis on the occupational health of migrant workers in order to strengthen social protection and promote health and well-being.

"I'm not the woman I was": Women's perceptions of the effects of fibromyalgia on private life.

In this qualitative study, we explored how gender shapes women's experiences of living with fibromyalgia and how it affects their private lives. Through thematic analysis of data from 13 in-depth interviews in Spain, we identified seven themes which reflect that these women feel remorse and frustration for not being able to continue to fulfill the gender expectation of caring for others and for the home. This research contributes to a better understanding of what suffering from fibromyalgia implies for women and provides insights into how families and providers can support women with fibromyalgia in order to achieve a beneficial lifestyle.

Barriers and facilitators to effective coverage of Intimate Partner Violence services for immigrant women in Spain.

OBJECTIVE: To explore service providers' perceptions in order to identify barriers and facilitators to effective coverage of Intimate Partner Violence (IPV) services for immigrant women in Spain, according to the different categories proposed in Tanahashi's model of effective coverage. METHODS: A qualitative study based on 29 in-depth personal interviews and four group interviews with a total of 43 professionals working in public services (social and health-care services, women's refuges, the police force, the judiciary) and NGOs in Barcelona, Madrid, Valencia and Alicante (Spain) in 2011. FINDINGS: Current IPV services in Spain partially fail in their coverage of abused immigrant women due to barriers of (i) availability, such as the inexistence of culturally appropriate services; (ii) accessibility, as having a residence permit is a prerequisite for women's access to different services and rights; (iii) acceptability, such as women's lack of confidence in the effectiveness of services; and (iv) effectiveness, for example, lack of specific training among professionals on the issues of IPV and immigration. However, interviewees also identified facilitators, such as the enabling environment promoted by the Spanish Law on Gender-Based Violence (1/2004), and the impetus it has provided for the development of other specific legislative tools to address IPV in immigrant populations in Spain (availability, accessibility and effectiveness). CONCLUSION: Whilst not dismissing cultural barriers, aspects related to service structure are identified by providers as the main barriers and facilitators to immigrant women use of IPV services. Despite noteworthy achievements, improvements are still required in terms of mainstreaming assistance tailored to immigrant women's needs in IPV policies and services.

[Fibromyalgia patients' perceptions of the impact of the disease in the workplace]. / Percepciones de pacientes con fibromialgia sobre el impacto de la enfermedad en el ámbito laboral.

OBJECTIVE: To explore the perceptions of patients with fibromyalgia (FM) on the problems they experience in the workplace, to discuss how they face and adapt to the limitations imposed by the symptoms of this disease. DESIGN: An exploratory qualitative study conducted in 2009. LOCATION: Associations of patients of FM from Valencia (Spain). PARTICIPANTS: Sixteen patients (13 women and 3 men) diagnosed with FM by a rheumatologist, of different ages and occupations, selected from key informants and the snowball technique. METHOD: Pragmatic sample. Semi-structured interviews until saturation of information when no new information emerged. Qualitative content analysis using the software Atlas.ti-5, to generate and assign codes, forming categories and identifying a latent theme. RESULTS: We identified four categories: difficulties in meeting the work demands, need for social support in the workplace, strategies adopted to continue working, and resistance to leave the employment. A theme which crosscut these categories emerged: FM patients motivation to continue in the labour market. CONCLUSIONS: Addressing the specific needs of patients it is essential in order to helping them to stay in the labour market, according to their capabilities. Awareness programs about the consequences of FM in the workplace are needed to achieve the collaboration of managers, entrepreneurs, occupational health professionals and primary care physicians and nurses.

Economic crisis, immigrant women and changing availability of intimate partner violence services: a qualitative study of professionals' perceptions in Spain.

INTRODUCTION: Since 2008, Spain has been in the throes of an economic crisis. This recession particularly affects the living conditions of vulnerable populations, and has also led to a reversal in social policies and a reduction in resources. In this context, the aim of this study was to explore intimate partner violence (IPV) service providers' perceptions of the impact of the current economic crisis on these resources in Spain and on their capacity to respond to immigrant women's needs experiencing IPV. METHODS: A qualitative study was performed based on 43 semi-structured in-depth interviews to social workers, psychologists, intercultural mediators, judges, lawyers, police officers and health professionals from different services dealing with IPV (both, public and NGO's) and cities in Spain (Barcelona, Madrid, Valencia and Alicante) in 2011. Transcripts were imported into qualitative analysis software (Atlas.ti), and analysed using qualitative content analysis. RESULTS: We identified four categories related to the perceived impact of the current economic crisis: a) "Immigrant women have it harder now", b) "IPV and immigration resources are the first in line for cuts", c) " Fewer staff means a less effective service" and d) "Equality and IPV policies are no longer a government priority". A cross-cutting theme emerged from these categories: immigrant women are triply affected; by IPV, by the crisis, and by structural violence. CONCLUSION: The professionals interviewed felt that present resources in Spain are insufficient to meet the needs of immigrant women, and that the situation might worsen in the future.

Understanding sickness presenteeism through the experience of immigrant workers in a context of economic crisis.

BACKGROUND: Previous economic recessions show that immigrant workers may experience longer periods of unemployment, a situation that may lead employees to presenteeism, the act of working in spite of a health problem. This study explored perceptions about the factors that lead to presenteeism in immigrant workers considering the context of economic crisis. METHODS: Six focus group discussions were held (February 2012), with men and women from Colombia, Ecuador, and Morocco (n=44) living in Spain and selected by theoretical sample. A qualitative content analysis was performed. RESULTS: Four categories were identified as factors that influence the occurrence of presenteeism in a context of economic crisis: poor employment conditions, fear of unemployment, employer/employee relationship, and difficulties in finding temporary replacement workers. Furthermore, musculoskeletal, respiratory, and mental problems were related to presenteeism. CONCLUSIONS: It is important to develop strategies to protect workers from negative working conditions that are associated with deterioration of health.

Experiences of male irregular migrants during their migration process and reception in Spain: lessons learned from the COVID-19 pandemic.

Background: The causes behind migration movements are complex. The COVID-19 pandemic highlighted how several countries failed to respond to the virus adequately, while simultaneously infringing on people's rights. Male irregular migrants fled their countries of origin and embarked on a perilous migration journey to Spain. The highly restrictive COVID-19 measures and border closures affected the mobility of male irregular migrants, whose reception in the host country posed a challenge. It led to the establishment of emergency facilities to accommodate male irregular migrants affected by COVID-19, which had repercussions on their mental health. The aim of this study was to describe and understand the experiences of male irregular migrants throughout their migration process and reception in Spain during the COVID-19 pandemic. Methods: Qualitative descriptive study. Sixteen male irregular migrants participated in this study. Data were collected between January and March 2023 through 16 one-on-one in-depth interviews. Thematic analysis was used to analyze the qualitative data using ATLAS.ti computer software. Results: Three main themes emerged: (1) How the COVID-19 pandemic drove male irregular migrants to leave their countries of origin, (2) How COVID-19 lockdown policies affected the migration journey, and (3) Receiving male irregular migrants in a pandemic: a housing labyrinth marked by isolation and loneliness. Conclusion: The COVID-19 pandemic increased the social, employment and health inequalities experienced by male irregular migrants. Border closures exacerbated the migration journey and the social stigmatization of this group, who were seen as carriers of the virus in both transit and host countries. Strict control measures in emergency and reception facilities had a significant psychological impact on the male irregular migrants due to the social isolation they experienced. Health institutions should develop programs to guarantee the care needs of irregular migrants.

"We want our freedom back, that's our only need": a qualitative study of health and social needs among asylum seekers and undocumented migrants crossing the borders from Belarus to Lithuania.

Background: The influx of undocumented migrants and asylum seekers into Lithuania, particularly during the COVID-19 pandemic, presents unique public health challenges. This study employs the Social Determinants of Health framework to explore the healthcare and social needs of this vulnerable population. Methods: In May 2022, we carried out a qualitative study through semi-structured interviews with asylum seekers across four centers in Lithuania. Employing both purposive and snowball sampling techniques, we selected participants for our investigation. The study comprised 21 interviews-19 conducted in Arabic and 2 in English-with durations ranging between 20 and 40 min each. We audio-recorded all interviews, transcribed them verbatim, and subsequently performed a thematic analysis using Atlas.ti software. This process of design and analysis strictly followed the principles of thematic analysis as outlined by Braun and Clarke, guaranteeing methodological precision and rigor. Findings: 21 interviews revealed critical insights into the healthcare access challenges, mental health issues, and social integration barriers faced by the participants. Key themes included 'Healthcare Needs and the Impact of the COVID-19 Pandemic 'and 'Social needs and Aspirations Amidst Pandemic-Induced Uncertainty '. The findings highlight the multifaceted healthcare and social needs of asylum seekers, juxtaposed against significant barriers they face. Access to medical services is hindered by long waiting times and financial constraints, especially for specialized care such as dental services. Communication issues during medical appointments due to language barriers and the lack of gender-specific healthcare, such as access to gynecological services, further exacerbate the challenges. Additionally, the COVID-19 pandemic introduces hurdles such as limited testing, isolation measures, language-specific information barriers, and insufficient social distancing practices. Mental health has emerged as a critical concern, with asylum seekers reporting significant stress and emotional exhaustion due to uncertainty and restrictive living conditions. Social needs extend to delayed asylum application processes, inconsistent language education opportunities, inadequate clothing, and nutrition that lacks cultural sensitivity, and living conditions characterized by overcrowding and insufficient facilities. The restricted freedom of movement within asylum seeking centres severely impacts their psychological well-being, underscoring a deep longing for autonomy and a better life despite the myriad of challenges faced. Discussion: The study illustrates the complex interplay between migration, health, and social factors in the context of a global pandemic. It highlights the need for culturally sensitive healthcare services, mental health support, and structured language education programs. Offering educational avenues alongside language courses for children and adults is essential for fostering social inclusion and securing economic prosperity. Addressing the challenge of language barriers is of utmost importance, as these barriers significantly impede undocumented migrants' and asylum seekers employment opportunities and their access to crucial services. The findings emphasized immigration as a health determinant and underscored the importance of inclusive health policies and advocacy for undocumented migrants and asylum seekers' rights and needs. Conclusion: There is an urgent need for comprehensive policies and practices that are grounded in the principles of equity, compassion, and human rights. Additionally, advocating for practice adaptations that are culturally sensitive, linguistically inclusive, and responsive to the unique challenges faced by undocumented migrants and asylum seekers. As global migration continues to rise, these findings are crucial for informing public health strategies and social services that cater to the diverse needs of this vulnerable population.

Challenges faced by migrant seasonal agricultural farmworkers for food accessibility in Spain: A qualitative study.

ABSTRACTMigrants who work seasonally in agriculture face living and working conditions that significantly impact their health. Some of these conditions are related to inadequate food access or food preservation and preparation hygiene. This study aimed to explore how migrant and seasonal agricultural farmworkers access food in Spain from the perspective of professionals supporting this population. We conducted a qualitative study in 2021 based on semistructured interviews with 92 social and health service professionals involved in the care of seasonal migrant workers in 4 Spanish provinces. We identified three themes through reflective thematic analysis: (1) Access to food depends on NGOs and institutions, especially after the COVID-19 pandemic; (2) Relevant cultural differences in diet depending on North African or sub-Saharan origin; (3) Seasonal migrant workers frequently suffer from nutritional and other health problems related to food security. The professionals interviewed described the diet of seasonal migrant workers as based on food with little variety, insufficient protein content, and obesogenic products. They also reported a generalized lack of hygiene in food storage and preparation. This study calls for encouraging dietary support strategies to reduce challenges in food accessibility, which would prevent health problems in this population and bring them social justice.

Estrés y ansiedad en estudiantes de enfermería durante la primera ola de la pandemia de COVID-19.

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 x?=36.31 (SD=5.71) and the stress score was x?=82.39 (SD=30.84). Lower anxiety levels were observed among those who joined the labour market (x?=35.67; SD=5.78) as compared to those who did not (x?=36.73; SD=5.67). Overall 92.4% of the students were acutely stressed. Acute stress was higher among those who did not work (x?=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.

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.