Publications by authors named "Albert Sesé-Abad"

14 Publications

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Health Sciences-Evidence Based Practice Questionnaire (HS-EBP): Normative Data and Differential Profiles in Spanish Osteopathic Professionals.

Int J Environ Res Public Health 2020 11 15;17(22). Epub 2020 Nov 15.

Department of Physiotherapy, Faculty of Nursing, Physiotherapy and Podiatry, Universidad de Sevilla, 41009 Sevilla, Spain.

The main goal of this study was to obtain normative data of the scores of the Health-Sciences Evidence Based Practice (HS-EBP) questionnaire, and to analyse evidence-based practice (EBP) among potential clusters of osteopathy professionals in Spain. An online descriptive cross-sectional study has been applied. A total number of 443 Spanish practicing osteopaths answered a survey including the 5 dimensions of the HS-EBP questionnaire and sociodemographic, training, and practice variables using the "LimeSurvey" online platform. Results point out that the median scores for each five HS-EBP questionnaire dimensions were 95.00, 86.00, 78.00, 84.00 and 62.00 considering that the range of possible scores in each of the dimensions was: from 12 to 120 in dimensions 1, 4 and 5; from 14-140 in dimension 2; and from 10-100 in dimension 3. A clustering algorithm extracted 6 different profiles across the five HS-EBP latent dimensions: low scores in all dimensions (cluster 1); low scores in all dimensions but with medium scores in dimension 1 (cluster 2); mixed pattern of scores, low in dimensions 2 and 5 and medium in the rest of the dimensions; medium scores in all dimensions (cluster 4); high scores in all dimensions and low scores in dimension 5 (cluster 5); and high scores in all dimensions (cluster 6). Significant relationship was found among the response patterns in the clusters and: academic degree level, EBP training and training level, and work time invested in healthcare activity, research and teaching activity. These results allow a description of the actual level of EBP and differential profiles of Osteopathy care practice in Spain. Knowledge of normative scores of the HS-EBP questionnaire and identification of different predictors of Spanish osteopaths' EBP, e.g., academic degree, EBP training and training level, work time invested in healthcare activity, research, and teaching activity, and having a working relationship with an accredited educational centre, enable a comprehensive evaluation of the EBP of osteopathic professionals and can also be useful for developing and implementing formative intervention programs for improving EBP practice in osteopathic practice.
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http://dx.doi.org/10.3390/ijerph17228454DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7696302PMC
November 2020

Impact of the implementation of best practice guidelines on nurse's evidence-based practice and on nurses' work environment: Research protocol.

J Adv Nurs 2021 Jan 15;77(1):448-460. Epub 2020 Oct 15.

Faculty of Nursing and Physiotherapy, Balearic Islands University, Palma de Mallorca, Spain.

Aim: To determine the impact of the Best Practice Spotlight Organization® initiative on nurses' perception of their work environment and their attitudes to evidence-based practice.

Design: Quasi-experimental, multicentre study. The intervention is the participation in Best Prectice Spotilight Organizations to implement Best Practice Guidelines.

Methods: The study will include seven centres in the interventional group and 10 in the non-equivalent control group, all of them belonging to the Spanish national health system. The Practice Environment Scale of the Nursing Work Index, and the Health Sciences Evidence-Based Practice Questionnaire will be administered to a sample of 1,572 nurses at the beginning of the programme and at 1 year. This 3-year study started in April 2018 and will continue until December 2021. Statistical analyses will be carried out using the SPSS 25.0. This project was approved by the Drug Research Ethics Committee of the Parc de Salut Mar and registered in Clinical Trials.

Discussion: The study findings will show the current state of nurses' perception of their work environment and attitudes to evidence-based practice, and possible changes in these parameters due to the programme.

Impact: The findings could provide a strong argument for health policymakers to scale up the Best Practice Spotlight Organization® initiative in the Spanish national health system.
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http://dx.doi.org/10.1111/jan.14598DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7756465PMC
January 2021

Latent structure and factor invariance of somatic symptoms in the patient health questionnaire (PHQ-15).

J Affect Disord 2020 01 30;261:21-29. Epub 2019 Sep 30.

Department of Experimental Psychology, School of Psychology, Universidad Complutense de Madrid, Madrid, Spain.

Background: Somatic symptoms are highly prevalent in primary care although insufficiently understood. The Patient Health Questionnaire (PHQ-15) is a valuable screening test but it has not yet been possible to unequivocally demonstrate its latent structure and measurement invariance.

Methods: A total of 1,255 patients from 28 primary care centres suffering symptoms of anxiety, depression or somatisation participated in a clinical trial. They completed the PHQ-15 at baseline and 374 retook it at three months. Exploratory structural equation modelling (ESEM) was used to compare three models: 1) a single global factor for somatisation, 2) four specific correlated factors, and 3) a bifactor model integrating the first two models.

Results: A multi-group invariance analysis of the best-fit model was performed: the bifactor model (χ=25.17, df=23, p = 0.34, RMSEA=0.009, CFI=1.00, TLI=0.999). Strict invariance was good for both gender (RMSEA = 0.046, CFI = 0.973, TLI = 0.963) and age (RMSEA = 0.048, CFI = 0.964, TLI = 0.962). Configural and metric invariance were confirmed for moment of assessment, but scalar invariance was not.

Limitations: The two main limitations were the sample (primary care patients with emotional disorders), which was not representative of the general population, and the utilisation of ESEM (vs. confirmatory factor analysis), which did not allow a second-order factor model to be tested.

Conclusions: PHQ-15 showed a bifactor structure, providing both a single global measure of somatisation and specific measures of pain, gastrointestinal, cardiopulmonary and fatigue factors. Its factor invariance with regard to both gender and age was confirmed.
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http://dx.doi.org/10.1016/j.jad.2019.09.077DOI Listing
January 2020

Health Sciences-Evidence Based Practice questionnaire (HS-EBP) for measuring transprofessional evidence-based practice: Creation, development and psychometric validation.

PLoS One 2017 9;12(5):e0177172. Epub 2017 May 9.

Department of Psychology, University of the Balearic Islands, Palma de Mallorca, Balearic Islands, Spain.

Introduction: Most of the EBP measuring instruments available to date present limitations both in the operationalisation of the construct and also in the rigour of their psychometric development, as revealed in the literature review performed. The aim of this paper is to provide rigorous and adequate reliability and validity evidence of the scores of a new transdisciplinary psychometric tool, the Health Sciences Evidence-Based Practice (HS-EBP), for measuring the construct EBP in Health Sciences professionals.

Methods: A pilot study and a subsequent two-stage validation test sample were conducted to progressively refine the instrument until a reduced 60-item version with a five-factor latent structure. Reliability was analysed through both Cronbach's alpha coefficient and intraclass correlations (ICC). Latent structure was contrasted using confirmatory factor analysis (CFA) following a model comparison aproach. Evidence of criterion validity of the scores obtained was achieved by considering attitudinal resistance to change, burnout, and quality of professional life as criterion variables; while convergent validity was assessed using the Spanish version of the Evidence-Based Practice Questionnaire (EBPQ-19).

Results: Adequate evidence of both reliability and ICC was obtained for the five dimensions of the questionnaire. According to the CFA model comparison, the best fit corresponded to the five-factor model (RMSEA = 0.049; CI 90% RMSEA = [0.047; 0.050]; CFI = 0.99). Adequate criterion and convergent validity evidence was also provided. Finally, the HS-EBP showed the capability to find differences between EBP training levels as an important evidence of decision validity.

Conclusions: Reliability and validity evidence obtained regarding the HS-EBP confirm the adequate operationalisation of the EBP construct as a process put into practice to respond to every clinical situation arising in the daily practice of professionals in health sciences (transprofessional). The tool could be useful for EBP individual assessment and for evaluating the impact of specific interventions to improve EBP.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0177172PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5423642PMC
September 2017

Advanced Practice Nursing Competency Assessment Instrument (APNCAI): clinimetric validation.

BMJ Open 2017 02 23;7(2):e013659. Epub 2017 Feb 23.

Nursing and Physiotherapy Department, Universitat de les Illes Balears, Palma, Spain.

Objective: To describe the development and clinimetric validation of the Advanced Practice Nursing Competency Assessment Instrument (APNCAI) through several evidence sources about reliability and validity in the Spanish context.

Design And Setting: APNCAI development was based on a multisequential and systematic process: literature review, instrument content consensus through qualitative Delphi method approach (a panel of 51 Advanced Practice in Nursing -APN- experts was selected) and the clinimetric validation process based on a sample of 600 nurses from the Balearic Islands public healthcare setting.

Methods: An initial step for tool's content development process based on Delphi method approach of expert consensus was implemented. A subsequent phase of tool validation started from the analysis of APN core competencies latent measurement model, including exploratory and confirmatory techniques. Reliability evidence for each latent factor was also obtained. Items' scores were submitted to descriptive analysis, plus univariate and multivariate normality tests.

Results: An eight-factor competency assessment latent model obtained adequate fit, and it was composed by 'Research and Evidence-Based Practice', 'Clinical and Professional Leadership', 'Interprofessional Relationship and Mentoring', 'Professional Autonomy', 'Quality Management', 'Care Management', 'Professional Teaching and Education' and 'Health Promotion'.

Conclusions: Adequate empirical evidence of reliability and validity for APNCAI makes it useful for application in healthcare policy programmes for APN competency assessment in Spain.
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http://dx.doi.org/10.1136/bmjopen-2016-013659DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5337725PMC
February 2017

Content validity of a health science evidence-based practice questionnaire (HS-EBP) with a web-based modified Delphi approach.

Int J Qual Health Care 2016 Dec;28(6):764-773

Faculty of Nursing and Physiotherapy, University of the Balearic Islands, 07122 Palma de Mallorca  (Balearic Islands), Spain.

Objective: To develop a tool for measuring evidence-based practice (EBP) and to evaluate its content validity by Delphi technique. A five-factor/dimensions latent structure for the EBP construct was defined a priori and operationalized.

Design: Online Delphi technique.

Setting And Participants: A group of 32 national EBP experts from different health professions.

Intervention: The experts rated the initial questionnaire items according to adequacy and relevance criteria using four-point Likert scales and including open fields for suggestions, with basic and supplementary criteria consensus established a priori.

Main Outcome Measure: Level of consensus in the Content Validity Index Item.

Results: An EBP construct solution was designed with the elements that constitute the operationalization proposal of the EBP. This initial version consisted of 76 items, whereas the version arising from the Delphi study was made up of 73 items. In the first round, 13 items did not reach the minimum level of consensus, and 12 of these were reformulated. Three additional items were removed in the second round.

Conclusions: A new psychometric tool forms measuring EBP with a five-factor structure, and 73 items obtained adequate content validity evidence based on expert opinion.
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http://dx.doi.org/10.1093/intqhc/mzw106DOI Listing
December 2016

[Consensus on competencies for advanced nursing practice in Spain].

Enferm Clin 2015 Sep-Oct;25(5):267-75. Epub 2015 Aug 8.

Departamento de Enfermería, Facultad de las Ciencias de la Salud,Universidad de Málaga, Málaga, España.

Introduction: There is a lack of international consensus on the exact definition and core competencies of advanced practice nursing (APN) roles, a problem particularly acute in our national context due to the lack of APN role development, which has a significantly short history in our country. The main objective of this paper was the delineation of the competence framework for Advanced Practice Nurses in our national context based on expert consensus through the Delphi method

Method: Based on a preliminary literature review process, a conglomerate of 17 domains of competence (clusters of related competencies) were identified. This initial set was revised, refined and validated by a group of expert panellists on the subject (clinicians, researchers, managers, and teachers) through successive rounds in search of a suitable consensus on each of the various proposed items

Results: The results helped to establish a solid foundation in the form of a skills map that could identify those sets of more specific competencies for advanced practice roles, regardless of regulatory and professional practice context, identifying domains such as Research and Evidence Based Practice, Clinical and Professional Leadership, or Care Management

Discussion: This set of skills related to advanced practice roles in our environment can delineate competency standards common to this level of nursing practice, and serve as a reference for policy development, a review of roles, or the establishment of academic profiles.
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http://dx.doi.org/10.1016/j.enfcli.2015.06.007DOI Listing
August 2017

A multisample model validation of the evidence-based practice questionnaire.

Res Nurs Health 2014 Oct 7;37(5):437-46. Epub 2014 Jul 7.

Faculty of Psychology, Balearic Islands University, Palma, Spain.

Evidence-based practice may be implemented more successfully if the barriers to its implementation have been previously identified. Many of the available instruments to measure these barriers have been validated in single samples or without confirmatory analyses. The objective of the study was to contrast the goodness of fit of two measurement models (24 items and 19 items) for the Spanish version of the Evidence-Based Practice Questionnaire (EBPQ) in a sample of 1,673 full-time registered nurses in 10 hospitals and 57 primary health care centers in the Spanish Public Health Service. The 19-item model performed better in all four subsamples. A hypothesis of strict invariance, with equal factor loadings, intercepts, and error variance in all contexts in which it was evaluated, was supported. Goodness-of-fit indices provided strong evidence of good fit according to standard cut-off criteria in a multisample confirmatory factor analysis.
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http://dx.doi.org/10.1002/nur.21609DOI Listing
October 2014

Validity and reliability of instruments aimed at measuring Evidence-Based Practice in Physical Therapy: a systematic review of the literature.

J Eval Clin Pract 2014 Dec 22;20(6):767-78. Epub 2014 May 22.

Enfermería y Fisioterapia, Universidad de las Islas Baleares, Palma de Mallorca, Islas Baleares, Spain.

Rationale, Aims And Objectives: Our goal is to compile and analyse the characteristics - especially validity and reliability - of all the existing international tools that have been used to measure evidence-based clinical practice in physiotherapy.

Methods: A systematic review conducted with data from exclusively quantitative-type studies synthesized in narrative format. An in-depth search of the literature was conducted in two phases: initial, structured, electronic search of databases and also journals with summarized evidence; followed by a residual-directed search in the bibliographical references of the main articles found in the primary search procedure. The studies included were assigned to members of the research team who acted as peer reviewers. Relevant information was extracted from each of the selected articles using a template that included the general characteristics of the instrument as well as an analysis of the quality of the validation processes carried out, by following the criteria of Terwee.

Results: Twenty-four instruments were found to comply with the review screening criteria; however, in all cases, they were found to be limited as regards the 'constructs' included. Besides, they can all be seen to be lacking as regards comprehensiveness associated to the validation process of the psychometric tests used.

Conclusion: It seems that what constitutes a rigorously developed assessment instrument for EBP in physical therapy continues to be a challenge.
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http://dx.doi.org/10.1111/jep.12180DOI Listing
December 2014

Using the R-MAPE index as a resistant measure of forecast accuracy.

Psicothema 2013 ;25(4):500-6

Universidad de las Islas Baleares.

Background: The mean absolute percentage error (MAPE) is probably the most widely used goodness-of-fit measure. However, it does not meet the validity criterion due to the fact that the distribution of the absolute percentage errors is usually skewed to the right, with the presence of outlier values. In these cases, MAPE overstates the corresponding population parameter. In this study, we propose an alternative index, called Resistant MAPE or R-MAPE based on the calculation of the Huber M-estimator, which allows overcoming the aforementioned limitation.

Method: The results derived from the application of Artificial Neural Network (ANN) and Autoregressive Integrated Moving Average (ARIMA) models are used to forecast a time series.

Results: The arithmetic mean, MAPE, overstates the corresponding population parameter, unlike R-MAPE, on a set of error distributions with a statistically significant right skew, as well as outlier values.

Conclusions: Our results suggest that R-MAPE represents a suitable alternative measure of forecast accuracy, due to the fact that it provides a valid assessment of forecast accuracy compared to MAPE.
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http://dx.doi.org/10.7334/psicothema2013.23DOI Listing
August 2014

Psychometric testing of the Spanish version of the practice environment scale of the nursing work index in a primary healthcare context.

J Adv Nurs 2012 Jan 29;68(1):212-21. Epub 2011 Jun 29.

Nursing Department, Evidence Based Clinical Practice and Knowledge Transfer Research Group Member, Balearic Islands University, Palma, Spain.

Aim: This paper is a report of psychometric testing of the Spanish version of the Practice Environment Scale of the Nursing Work Index for use in a primary health care.

Background: The Practice Environment Scale of the Nursing Work Index has been widely used in different studies and contexts. However, there is no validated version for primary care nursing staff in Spain.

Methods: A descriptive, multicentre, cross-sectional study for transcultural adaptation and psychometric validation purposes. Data were collected from October 2009 to January 2010. To test the reliability of the factors in the measurement model, Cronbach's alpha was used. To study the measurement model, different structural models were tested, using exploratory and confirmatory factor analyses. 377 completed questionnaires were obtained from a total of 553 nurses working for the Public Health Service in the Balearic Islands (Spain). This represents a response rate of 68·2%.

Results: For overall reliability, a Cronbach alpha of 0·91 was obtained. The confirmatory analysis upholds the original five-factor structure.

Conclusion: The excellent goodness of fit of the confirmatory analysis corroborates the validity of this adapted version in primary healthcare contexts.
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http://dx.doi.org/10.1111/j.1365-2648.2011.05730.xDOI Listing
January 2012

[Nursing practice settings and competence to incorporate evidence into decisions: analysis of the situation in the Balearic Islands (Spain)].

Gac Sanit 2011 May-Jun;25(3):191-7. Epub 2011 Feb 25.

Departamento de Enfermería y Fisioterapia, Universitat de les Illes Balears, Palma de Mallorca, España.

Objectives: To determine the factors that nursing professionals perceive as facilitating evidence-based clinical practice (EBCP) in the Balearic Islands Health Service (Spain) by identifying possible differences according to nurses' characteristics and their occupational settings.

Methods: We performed a multicenter, cross-sectional, observational study of 3,129 staff nurses in the Balearic Islands Health Service in 2009, who were surveyed using the Evidence-Based Practice Questionnaire (EBPQ) and the Nursing Work Index (PES-NWI). The strategy for the analysis encompassed an exploratory analysis, bivariate analysis with parametric and non-parametric tests according to the nature of the distributions (correlation, ANOVA, Kruskall-Wallis, chi square) and multivariate analysis of the main study variables and factors on the PES-NWI and EBPQ questionnaires. The analyses had a confidence level of 95%.

Results: A total of 1,753 questionnaires were received, corresponding to a participation rate of 56.02%. The results established significant differences between the two questionnaires in the analysis of the hospital setting and primary care (p<0.001). These differences remained significant when the questionnaires were compared according to professional category and experience.

Conclusions: This study compared nursing practice environments with different characteristics. Of the factors included in the questionnaires, that with the greatest influence on EBP was the support of nursing managers. This study also found that the two validated instruments are plausible tools for assessing EBCP and help to establish areas for improvement both at the individual and organizational level.
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http://dx.doi.org/10.1016/j.gaceta.2010.11.007DOI Listing
October 2011

[Validation of the Spanish version of the Evidence Based Practice Questionnaire in Nurses].

Rev Esp Salud Publica 2009 Jul-Aug;83(4):577-86

Escuela Universitaria de Enfermería y Fisioterapia, Universitat de les Illes Balears, Palma, Islas Baleares, España.

Background: The lack of adequate instruments prevents the possibility of assessing the competence of health care staff in evidence-based decision making and further, the identification of areas for improvement with tailored strategies. The aim of this study is to report about the validation process in the Spanish context of the Evidence-Based Practice Questionnaire (EBPQ) from Upton y Upton.

Methods: A multicentre, cross-sectional, descriptive psychometric validation study was carried out. For cultural adaptation, a bidirectional translation was developed, accordingly to usual standards. The measuring model from the questionnaire was undergone to contrast, reproducing the original structure by Exploratory Factorial Analysis (EFA) and Confirmatory Factorial Analysis (CFA), including the reliability of factors.

Results: Both EFA (57.545% of total variance explained) and CFA (chi(2)=2359,9555; gl=252; p < 0.0001; RMSEA=0,1844; SRMR=0,1081), detected problems with items 7, 16, 22, 23 and 24, regarding to the original trifactorial version of EBPQ. After deleting some questions, a reduced version containing 19 items obtained an adequate factorial structure (62.29% of total variance explained), but the CFA did not fit well. Nevertheless, it was significantly better than the original version (chi(2)=673.1261; gl=149; p < 0.0001; RMSEA=0.1196; SRMR=0.0648).

Conclusions: The trifactorial model obtained good empiric evidence and could be used in our context, but the results invite to advance with further refinements into the factor "attitude", testing it in more contexts and with more diverse professional profiles.
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http://dx.doi.org/10.1590/s1135-57272009000400009DOI Listing
January 2010

The methodology of Data Mining. An application to alcohol consumption in teenagers.

Adicciones 2009 ;21(1):65-80

Area de Metodología de las Ciencias del Comportamiento. Departamento de Psicología. Universitat de les Illes Balears. Spain.

This paper is aimed mainly at making researchers in the field of drug addictions aware of a methodology of data analysis aimed at knowledge discovery in databases (KDD). KDD is a process consisting of a series of phases, the most characteristic of which is called data mining (DM), whereby different modelling techniques are applied in order to detect patterns and relationships among the data. Common and differentiating factors between the most widely used DM techniques are analysed, mainly from a methodological viewpoint, and their use is exemplified using data related to alcohol consumption in teenagers and its possible relationship with personality variables (N=7030). Although the overall accuracy obtained (% correct predictions) is very similar in the three models analyzed, the Artificial Neural Network (ANN) technique generates the most accurate model (64.1%), followed by Decision Trees (DT) (62.3%) and Naïve Bayes (NB) (59.9%).
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June 2009