Publications by authors named "Macia-Soler Loreto"

21 Publications

  • Page 1 of 1

Reduction of ventilatory time using the multidisciplinary disconnection protocol. Pilot study.

Rev Lat Am Enfermagem 2019 5;27:e3215. Epub 2019 Dec 5.

Universidad de Alicante, Alicante, Spain.

Objective: compare ventilatory time between patients with the application of a disconnection protocol, managed in a coordinated way between doctor and nurse, with patients managed exclusively by the doctor.

Method: experimental pilot study before and after. Twenty-five patients requiring invasive mechanical ventilation for 24 hours or more were included, and the protocol-guided group was compared with the protocol-free group managed according to usual practice.

Results: by means of the multidisciplinary protocol, the time of invasive mechanical ventilation was reduced (141.94 ± 114.50 vs 113.18 ± 55.14; overall decrease of almost 29 hours), the time spent on weaning (24 hours vs 7.40 hours) and the numbers of reintubation (13% vs 0%) in comparison with the group in which the nurse did not participate. The time to weaning was shorter in the retrospective cohort (2 days vs. 5 days), as was the hospital stay (7 days vs. 9 days).

Conclusion: the use of a multidisciplinary protocol reduces the duration of weaning, the total time of invasive mechanical ventilation and reintubations. The more active role of the nurse is a fundamental tool to obtain better results.
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February 2020

Mobile applications in oncology: A systematic review of health science databases.

Int J Med Inform 2020 01 19;133:104001. Epub 2019 Oct 19.

Department of Nursing, University of Murcia, Murcia, Spain.

Introduction: In recent years there has been an exponential growth in the number of mobile applications (apps) relating to the early diagnosis of cancer and prevention of side effects during cancer treatment. For health care professionals and users, it can thus be difficult to determine the most appropriate app for given needs and assess the level of scientific evidence supporting their use. Therefore, this review aims to examine the research studies that deal with this issue and determine the characteristics of the apps involved.

Methodology: This study involved a systematic review of the scientific literature on randomized clinical trials that use apps to improve cancer management among patients, using the Pubmed (Medline), Latin America and the Caribbean in Health Sciences (LILACS), and Cochrane databases. The search was limited to articles written in English and Spanish published in the last 10 years. A search of the App Store for iOS devices and Google Play for Android devices was performed to find the apps identified in the included research articles.

Results: In total, 54 articles were found to analyze the development of an application in the field of oncology. These articles were most frequently related to the use of apps for the early detection of cancer (n = 28), particularly melanoma (n = 9). In total, 21 studies reflected the application used. The apps featured in nine articles were located using the App Store and Google Play (n = 9), of which five were created to manage cancer-related issues. The rest of the apps were designed for use in the general population (n = 4).

Conclusions: There is an increasing number of research articles that study the use of apps in the field of oncology; however, these mobile applications tend to disappear from app stores after the studies are completed.
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January 2020

User satisfaction in the spanish health system: trend analysis.

Rev Saude Publica 2019 30;53:87. Epub 2019 Sep 30.

Universitat Jaume I. Departamento de Enfermería. Castellón, CS, España.

Objective: To analyze the trend of opinion and satisfaction indicators of the Spanish national health system from 2005 to 2017.

Methods: Ecological study of time series analyzing the trend of eight indicators of opinion and satisfaction on the Spanish national health system and its autonomous communities from 2005 to 2017. The data was obtained from the Ministry of Health, Social Services and Equality and from the Health Barometer. The Prais-Winsten regression method was used.

Results: A static tendency was observed in the perception of users on how the health system works (APC = 1.898, 95%CI -0.954 - 4.751) and decreasing opinion on the improvement of primary care (APC = -0.283; 95%CI -0.335 - -0.121), specialized (APC = -0.241, 95%CI -0.74 - -0.109) and hospitalization (APC = -0.171, 95%CI -0.307 - -0.036). Satisfaction with knowledge and follow-up by the family doctor and pediatrician showed an increasing trend (APC = 7.939, 95%CI 3.965 - 11.914). Satisfaction with medical and nursing professionals was static. No large differences were observed in the trends of the indicators studied in the autonomous communities.

Conclusions: A negative trend was observed in the opinion of the Spanish national health system users. Financing, human resources, quality management systems and differences in the autonomous communities may be some of the causes.
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October 2019

Student nurses at Spanish universities and their attitude toward xenotransplantation.

Xenotransplantation 2019 05 8;26(3):e12507. Epub 2019 Apr 8.

Department of Surgery, Transplant Unit, Virgen de la Arrixaca Univeristy Hospital, El Palmar, Spain.

Introduction: Recent immunological and transgenic advances are a promising alternative using limited materials of human origin for transplantation. However, it is essential to achieve social acceptance of this therapy.

Objective: To analyze the attitude of nursing students from Spanish universities toward organ xenotransplantation (XTx) and to determine the factors affecting their attitude.

Materials And Methods: Type of study: A sociological, multicentre, and observational study.

Study Population: Nursing students enrolled in Spain (n = 28,000).

Sample Size: A sample of 10 566 students estimating a proportion of 76% (99% confidence and precision of ±1%), stratified by geographical area and year of study. Instrument of measurement: A validated questionnaire (PCID-XenoTx-RIOS) was handed out to every student in a compulsory session. This survey was self-administered and self-completed voluntarily and anonymously by each student in a period of 5-10 min.

Statistical Analysis: descriptive analysis, Student's t test, the chi-square test, and a logistic regression analysis.

Results: A completion rate: 84% (n = 8913) was obtained. If the results of XTx were as good as in human donation, 74% (n = 6564) would be in favor and 22% (n = 1946) would have doubts. The following variables affected this attitude: age (P < 0.001); sex (P < 0.001); geographical location (P < 0.001); academic year of study (P < 0.001); attitude toward organ donation (P < 0.001); belief in the possibility of needing a transplant (P < 0.001); discussion of transplantation with one's family (P < 0.001) and friends (P < 0.001); and the opinion of one's partner (P < 0.001). The following variables persisted in the multivariate analysis: being a male (OR = 1.436; P < 0.001); geographical location (OR = 1.937; P < 0.001); an attitude in favor of donation (OR = 1.519; P < 0.001); belief in the possibility of needing a transplant (OR = 1.497; P = 0.036); and having spoken about the issue with family (OR = 1.351; P < 0.001) or friends (OR = 1.240; P = 0.001).

Conclusions: The attitude of nursing students toward organ XTx is favorable and is associated with factors of general knowledge about organ donation and transplantation and social interaction.
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May 2019

Questionnaire to Measure the Participation of Nursing Professionals in Mentoring Students.

Invest Educ Enferm 2017 May;35(2):182-190

Universitat Jaume I, Spain,

Objectives: The aim herein was to validate a questionnaire to measure the level of participation of clinical nursing professionals in the mentorship of nursing students during clinical practices.

Methods: Design and validation of a questionnaire. The psychometric properties of the tool were determined through four phases: 1- literature review; 2- evaluation of content validity; 3- pilot test, cognitive pretest and intra-observer reliability study; 4- construct validity study through an exploratory factor analysis of main components with varimax rotation in a sample of 249 nursing professionals from primary care and hospital care from different Spanish provinces. The internal consistency was studied with Cronbach's alpha coefficient.

Results: The global content validity was above 0.8. The final version of the questionnaire had 33 items, with a global intraclass correlation coefficient of 0.852 and Cronbach's alpha of 0.837. Factor analysis explained 55.4% of the total variance, with a solution of five factors that made up the dimensions: Implication, Motivation, Satisfaction, Obstacles, and Commitment.

Conclusions: The questionnaire evaluated has adequate validity and reliability to permit determining the level of nurse participation in the mentorship of students.
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May 2017

Predictors of nurses' level of participation in student care: A multivariable analysis.

Nurse Educ Today 2018 Jun 19;65:162-168. Epub 2018 Mar 19.

Nursing Department, Univesitat Jaume I, Avda Sos Baynat s/n, 12071 Castellón, Spain. Electronic address:

Objective: To determine the association and predictive nature of certain socio-demographic, education, work and research variables on nurses' participation level in the clinical care of students.

Design: A cross-sectional analytical study using a validated questionnaire between February and June 2014.

Setting And Participants: A consecutive sample of 117 nurses who worked in public health centres in the province of Castellón (Spain) in 2014. The nurses who had never mentored students and the questionnaires that were <50% complete were excluded.

Methods: A descriptive analysis of the sample and an association analysis between variables were performed. The questionnaire and its dimensions were performed with a logistic regression and the maximum likelihood method, which used a complementary log-log link method. The concordance index was calculated using contingency tables.

Results: The mean age was 42.56 years, and the overall mean questionnaire score was 122.84 (SD = 18.69; 95% CI: 119.415-126.26). Across the sample, 58.1% (n = 68) of the nurses obtained an Excellent score, followed by Adequate in 41% (n = 48). Overall, the predictive variables were age, mentoring of students in the last 5 years and previous training to mentor students.

Conclusion: The main predictive variable for greater participation in the mentorship of students was previous training in mentoring. This study also reflected on other variables that could influence nurses' participation in student mentoring.
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June 2018

Comparative analysis of the psychometric parameters of two quality-of-life questionnaires, the SGRQ and CAT, in the assessment of patients with COPD exacerbations during hospitalization: A multicenter study.

Chron Respir Dis 2018 11 12;15(4):374-383. Epub 2018 Mar 12.

3 Hospital Clínic de Barcelona, Barcelona, Spain.

The aim of this study was to assess health-related quality of life (HRQL) in patients with chronic obstructive pulmonary disease (COPD) and to discuss the different tools available for its assessment. The most widely used assessments are the St. George respiratory questionnaire (SGRQ) and the COPD assessment test (CAT) questionnaire. Both have a different difficulty in exam completion, calculation, and scoring. No studies exist that analyze the validity and internal consistency of using both questionnaires on patients admitted to the hospital for a COPD exacerbation. A multicenter, cross-sectional analytic observational study of patients admitted to the hospital due to a COPD exacerbation (CIE 491.2). During their hospital stay, they were administered the SGRQ and the CAT questionnaire within the framework of a therapeutic education program (APRENDEPOC). Descriptive and comparative analysis, correlations between the scales (Pearson's correlation index), consistency and reliability calculations (Cronbach's α), and a forward stepwise multiple linear regression were performed, with significant correlations in both questionnaires considered p < 0.01 with the total scores. A statistical significance of p < 0.05 was assumed. Altogether, 231 patients were admitted for a COPD exacerbation ( n = 77) at Hospital Clínic of Barcelona (HCB) and ( n = 154) at Hospital Universitario General of Castellón (HUGC). The sample profile was not homogeneous between both centers, with significant differences in HRQL between hospitals. Correlation were noted between both scales ( p < 0.01), along with high levels of internal consistency and reliability (CAT 0.836 vs. SGRQ 0.827). The HRQL is related to dyspnea, wheezing, daytime drowsiness, and edema, as well as to the need to sleep in a sitting position, anxiety, depression, and dependence on others in the execution of daily activities. Our regression analysis showed that the SGRQ questionnaire could predict more changes in HRQL with a higher number of variables.
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November 2018

Participation of clinical nurses in the practical education of undergraduate nursing students.

Enferm Clin (Engl Ed) 2018 May - Jun;28(3):171-178. Epub 2017 Dec 11.

Departamento de Enfermería, Universidad de Alicante, San Vicent del Raspeig, Alicante, España.

Objective: To evaluate the level of participation of clinical nurses from Castellón where Universitat JaumeI nursing students do their clinical clerkship. To identify the variables that may influence clinical nurses' participation in students' clinical mentorship.

Method: This observational, cross-sectional and descriptive study was conducted by applying the validated Involvement, Motivation, Satisfaction, Obstacles and Commitment (IMSOC) questionnaire. The variables collected were: age, work environment and previous training. The study was conducted between January and December 2014.

Results: The sample included 117 nurses. The overall mean questionnaire score was 122.838 (standard deviation: ±18.692; interquartile range 95%: 119.415-126.26). The variable "previous training for mentorship students" was statistically significant in the overall score and for all dimensions (P<.05). Primary care nurses obtained better scores in the dimension Implication than professionals working at other care levels.

Conclusions: The level of participation of the clinical nurses from Castellón is adequate. The previous training that professionals receive for mentoring students improves both their level of participation and primary care level. Extending this research to other national and international environments is recommended.
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January 2019

[The Challenge of Care Continuity in Complex Chronic Patients from Nurses' Perspective].

Rev Enferm 2017 Feb;40(2):50-6

Introduction: The complex chronic disease requires a model of care based found on multidisciplinary teams. The aim of this study was to analyse the development of nursing leadership in managing the complex chronic patient (CCP) and to identify how the resources for the attention and follow up of these patients are managed.

Method: A qualitative descriptive approach was followed through participant observation, in-depth interview to 7 health professionals (5 nurses, a doctor, and a social worker) and a discussion group with 9 Primary Health Care nurses from a intentional sample. Discourse analysis was undertaken following Conde approach: fixing discurse positions, creating and analyzing symbolic configuratons, analyzing and interpreting semantic configurations and drawing up the discourse.

Results: From discourse analysis two main dimensions emerged on the nursing leadership and management: a) nursing as the leader of care: the need of nursing leadership and of improvement in the coordination structures were recognized, and b) nursing as resources manager in the CCP care related to social and health risks and resources coordination.

Conclusions: Our findings enhance the case management and the home delivery care as foundations to be effective handle of CCP, where nursing has a privileged role.
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February 2017

Cultural analysis of surgical safety checklist items in Spain and Argentina.

Rev Gaucha Enferm 2016 Aug 25;37(3):e56359. Epub 2016 Aug 25.

Universidad Jaume I, Facultad en Ciencias de la Salud, Departamento de Enfermería. Castellón de la Plana, España.

Objective: To compare the agreement between two surgical checklists implanted in two hospitals in Spain and Argentina, using the international classification for patient safety as a framework.

Method: This was an expert opinion study carried out using an ad hoc questionnaire in electronic format, which included 7 of the 13 categories of the international classification for patient safety. Fifteen surgical security experts from each country participated in this study by classifying the items on the checklists into the selected ICPS categories. The data were analyzed with SPSS V20 software.

Results: There was a greater percentage of classifications in fields related to the prevention of critical events. The category "clinical processes and procedures" was mentioned most frequently in both lists.

Conclusion: The implementation of the surgical safety checklist is variable. Experts considered that the Argentinian list was clearer in every dimension.
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August 2016

Nurses' experiences working with nursing students in a hospital: a phenomenological enquiry.

Rev Lat Am Enfermagem 2016 25;24:e2788. Epub 2016 Jul 25.

Department of Health Science, Universidad Rey Juan Carlos, Spain.

Objective: this paper explores the experiences of registered nurses working with Spanish nursing students within the hospital.

Methods: a qualitative phenomenological approach was followed. Purposeful sampling was employed. Twenty-one registered nurses, from a public hospital located in Spain, were included in the study. Data were collected by means of unstructured and semi-structured interviews and were analysed using Giorgi's proposal. The Consolidated Criteria for Reporting Qualitative Research were followed.

Results: three main themes described the experience of registered nurses: "The nurse's relationship with nursing students"; most nurses emphasized the importance of the first contact with students and they considered students' attitude to be key. "Defining the role of the student in clinical practice"; it is necessary to unify the nurse's role and interventions to avoid misleading students and establish priorities in clinical practice. "Building bridges between clinical settings and the University"; the need to establish a common ground and connection between the university and hospital clinical settings was emphasized. Nurses felt that the training program should also be designed by the clinical settings themselves.

Conclusions: understanding the meaning of nursing students with registered nurses might gain a deeper insight into their expectations.
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October 2017

Obesity, knee osteoarthritis, and polypathology: factors favoring weight loss in older people.

Patient Prefer Adherence 2016 27;10:957-65. Epub 2016 May 27.

Universitat Autònoma de Barcelona, Barcelona, Spain.

Aim: We aimed to explore the meaning of obesity in elderly persons with knee osteoarthritis (KO) and to determine the factors that encourage or discourage weight loss.

Background: Various studies have demonstrated that body mass index is related to KO and that weight loss improves symptoms and functional capacity. However, dietary habits are difficult to modify and most education programs are ineffective.

Design: A phenomenological qualitative study was conducted. Intentional sampling was performed in ten older persons with KO who had lost weight and improved their health-related quality of life after participating in a health education program. A thematic content analysis was conducted following the stages proposed by Miles and Huberman.

Findings: Participants understood obesity as a risk factor for health problems and stigma. They believed that the cause of obesity was multifactorial and criticized health professionals for labeling them as "obese" and for assigning a moral value to slimness and diet. The factors identified as contributing to the effectiveness of the program were a tolerant attitude among health professionals, group education that encouraged motivation, quantitative dietary recommendations, and a meaningful learning model based on social learning theories.

Conclusion: Dietary self-management without prohibitions helped participants to make changes in the quantity and timing of some food intake and to lose weight without sacrificing some foods that were deeply rooted in their culture and preferences. Dietary education programs should focus on health-related quality of life and include scientific knowledge but should also consider affective factors and the problems perceived as priorities by patients.
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June 2016

Assessment of bachelor's theses in a nursing degree with a rubrics system: Development and validation study.

Nurse Educ Today 2016 Feb 15;37:103-7. Epub 2015 Dec 15.

Nursing Department, University of Alicante, Carretera San Vicente del Raspeig s/n, Alicante 03080, Spain. Electronic address:

Background: Writing a bachelor thesis (BT) is the last step to obtain a nursing degree. In order to perform an effective assessment of a nursing BT, certain reliable and valid tools are required.

Objectives: To develop and validate a 3-rubric system (drafting process, dissertation, and viva) to assess final year nursing students' BT.

Design: A multi-disciplinary study of content validity and psychometric properties. The study was carried out between December 2014 and July 2015.

Settings: Nursing Degree at Universitat Jaume I. Spain.

Participants: Eleven experts (9 nursing professors and 2 education professors from 6 different universities) took part in the development and content validity stages. Fifty-two theses presented during the 2014-2015 academic year were included by consecutive sampling of cases in order to study the psychometric properties.

Methods: First, a group of experts was created to validate the content of the assessment system based on three rubrics (drafting process, dissertation, and viva). Subsequently, a reliability and validity study of the rubrics was carried out on the 52 theses presented during the 2014-2015 academic year.

Results: The BT drafting process rubric has 8 criteria (S-CVI=0.93; α=0.837; ICC=0.614), the dissertation rubric has 7 criteria (S-CVI=0.9; α=0.893; ICC=0.74), and the viva rubric has 4 criteria (S-CVI=0.86; α=8.16; ICC=0.895).

Conclusion: A nursing BT assessment system based on three rubrics (drafting process, dissertation, and viva) has been validated. This system may be transferred to other nursing degrees or degrees from other academic areas. It is necessary to continue with the validation process taking into account factors that may affect the results obtained.
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February 2016

Interpersonal relations and nurses' job satisfaction through knowledge and usage of relational skills.

Appl Nurs Res 2015 Nov 26;28(4):257-61. Epub 2015 Feb 26.

Department of Nursing, Autonomous University of Madrid, Madrid, Spain. Electronic address:

Background/rationale: Many interpersonal labor disputes stem from the lack of communication skills and the relational problems in the interactions between health professionals.

Aims/methods: A qualitative study was conducted in a Spanish hospital in order to get to know how the communicative interaction between hospital nurses is like in relation to the nurses' interpersonal interaction and communication skills developed in their working relationships. Twenty-one hospital nurses between 29 and 55 years old, working in different wards, were interviewed. Open-ended interview discourses were transcribed verbatim and analyzed using qualitative content analysis.

Results: The following four key themes were analyzed: communication and sender; communication and awareness of who has the problem; non-verbal communication; communication and recipient.

Conclusion: The results of this study highlight the need to broaden nurses' relational-communication skills in order to increase job satisfaction.
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November 2015

Doctorate nursing degree in Spain.

Rev Lat Am Enfermagem 2015 May-Jun;23(3):372-8

Departamento de Enfermería, Universidad de Alicante, Alicante, ES.

Unlabelled: Analytical and descriptive study of the process of change being experienced in the Spanish university system over the last decade (2005-2014).

Objective: To describe the structural changes occurring in Nursing Education in Spain, reaching access to doctoral studies from the European Convergence Process and the subsequent legislative development.

Methodology: Bibliographical review of royal decrees and reference literature on the subject of study and descriptive analysis of the situation.

Results: Carries various changes suffered in the curricula of nursing education in the last decade, the legislation of the European Higher Education sets the guidelines for current studies of Masters and Doctorates.

Conclusions: The implementation of the Master and Doctorate stages after a basic degree, which is now possible with the new legislation. A formal beginning made of scientific nursing in order to generate their own lines of research led by Doctors of nursing who can integrate in research groups under the same condition as other researcher, yet now, from the nursing discipline itself.
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July 2017

Supplemental nursing staff´s experiences at a Spanish hospital: Qualitative phenomenology research.

Rev Esc Enferm USP 2014 Dec 1;48 Spec No. 2:59-65. Epub 2014 Dec 1.

Rehabilitation and Physical Medicine, University Rey Juan Carlos, Department of Physical Therapy, Occupational Therapy, Madrid, Spain.

The objective of this study was to describe the Supplemental Nursing Staff´s experiences at different hospital units. A qualitative phenomenological approach was conducted; a purposeful and theoretical sampling was implemented with supplemental nursing staff at Santa Barbara Hospital of Soria (Spain), to gain a more in-depth understanding of the Supplemental Nursing Staff ´s experience. Data were collected by in-depth interviews and through a field notebook. Data were analyzed using the Giorgi proposal. Twenty-one nurses with a mean age of 46 years were included. Three main topics emerged from the data analysis: building the first contact, carving out a niche and establishing interprofessional/interpersonal relationships. We conclude that the experience of hosting the supplemental nursing staff in changing clinical environments is conditioned by various factors. It is necessary for nurses and hospital managers to establish clear objectives with regard to the supplemental nursing staff´s role in the units.
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December 2014

[Nursing professionals and health care assistants' perception of patient safety culture in the operating room].

Enferm Clin 2015 Mar-Apr;25(2):64-72

Departamento de Enfermería, Universidad de Alicante, España.

Objectives: To assess nursing professionals and health care assistants' perceptions, opinions and behaviours on patient safety culture in the operating room of a public hospital of the Spanish National Health Service. To describe strengths and weaknesses or opportunities for improvement according to the Agency for Healthcare Research and Quality criteria, as well as to determine the number of events reported.

Method: A descriptive, cross-sectional study was conducted using the Spanish version of the questionnaire Hospital Survey on Patient Safety Culture. The sample consisted of nursing professionals, who agreed to participate voluntarily in this study and met the selection criteria. A descriptive and inferential analysis was performed depending on the nature of the variables and the application conditions of statistical tests. Significance if p < .05.

Results: In total, 74 nursing professionals responded (63.2%). No strengths were found in the operating theatre, and improvements are needed concerning staffing (64.0%), and hospital management support for patient safety (52.9%). A total of 52.3% (n = 65) gave patient safety a score from 7 to 8.99 (on a 10 point scale); 79.7% (n = 72) reported no events last year. The total variance explained by the regression model was 0.56 for "Frequency of incident reporting" and 0.26 for "Overall perception of safety".

Conclusions: There was a more positive perception of patient safety culture at unit level. Weaknesses have been identified, and they can be used to design specific intervention activities to improve patient safety culture in other nearby operating theatres.
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March 2017

[Nursing: a new phase].

Enferm Clin 2014 Sep-Oct;24(5):267-8. Epub 2014 Jul 26.

Departamento de Enfermería, Universidad de Alicante, Alicante, España. Electronic address:

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July 2016

Content validity of the Spanish version of the Practice Environment Scale of the Nursing Work Index.

Appl Nurs Res 2013 Nov 14;26(4):e5-9. Epub 2013 Oct 14.

Department of Nursing, University Jaume I, Castellón, Spain. Electronic address:

Objective: The objective of this study is to evaluate the content validity of the Iberian Spanish version of the questionnaire The Practice Environment Scale of the Nursing Work Index (PES-NWI) by using the Content Validity Indexing (CVI).

Methods: A descriptive cross-sectional observational study was conducted. The Spanish version of the questionnaire was translated from the American English instrument through forward and back translation processes. Experts evaluated the translated items through content validity indexing. Once the assessments were completed, CVI indicators were calculated: number of agreements, item Content Validity Index and overall content validity and modified kappa coefficient of the instrument.

Results: The overall content validity of the instrument was 0.82. The average modified kappa coefficient of the items was 0.80, with a rating of 'excellent'. Only 4 of the items were rated as weak or poor.

Conclusions: The study demonstrates that the content validity of the Spanish version of the PES-NWI is acceptable. Some results indicate that some items have cross-cultural applicability challenges that need to be addressed in future research studies. Use of the instrument in other Spanish language speaking countries should be taken with caution since some words may not reflect the language of the healthcare systems there.
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November 2013

[Research in nursing].

Enferm Clin 2008 Nov-Dec;18(6):287-8

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June 2009

[Local anesthesia in arterial puncture: nurses' knowledge and attitudes].

Arch Bronconeumol 2008 Jul;44(7):360-3

Enfermería, Unidad de Hospitalización de Neumología, Hospital General Universitario, Elche, Alicante, Spain.

Objective: Local anesthesia is rarely used in arterial puncture, even though it is recommended. The aim of this study was to examine attitudes and beliefs among nurses and third-year undergraduate nursing students in hospital training regarding the use of local anesthesia when performing arterial puncture and to assess their knowledge of the technique.

Material And Methods: Nurses and nursing students were issued a 15-item questionnaire consisting of 2 parts. The first part contained questions on the nurse's use of local anesthesia when extracting arterial blood for analysis and the second part involved questions regarding technical knowledge of this test. The results of nurses from the respiratory medicine department, nurses from the rest of the hospital, and nursing students were compared.

Results: The questionnaire was answered by the 131 the nurses surveyed. Valid questionnaires were returned by 17 of the 19 nursing students surveyed. Questionnaires returned by nurses from the respiratory medicine department (n=11) were separated from those returned by the rest of nurses. Local anesthesia was used routinely by 7 nurses (5%), of whom 3 (27%) belonged to the respiratory medicine department; local anesthesia was not used by any of the nursing students. The main reasons given by nurses for not using local anesthesia were lack of knowledge (54%), need to perform 2 punctures when anesthesia is used (11%), belief that the same amount of pain is caused with anesthesia (8%), and success on the first attempt at arterial puncture (7%). The main reason given by student nurses for not using local anesthesia was also lack of knowledge (53%), followed by the fact that it was not used by the nurses (24%). Most of those surveyed (63%) indicated a desire to receive anesthesia should they undergo arterial puncture.

Conclusions: Local anesthesia is used very little in arterial puncture. Knowledge about how to perform arterial blood extraction for blood gas analysis is insufficient and needs to be improved among both nurses and nursing students. Nonetheless it is noteworthy that most of those surveyed indicated a preference for receiving local anesthesia if they were to undergo the procedure. These data should be taken into consideration when training nurses to perform arterial puncture.
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July 2008