Publications by authors named "Teresa Lluch-Canut"

30 Publications

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Validity and reliability of the Spanish version of the "Wijma Delivery Expectancy/Experience Questionnaire" (W-DEQ-B).

PLoS One 2021 26;16(4):e0249942. Epub 2021 Apr 26.

Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain.

The Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ-B) is an instrument that allows the experiences around fear of childbirth to be examined after the birth. It is currently the most widely used to measure different aspects related to the fear of childbirth and enables healthcare and additional assistance to women after birth to be adapted according to their needs. The objective of this study was to translate the W-DEQ-B into Spanish and analyse its reliability and validity. The study was carried out in two phases: (1) transcultural adaption of the questionnaire to Spanish and (2) a transversal study in a sample of 190 postpartum women from Sexual and Reproductive Health Clinics in the province of Barcelona (Spain). The psychometric properties were examined in terms of reliability (internal consistency and temporal stability) and construct validity (confirmatory factorial analysis [CFA] and exploratory factorial analysis [EFA]). The results of the CFA did not confirm unidimensionality of the W-DEQ-B questionnaire. The EFA suggested four very similar, but not identical, dimensions to those obtained in other studies in which the W-DEQ-B has been evaluated. Both the Cronbach's alpha and the omega coefficient were adequate for the total questionnaire and for each of the four dimensions. The results of this study confirm that the W-DEQ-B is multi-dimensional. In the Spanish version of the W-DEQ-B-Sp four dimensions have been identified that allow the experiences around fear of childbirth to be examined after the birth. The Spanish version of the WDEQ-B (WDEQ-B-Sp) is reliable and valid for the measurement of fear of childbirth in clinical practice and for use in future research.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0249942PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8075224PMC
April 2021

Reliability and validity study of the Spanish adaptation of the "Wijma Delivery Expectancy/Experience Questionnaire" (W-DEQ-A).

PLoS One 2021 19;16(3):e0248595. Epub 2021 Mar 19.

Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain.

The Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ-A) is an instrument that evaluates fear of childbirth through the expectations of women in relation to childbirth and their experience during the birth. The objective of this study was to translate the W-DEQ-A into Spanish and analyse its reliability and validity. The study was carried out in two phases: (1) adapting the questionnaire to Spanish and (2) a transversal study in a sample of 273 pregnant women in the Sexual and Reproductive Health centres in the Metropolitan Northern Barcelona in Catalonia (Spain). The psychometric properties were analysed in terms of reliability and construct validity. The confirmatory factorial analysis did not confirm the unidimensionality of the original structure of the WDEQ-A, as happened with the other studies in which it has previously been validated. The result of the exploratory factorial analysis suggests four factors, or dimensions, very similar but not identical to those obtained in other analysis studies of the W-DEQ-A. The Cronbach alpha and the omega scale were also adequate for all the scales and for each of the dimensions. The results of this study confirm the findings of other studies that suggest that the W-DEQ-A is multi-dimensional. In the Spanish version of the W-DEQ-A four dimensions have been identified to explore fear of childbirth in pregnant women. The Spanish version of the WDEQ-A (WDEQ-A-Sp) is reliable and valid for the measurement of fear of childbirth in clinical practice and for use in future research.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0248595PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7978360PMC
March 2021

A method to determine a personalized set of online exercises for improving the positive mental health of a caregiver of a chronically ill patient.

BMC Med Inform Decis Mak 2021 02 25;21(1):74. Epub 2021 Feb 25.

Nursing Department, Universitat Rovira i Virgili, Avinguda Catalunya 35, 43002, Tarragona, Catalonia, Spain.

Background: Taking care of chronic or long-term patients at home is an arduous task. Non-professional caregivers suffer the consequences of doing so, especially in terms of their mental health. Performing some simple activities through a mobile phone app may improve their mindset and consequently increase their positivity. However, each caregiver may need support in different aspects of positive mental health. In this paper, a method is defined to calculate the utility of a set of activities for a particular caregiver in order to personalize the intervention plan proposed in the app.

Methods: Based on the caregivers' answers to a questionnaire, a modular averaging method is used to calculate the personal level of competence in each positive mental health factor. A reward-penalty scoring procedure then assigns an overall impact value to each activity. Finally, the app ranks the activities using this impact value.

Results: The results of this new personalization method are provided based on a pilot test conducted on 111 caregivers. The results indicate that a conjunctive average is appropriate at the first stage and that reward should be greater than penalty in the second stage.

Conclusions: The method presented is able to personalize the intervention plan by determining the best order of carrying out the activities for each caregiver, with the aim of avoiding a high level of deterioration in any factor.
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http://dx.doi.org/10.1186/s12911-021-01445-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7905974PMC
February 2021

A qualitative study exploring the patients' perspective from the 'Reserved Therapeutic Space' nursing intervention in acute mental health units.

Int J Ment Health Nurs 2021 Jun 17;30(3):783-797. Epub 2021 Feb 17.

Department of Public Health, Mental Health and Maternal and Child Health Nursing, Nursing School, Universitat de Barcelona, L´Hospitalet de Llobregat, Spain.

This study aimed to explore the perspective of people who had experienced treatment as patients at acute mental health units, regarding an intervention model to improve therapeutic relationships in the units, which had been previously designed by the nurses. The study participants were people linked to collectives for social activism in mental health. Six focus groups were held. The results were classified into three themes: (a) the meaning of a space to enable the establishment of a therapeutic relationship, (b) the procedures to implement the space, and (c) the difficulties to overcome to establish the space. For the participants, the Reserved Therapeutic Space intervention was perceived as a space where they could share expectations and needs with the nurses, considering it as both valid and useful to improve the therapeutic relationship in acute units. For the participants, the intervention should be structured in three stages: orientation, follow-up, and discharge. The content of the intervention should be proposed by the patients based on their needs and concerns. The barriers identified for carrying out the intervention were the lack of relational competence, the violation of rights, and the lack of accessibility of nurses. The facilitating elements were the availability of nurses, active listening, and empathy. The resulting intervention model includes realities of both groups, providing insights for nurses to initiate a space with patients and improve their therapeutic relationship. This intervention model could be used by managers to test its effectiveness.
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http://dx.doi.org/10.1111/inm.12848DOI Listing
June 2021

A Mobile App-Based Intervention Program for Nonprofessional Caregivers to Promote Positive Mental Health: Randomized Controlled Trial.

JMIR Mhealth Uhealth 2021 01 22;9(1):e21708. Epub 2021 Jan 22.

Department of Nursing, Universitat Rovira i Virgili, Tortosa, Spain.

Background: While nonprofessional caregivers often experience a sense of fulfillment when they provide care, there is also a significant risk of emotional and physical burnout. Consequently, this can negatively affect both the caregiver and the person being cared for. Intervention programs can help empower nonprofessional caregivers of people with chronic diseases and develop solutions to decrease the physical and psychological consequences resulting from caregiving. However, most clinically tested intervention programs for nonprofessional caregivers require face-to-face training, and many caregivers encounter obstacles that hinder their participation in such programs. Consequently, it is necessary to design internet-based intervention programs for nonprofessional caregivers that address their needs and test the efficacy of the programs.

Objective: The aim of this study was to evaluate the effectiveness of a smartphone app-based intervention program to increase positive mental health for nonprofessional caregivers.

Methods: This study was a randomized controlled trial of 3 months' duration. A total of 152 caregivers over 18 years of age with a minimum of 4 months' experience as nonprofessional caregivers were recruited from primary health care institutions. Nonprofessional caregivers were randomized into two groups. In the intervention group, each caregiver installed a smartphone app and used it for 28 days. This app offered them daily activities that were based on 10 recommendations to promote positive mental health. The level of positive mental health, measured using the Positive Mental Health Questionnaire (PMHQ), and caregiver burden, measured using the 7-item short-form version of the Zarit Caregiver Burden Interview (ZBI-7), were the primary outcomes. Users' satisfaction was also measured.

Results: In all, 113 caregivers completed the study. After the first month of the intervention, only one factor of the PMHQ, F1-Personal satisfaction, showed a significant difference between the groups, but it was not clinically relevant (0.96; P=.03). However, the intervention group obtained a higher mean change for the overall PMHQ score (mean change between groups: 1.40; P=.24). The results after the third month of the intervention showed an increment of PMHQ scores. The mean difference of change in the PMHQ score showed a significant difference between the groups (11.43; P<.001; d=0.82). Significant changes were reported in 5 of the 6 factors, especially F5-Problem solving and self-actualization (5.69; P<.001; d=0.71), F2-Prosocial attitude (2.47; P<.001; d=1.18), and F3-Self-control (0.76; P=.03; d=0.50). The results of the ZBI-7 showed a decrease in caregiver burden in the intervention group, although the results were inconclusive. Approximately 93.9% (46/49) of the app users indicated that they would recommend the app to other caregivers and 56.3% (27/49) agreed that an extension of the program's duration would be beneficial.

Conclusions: The app-based intervention program analyzed in this study was effective in promoting positive mental health and decreasing the burden of caregivers and achieved a high range of user satisfaction. This study provides evidence that mobile phone app-based intervention programs may be useful tools for increasing nonprofessional caregivers' well-being. The assessment of the effectiveness of intervention programs through clinical trials should be a focus to promote internet-based programs in health policies.

Trial Registration: ISRCTN Registry ISRCTN14818443; http://www.isrctn.com/ISRCTN14818443.

International Registered Report Identifier (irrid): RR2-10.1186/s12889-019-7264-5.
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http://dx.doi.org/10.2196/21708DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7864775PMC
January 2021

A Communicative Intervention to Improve the Psychoemotional State of Critical Care Patients Transported by Ambulance.

Am J Crit Care 2021 01;30(1):45-54

Teresa Lluch-Canut is a professor of psychosocial and mental health, School of Nursing, Faculty of Medicine and Health Sciences, University of Barcelona; and a researcher in the GEIMAC Research Group, Barcelona, Spain.

Background: Communication is key to understanding the emotional state of critical care patients.

Objective: To analyze the effectiveness of the communicative intervention known as CONECTEM, which incorporates basic communication skills and augmentative alternative communication, in improving pain, anxiety, and posttraumatic stress disorder symptoms in critical care patients transported by ambulance.

Methods: This study had a quasi-experimental design with intervention and control groups. It was carried out at 4 emergency medical centers in northern Spain. One of the centers served as the intervention unit, with the other 3 serving as control units. The nurses at the intervention center underwent training in CONECTEM. Pretest and posttest measurements were obtained using a visual analog scale to measure pain, the short-version State-Trait Anxiety Inventory to measure anxiety, and the Impact of Event Scale to measure posttraumatic stress disorder symptoms.

Results: In the comparative pretest-posttest analysis of the groups, significant differences were found in favor of the intervention group (Pillai multivariate, F2,110 = 57.973, P < .001). The intervention was associated with improvements in pain (mean visual analog scale score, 3.3 pretest vs 1.1 posttest; P < .001) and posttraumatic stress disorder symptoms (mean Impact of Event Scale score, 17.8 pretest vs 11.2 posttest; P < .001). Moreover, the percentage of patients whose anxiety improved was higher in the intervention group than in the control group (62% vs 4%, P < .001).

Conclusion: The communicative intervention CONECTEM was effective in improving psychoemotional state among critical care patients during medical transport.
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http://dx.doi.org/10.4037/ajcc2021619DOI Listing
January 2021

Nursing Process Addressing the Focus "Anxiety": A Scoping Review.

Clin Nurs Res 2020 Dec 8:1054773820979576. Epub 2020 Dec 8.

University School of Nursing of the University of Barcelona, Barcelona, Spain.

The aim of this review was to map the body of literature on data, diagnoses and interventions addressing the nursing focus "anxiety." A scoping review methodology was employed. The Joanna Briggs guidelines for scoping reviews and PRISMA checklist for scoping reviews were followed. Electronic database searches (MEDLINE, CINAHL and Web of Science) located 829 articles. From the total of articles located, 165 were included. The nursing diagnosis "anxiety" can be considered a parent diagnosis, from which other children diagnoses are derived. Data that lead to nursing diagnoses in the anxiety domain can be divided into cognitive and somatic data. Some interventions, such as educational and music-based interventions, seem to be useful to address nursing diagnoses in the anxiety domain. The findings of this review can add substantial value for systematising the nursing process related to the focus "anxiety." Therefore, reaching consensus regarding this nursing process seems highly relevant.
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http://dx.doi.org/10.1177/1054773820979576DOI Listing
December 2020

E-Learning course for nurses on pain assessment in patients unable to self-report.

Nurse Educ Pract 2020 Jan 28;43:102728. Epub 2020 Jan 28.

GEIMAC Research Group (2017-1681): Grupo de Estudios de Invarianza de los Instrumentos de Medida y Análisis del Cambio en los Ámbitos Social y de la Salud), Barcelona, Spain; Teaching Campus, Sant Joan de Déu-Fundació Privada, School of Nursing, University of Barcelona, Barcelona, Spain; GIESS Research Group (Grupo de investigación en Enfermería, Educación y Sociedad), Barcelona, Spain; GIRISAME Research Group (International Researchers Group of Mental Health Nursing Care), Madrid, Spain; REICESMA Research Group (Red Española Investigación de Enfermería en Cuidados de Salud Mental y Adicciones), Madrid, Spain. Electronic address:

Public hospitals in Catalonia, Spain, have recommended assessing pain in non-communicative inpatients by means of the Spanish version of the Pain Assessment in Advanced Dementia scale (PAINAD-Sp) since 2010; a modification for patients with neurologic disorders and cancer, PAINAD-Sp_Hosp, has also been validated. However, nurses are not routinely trained in the use of the scales. The aim of this study was to assess knowledge on pain assessment in nurses following an online training course. We surveyed participants prior to the course to determine baseline knowledge of pain and pain assessment. Course material included conceptual content on pain and practical videos demonstrating the scoring system for the PAINAD-Sp_Hosp scale. After completing the course, participants took a multiple choice quiz to test understanding of course content and a satisfaction survey to determine acceptability. Of the 836 nurses invited, 401 participated in the training course; 37.7% reported having no previous specific training on pain, and just 32.2% used the PAINAD-Sp scale regularly. Following the course, virtually all (99%) of the participants passed the quiz. Overall satisfaction among nurses with regard to the training received was 8.6/10. Thus, the e-learning course was effective and acceptable for training nurses on pain assessment using validated tools.
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http://dx.doi.org/10.1016/j.nepr.2020.102728DOI Listing
January 2020

Ethical conflicts and their characteristics among critical care nurses.

Nurs Ethics 2020 Mar 14;27(2):537-553. Epub 2019 Jul 14.

Campus Docent Sant Joan de Déu Fundació Privada, Spain.

Introduction: Ethical conflict is a phenomenon that has been under study over the last three decades, especially the types moral dilemma and moral distress in the field of nursing care. However, ethical problems and their idiosyncrasies need to be further explored.

Aim: The objectives of this study were, first, to obtain a transcultural Portuguese-language adaptation and validation of the Ethical Conflict Nursing Questionnaire-Critical Care Version and, second, to analyse Portuguese critical care nurses' level of exposure to ethical conflict and its characteristics.

Methods: A cross-cultural validation and descriptive, prospective and correlational study. The sample was made for 184 critical care nurses in 2016.

Ethical Considerations: The study was authorised by Bioethics Commission of the University of Barcelona, the Associaçâo de Apoio ao Serviço de Cuidados Intensivos do Centro Hospitalar do Porto and the Sociedade Portuguesa de Enfermagem de Saúde Mental.

Findings: The Portuguese version of the Ethical Conflict Nursing Questionnaire-Critical Care Version was a valid and reliable instrument to measure exposure to conflict. Moral outrage was the most common type of conflict. The most problematic situations were the ineffectiveness of analgesic treatments, the administration of treatments considered futile and the mismanagement of resources.
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http://dx.doi.org/10.1177/0969733019857785DOI Listing
March 2020

Levels of Positive Mental Health in Portuguese and Spanish Nursing Students.

J Am Psychiatr Nurses Assoc 2020 Sep/Oct;26(5):483-492. Epub 2019 May 23.

Juan Roldán-Merino, RMHN, PhD, Campus Docent Sant Joan de Déu, Escola Universitària d'Infermeria, adscrit a la Universitat de Barcelona, Barcelona, Spain.

Positive mental health (PMH) is described as the sense of feeling good and functioning well. PMH is vital for the individual's positive functioning and psychological well-being, particularly regarding the factors important for living a purposeful life and accomplishing personal goals. Nursing students are exposed to a variety of stressors that are very likely to decrease well-being and trigger stress, anxiety, and depression. Data focusing on PMH in nursing students are lacking, and this subject has been frequently neglected in nursing practice and research on positive functioning. To assess positive mental health levels in two samples of nursing students. A quantitative cross-sectional study. A convenience sample of 2,238 nursing students with an average age of 21 years (17-36 years old) were recruited from two nursing schools-Porto (Portugal) and Barcelona (Spain). The Positive Mental Health Questionnaire and sociodemographic items were used to measure the PMH. The majority of participants were female (88.6%), and 7.7% had physical health problem and 2.6% referred to a mental health problem. The mean PMH score was 83.4, indicating a good PMH level. A total of 58.4% reported a moderate PMH, and only 0.5% indicated low PMH level. Results were not significantly different between genders ( > .05). The findings of this study make important contributions to our understanding of PMH levels in a large sample of nursing students and the efficacy of Positive Mental Health Questionnaire, which is an accurate tool to measure PMH. Our findings also prompt discussion about PMH and its implications for practice and teaching.
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http://dx.doi.org/10.1177/1078390319851569DOI Listing
May 2019

Impact of a Training Intervention on the Pain Assessment in Advanced Dementia (PAINAD) Scale in Noncommunicative Inpatients.

Pain Manag Nurs 2019 10 15;20(5):468-474. Epub 2019 May 15.

Nursing Research Group (GRIN), IDIBELL, Biomedical Research Institute, Barcelona, Spain; Nursing Research, Institut Català d'Oncologia, Barcelona, Spain; University of Barcelona, University School of Nursing, Health Sciences Campus of Bellvitge, Barcelona, Spain; Care Management, Institut Català d'Oncologia, Barcelona, Spain.

Background: Public hospitals in Catalonia (Spain) recommend using the Spanish version of the Pain Assessment in Advanced Dementia (PAINAD-Sp) scale for assessing pain in adult patients unable to self-report. However, since its inclusion in Catalonian nursing care plans in 2010, there have been no training programs for nurses, contributing to its current underuse.

Aims: The aim of this study was to assess the impact of a nurse training intervention on the PAINAD-Sp scale in noncommunicative inpatients unable to self-report.

Design: Before-after study.

Settings: Two public hospitals in Catalonia (Spain).

Participants/subjects: Four hundred and one nurses participated in the training course and 219 patients received PAINAD-Sp assessments.

Methods: We used a before-after study design, evaluating the use of the PAINAD-Sp scale over two 6-month periods before and after an online training intervention for nurses in February 2017, in two public hospitals. Data were collected from patient records in each center. The primary outcome was the number of patients receiving PAINAD-Sp assessments during admission. Secondary outcomes were the number of assessments undertaken per patient during admission, the total (0-10) and item-specific (0-2) PAINAD-Sp score, and pharmacologic treatment administered.

Results: There were 401 nurses who took part in the training program. Over the study period, 219 patients received PAINAD-Sp assessments: 29 in the preintervention period and 190 in the postintervention period (p < .001). Administration of analgesics and antipyretics decreased (p < .001) after the intervention, whereas use of hypnotic drugs and sedatives increased.

Conclusions: Theoretical and practical training may be an effective way to improve nurses' approach to identifying, assessing, and managing pain in patients unable to self-report.
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http://dx.doi.org/10.1016/j.pmn.2019.01.007DOI Listing
October 2019

Validation of the Spanish Version of the Pain Assessment in Advanced Dementia Scale (PAINAD-Sp) in Hospitalized Patients with Neurologic Disorders and Oncologic Patients Unable to Self-Report Their Pain.

Pain Manag Nurs 2019 08 10;20(4):323-330. Epub 2018 Nov 10.

Research Group GEIMAC (Group Consolidat 2014-1139: Grupo de Estudios de Invarianza de los Instrumentos de Medida y Análisis del Cambio en los Ámbitos Social y de la Salud), Barcelona, Spain; Sant Joan de Déu-Fundació Privada, School of Nursing, University of Barcelona, Barcelona, Spain; Research Group GIESS (Grupo de investigación en Enfermería, Educación y Sociedad), Barcelona, Spain; Research Group GIRISAME (International Researchers Group of Mental Health Nursing Care), Madrid, Spain; Research Group REICESMA (Red Española Investigación de Enfermería en Cuidados de Salud Mental y Adicciones), Madrid, Spain.

Background: Pain has a significant impact on hospitalized patients and is a quality indicator for nursing care. The Pain Assessment in Advanced Dementia (PAINAD) scale measures pain in people with communication disorders and advanced dementia, but it has not been validated in any other population.

Aims: The aim of this study was to validate the Spanish version (PAINAD-Sp) in hospitalized patients with neurologic disorders and in end-of-life cancer patients with difficulty self-reporting.

Design: The study had two phases: (1) analysis of the content by a committee of experts and (2) a cross-sectional study.

Settings: We collected phase 2 data from January 2017 to December 2017 in four hospitals in Barcelona: Hospital Germans Trias i Pujol, Institut Català d'Oncologia, Hospital Vall d'Hebron, and Hospital de Bellvitge.

Participants/subjects: We included all adults who had either a neurological disorder affecting language or an oncological disease with an end-of-life prognosis and difficulty self-reporting pain. We excluded patients with a diagnosis of dementia.

Methods: The cross-sectional study included 325 patients who were simultaneously evaluated by two observers both at rest and in movement. We analyzed psychometric properties in terms of construct validity, reliability, and sensitivity to change.

Results: We obtained Cronbach α > .70 in both situations and an inter-rater reliability of 0.80. Confirmatory factor analysis indicated that the model adjusted adequately to a unidimensional structure. In terms of sensitivity to change, the mean difference was greater in movement than at rest (difference in means was 1.15).

Conclusions: The PAINAD-Sp_Hosp scale had good psychometric qualities in terms of validity and reliability in neurology and oncology patients unable to self-report pain.
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http://dx.doi.org/10.1016/j.pmn.2018.08.004DOI Listing
August 2019

Critical thinking: A comparative analysis between nurse managers and registered nurses.

J Nurs Manag 2018 Nov 10;26(8):1083-1090. Epub 2018 Sep 10.

School of Nursing, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain.

Aim: To analyse the levels of critical thinking among nurse managers and registered nurses and to explore the association between these levels and socio-demographic and occupational factors.

Background: Critical thinking is an essential skill in advanced clinical nursing. However, few studies to date have explored critical thinking levels in nurse managers or compared them with those recorded in registered nurses.

Methods: A randomized sample of 44 nurse managers and 295 registered nurses from a tertiary hospital in Barcelona participated in this study. The Nursing Critical Thinking in Clinical Practice Questionnaire was used to measure the level of critical thinking. The data were analysed using multivariate analysis by logistic regression.

Results: Levels of critical thinking were higher in nurse managers than in registered nurses. Age, work shift schedule and educational level were associated with a higher level of critical thinking in nurse managers and were predictor factors.

Conclusions: This study identified age, work shift schedule and educational level as factors that impact on the acquisition of critical thinking skills among nurse managers.

Implications For Nursing Management: This study provides substantive evidence of the levels of critical thinking among nurse managers. When introducing strategies to enhance these skills, the associated occupational factors should be taken into account.
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http://dx.doi.org/10.1111/jonm.12640DOI Listing
November 2018

Implementation of the evidence for the improvement of nursing care to the critical patient's family: a Participatory Action Research.

BMC Health Serv Res 2018 05 11;18(1):357. Epub 2018 May 11.

Fundamental and Medical-Surgical Nursing Department, Nursing School (Faculty of Medicine and Health Sciences), University of Barcelona, Barcelona, Spain.

Background: There are many descriptive studies regarding the needs of the family, as well as those regarding nursing care aimed directly at family members. However, there is no widespread application of such evidence in clinical practice. There has also been no analysis made of the evolution of patterns of knowing during the act of improving clinical practice. Therefore, the purpose of the study is to understand the change process aimed at improving care to critical patient's families, and to explore the evolution of patterns of knowing that nurses use in this process.

Methods: Qualitative study with a Participatory Action Research method, in accordance with the Kemmis and McTaggart model. In this model, nurses can observe their practice, reflect upon it and compare it with scientific evidence, as well as define, deploy and evaluate improvement strategies adapted to the context. Simultaneously, the process of empowerment derived from the Participatory Action Research allows for the identification of patterns of knowing and their development over time. The research will take place in the Intensive Care Units of a tertiary hospital. The participants will be nurses who are part of the regular workforce of these units, with more than five years of experience in critical patients, and who are motivated to consider and critique their practice. Data collection will take place through participant observation, multi-level discussion group meetings and documentary analysis. A content analysis will be carried out, following a process of codification and categorisation, with the help of Nvivo10. The approval date and the beginning of the funding were December 2012 and 2013, respectively.

Discussion: The definition, introduction and evaluation of care strategies for family members will allow for their real and immediate implementation in practice. The study of the patterns of knowing in the Participatory Action Research will be part of the theoretical and practical feedback process of a professional discipline. Also, the identification of the construction and evolution of knowledge will provide decision elements to managers and academics when choosing strategies for increased quality.
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http://dx.doi.org/10.1186/s12913-018-3177-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5946428PMC
May 2018

Nursing Intensive-Care Satisfaction Scale [NICSS]: Development and validation of a patient-centred instrument.

J Adv Nurs 2018 Jun 9;74(6):1423-1435. Epub 2018 Mar 9.

Fundamental Care and Medical-Surgical Nursing Department, Bellvitge Biomedical Research Institute (IDIBELL), HU-CI International Research Project, University of Barcelona, Barcelona, Spain.

Aim: The aim of this study was to develop and validate the Nursing Intensive-Care Satisfaction Scale to measures satisfaction with nursing care from the critical care patient's perspective.

Background: Instruments that measure satisfaction with nursing cares have been designed and validated without taking the patient's perspective into consideration. Despite the benefits and advances in measuring satisfaction with nursing care, none instrument is specifically designed to assess satisfaction in intensive care units.

Design: Instrument development.

Methods: The population were all discharged patients (January 2013 - January 2015) from three Intensive Care Units of a third level hospital (N = 200). All assessment instruments were given to discharged patients and 48 hours later, to analyse the temporal stability, only the questionnaire was given again. The validation process of the scale included the analysis of internal consistency, temporal stability; validity of construct through a confirmatory factor analysis; and criterion validity.

Results: Reliability was 0.95. The intraclass correlation coefficient for the total scale was 0.83 indicating a good temporal stability. Construct validity showed an acceptable fit and factorial structure with four factors, in accordance with the theoretical model, being Consequences factor the best correlated with other factors. Criterion validity, presented a correlation between low and high (range: 0.42-0.68).

Conclusions: The scale has been designed and validated incorporating the perspective of critical care patients. Thanks to its reliability and validity, this questionnaire can be used both in research and in clinical practice. The scale offers a possibility to assess and develop interventions to improve patient satisfaction with nursing care.
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http://dx.doi.org/10.1111/jan.13546DOI Listing
June 2018

Improving the therapeutic relationship in inpatient psychiatric care: Assessment of the therapeutic alliance and empathy after implementing evidence-based practices resulting from participatory action research.

Perspect Psychiatr Care 2018 Apr 13;54(2):300-308. Epub 2017 Sep 13.

School of Nursing, Rovira i Virgili University, Tarragona, Spain.

Purpose: To examine how evidence about the therapeutic alliance gleaned from participatory action project affected the level of this alliance and the degree of empathy of psychiatric nurses.

Design And Methods: Quasi-experimental study in two psychiatric units. In one group, evidence-based practices that affected the therapeutic alliance were implemented; in the comparison group, there was no such intervention.

Findings: The nurses from the intervention group improved their degree of empathy and factors such as agreement on objectives and tasks with the patient.

Practice Implications: The results confirm the possibility of measuring and improving the therapeutic relationship in psychiatric care.
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http://dx.doi.org/10.1111/ppc.12238DOI Listing
April 2018

Positive Mental Health and Prevalence of Psychological Ill-Being in University Nursing Professors in Catalonia, Spain.

J Psychosoc Nurs Ment Health Serv 2017 Jul;55(7):38-48

The aim of the current study was to examine the prevalence of psychological ill-being among university nursing professors in Spain and determine their grade of positive mental health. A cross-sectional study was conducted from June 2013 to December 2013 with a sample of 263 university nursing professors. Sociodemographic and occupational variables, as well as variables related to daily habits and lifestyle, were collected. Psychological ill-being was measured using the General Health Questionnaire (GHQ-12) and positive mental health was evaluated with the Positive Mental Health Questionnaire (PMHQ). Prevalence of psychological ill-being (GHQ-12 score >2) among the sample was 27% (range = 21.8% to 32.6%), with a higher prevalence in teachers from first and second cycles (Bachelor's degree and Master's degree, respectively) and a lower prevalence in those having very satisfactory social relationships. Significant differences were found in relation to consumption of tranquilizer drugs and Bach flower remedies. PMHQ scores were lower among teachers with a GHQ-12 score >2. Participants presented a good level of positive mental health. Preventive policies should be applied with the aim of reducing psychological ill-being among professors and potentiating positive mental health. [Journal of Psychosocial Nursing and Mental Health Services, 55(7), 38-48.].
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http://dx.doi.org/10.3928/02793695-20170619-06DOI Listing
July 2017

Content Validity of a Psychotherapeutic Intervention Model in Nursing: A Modified e-Delphi Study.

Arch Psychiatr Nurs 2017 04 14;31(2):147-156. Epub 2016 Sep 14.

Department of Public Health, Mental Health and Perinatal Nursing, Barcelona University School of Nursing, Feixa Llarga, s/n, 08907 L'Hospitalet Ll., Barcelona, Spain. Electronic address:

Aim: To estimate the content validity of a psychotherapeutic intervention model in nursing.

Background: Mental health nurses encounter great extrinsic difficulties when it comes to providing psychotherapeutic interventions due to the fact that they are not allowed to perform such practice in some countries. In this light, the pursuit of a psychotherapeutic intervention model in nursing seems germane to guide the professionals' psychotherapeutic practice, contributing hereof to increase mental health nurses' professional autonomy.

Design: Modified e-Delphi.

Methods: Data were collected from October 2015 to January 2016 by means of three rounds of online questionnaires. The initial questionnaire was structured into five sections: general structure of the model, patients' exclusion criteria, assessment framework, nursing diagnoses, and nursing psychotherapeutic interventions. From the 42 experts invited, at least twenty (20) participated in each round.

Results: The experts achieved consensus with regard to the conclusion that nursing psychotherapeutic interventions should always seek to address a nursing diagnosis. These defined furthermore that a psychotherapeutic intervention model in nursing should be exercised by means of 3 to 12 sessions using Nursing Interventions Classification (NIC) as a resource. Finally, experts deemed that the model should follow the principles of integrative psychotherapy, so that techniques from different schools of psychotherapy could therefore be used in conjunction to promote the resolution of a nursing diagnosis.

Conclusion: Achieving consensus about the structure of a psychotherapeutic intervention model in nursing is imperative to guide nurses in the provision of nursing psychotherapeutic interventions and to enable an effective evaluation of the health gains associated with its implementation.
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http://dx.doi.org/10.1016/j.apnu.2016.09.007DOI Listing
April 2017

Implementation of evidence on the nurse-patient relationship in psychiatric wards through a mixed method design: study protocol.

BMC Nurs 2017 11;16. Epub 2017 Jan 11.

School of Nursing, Rovira i Virgili University, Avda Remolins 13-15, Tortosa, 43500 Tarragona Spain.

Background: Psychiatric nurses are aware of the importance of the therapeutic relationship in psychiatric units. Nevertheless, a review of the scientific evidence indicates that theoretical knowledge alone is insufficient to establish an adequate therapeutic alliance. Therefore, strategies are required to promote changes to enhance the establishment of the working relationship. The aims of the study are to generate changes in how nurses establish the therapeutic relationship in acute psychiatric units, based on participative action research and to evaluate the effectiveness of the implementation of evidence through this method.

Methods/design: The study will use a mixed method design. Qualitative methodology, through participative action research, will be employed to implement scientific evidence on the therapeutic relationship. A quasi-experimental, one-group, pre-test/post-test design will also be used to quantitatively measure the effectiveness of the implementation of the evidence. Participants will consist of nurses and patients from two psychiatric units in Barcelona. Nurses will be selected by theoretical sampling, and patients assigned to each nurses will be selected by consecutive sampling. Qualitative data will be gathered through discussion groups and field diaries. Quantitative data will be collected through the Working Alliance Inventory and the Interpersonal Reactivity Index. Qualitative data will be analysed through the technique of content analysis and quantitative data through descriptive and inferential statistics.

Discussion: This study will help to understand the process of change in a nursing team working in an inpatient psychiatric ward and will allow nurses to generate knowledge, identify difficulties, and establish strategies to implement change, as well as to assess whether the quality of the care they provide shows a qualitative improvement.
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http://dx.doi.org/10.1186/s12912-016-0197-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5234145PMC
January 2017

The Therapeutic Relationship in Inpatient Psychiatric Care: A Narrative Review of the Perspective of Nurses and Patients.

Arch Psychiatr Nurs 2016 12 8;30(6):782-787. Epub 2016 Mar 8.

Campus Docent Fundació Privada Sant Joan de Déu. School of Nursing, University of Barcelona, Santa Rosa, 39-57, Esplugues de Llobregat, Spain. Electronic address:

Purpose: To study the significance of 'therapeutic relationship' between nurses and patients within the context of a psychiatric hospital.

Method: Narrative literature review. Content analysis.

Findings: The significance of the therapeutic relationship is quite similar for both nurses and patients in psychiatric hospital units. Nevertheless, several factors may separate the two positions: the time available for the relationship, the negative perceptions on the part of both parties, and the insecurity of the setting.

Practice Implications: Increased knowledge and understanding of the significance of the therapeutic relationship from the perspective of nurses and patients would allow the strengthening of areas of mutual interest.
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http://dx.doi.org/10.1016/j.apnu.2016.03.001DOI Listing
December 2016

Analysis of University Postgraduate Nursing Education in Spain.

J Nurs Educ 2016 Nov;55(11):615-622

Background: The nursing education program framework in Spain has recently been adapted and modified. This study aimed to analyze university postgraduate master'slevel nursing education during the past 21 years in Spain in terms of educational supply and demand.

Method: A retrospective, longitudinal, descriptive, and observational design was used. The educational offerings at 15 university nursing schools in Spain were examined. The target population was 7,871 registered and licensed nurses who had completed postgraduate education.

Results: Among the 211 programs offered, public universities' educational offerings focused on two areas-public health and emergency care-whereas most courses in private universities were in surgery. Regarding demand, 1,235 nurses were enrolled. The most frequently requested educational areas were surgery, emergency and urgent care, and public health.

Conclusion: Although the postgraduate nursing education situation has changed, supply and demand for this type of education in Spain are well balanced at both public and private universities. [J Nurs Educ. 2016;55(11):615-622.].
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http://dx.doi.org/10.3928/01484834-20161011-03DOI Listing
November 2016

Psychometric evaluation of a new instrument in Spanish to measure the wellness of university nursing faculty.

Arch Environ Occup Health 2018 Jan 20;73(1):29-37. Epub 2016 Oct 20.

a Sant Joan de Déu-Fundació Privada, School of Nursing, University of Barcelona , Barcelona , Spain.

The aim of this study was to design and validate an instrument to measure the wellness among university nursing faculty. The study was performed in two phases. Phase I consisted of the development of the instrument with discussion groups and participant consensus. We designed an instrument including the 21 items or psychosocial risk factors identified and estimated an index by evaluating the frequency and intensity of each item. The items were grouped into 3 dimensions: teaching work demands, curricular demands, and organizational difficulties. Phase II, we evaluated the psychometric properties of the tool in a sample of 263 participants. Exploratory factor analysis showed a 3-factor structure that explained 53% of the total variance. The internal consistency of the instrument was 0.91 for the whole instrument. The results indicate that the tool developed is valid and reliable and may be a good instrument to monitor the wellness of university nursing faculty.
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http://dx.doi.org/10.1080/19338244.2016.1246411DOI Listing
January 2018

Software Quality Evaluation Models Applicable in Health Information and Communications Technologies. A Review of the Literature.

Stud Health Technol Inform 2016 ;226:169-72

Nursing School, University of Barcelona, Spain.

Information and Communications Technologies in healthcare has increased the need to consider quality criteria through standardised processes. The aim of this study was to analyse the software quality evaluation models applicable to healthcare from the perspective of ICT-purchasers. Through a systematic literature review with the keywords software, product, quality, evaluation and health, we selected and analysed 20 original research papers published from 2005-2016 in health science and technology databases. The results showed four main topics: non-ISO models, software quality evaluation models based on ISO/IEC standards, studies analysing software quality evaluation models, and studies analysing ISO standards for software quality evaluation. The models provide cost-efficiency criteria for specific software, and improve use outcomes. The ISO/IEC25000 standard is shown as the most suitable for evaluating the quality of ICTs for healthcare use from the perspective of institutional acquisition.
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May 2017

Levels of exposure to ethical conflict in the ICU: Correlation between sociodemographic variables and the clinical environment.

Intensive Crit Care Nurs 2016 Apr 13;33:12-20. Epub 2016 Jan 13.

Faculty of Psychology, Consolidated Research Group 2014-326 Advanced Statistical Techniques Applied Psychology, Research Institute on Brain, Cognition and Behaviour (IR3C), University of Barcelona, Spain.

Objectives: To analyse the level of exposure of nurses to ethical conflict and determine the relationship between this exposure, sociodemographic variables and perceptions of the clinical environment.

Design And Setting: Prospective and descriptive correlational study conducted at 10 intensive care units in two tertiary hospitals affiliated to the University of Barcelona. Sociodemographic and professional data were recorded from a questionnaire and then the previously validated Ethical Conflict in Nursing Questionnaire-Critical Care Version was administered to obtain data regarding experiences of ethical conflict.

Results: Two hundred and three nurses (68.6%) participated in the study, of whom only 11.8% had training in bioethics. Exposure to ethical conflict was moderate with a x¯=182.35 (SD=71.304; [0-389]). The realisation that analgesia is ineffective and the administration of treatment without having participated in the decision-making process were the most frequently reported ethical conflicts. Professionals who perceived their environment as supportive for dealing with ethical conflicts reported lower levels of these events (p=0.001).

Conclusions: Ethical conflict is an internal problem but it is strongly influenced by certain variables and environmental conditions. The involvement of nurses in the decision-making processes regarding the care of critically ill patients emerges as a factor that protects against ethical conflicts.
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http://dx.doi.org/10.1016/j.iccn.2015.10.004DOI Listing
April 2016

[Impact of an informative intervention on the colorectal cancer screening program in primary care professionals].

Enferm Clin 2015 Sep-Oct;25(5):223-31. Epub 2015 Jul 10.

Programa de Detección Precoz del Cáncer, Institut Català d'Oncologia - IDIBELL, Hospitalet de Llobregat, Barcelona, España.

Objective: To evaluate the impact of an intervention in primary care professionals on their current knowledge about colorectal cancer screening, subsequent surveillance recommendations and referral strategies.

Methods Design: Cluster randomized controlled trial.

Location: Primary Care Centers in L'Hospitalet de Llobregat (Barcelona).

Participants: Primary Care Professionals (doctors and nurses).

Intervention: Training session in six of the 12 centers (randomly selected) about the colorrectal cancer screening program, and three emails with key messages.

Main Measurements: Professionals and centers characteristics and two contextual variables; involvement of professionals in the screening program; information about colorectal cancer knowledge, risk factors, screening procedures, surveillance recommendations and referral strategies.

Results: The total score mean on the first questionnaire was 8.07 (1.38) and the second 8.31 (1.39). No statistically significant differences between the intervention and control groups were found, however, in 9 out of 11 questions the percentage of correct responses was increased in the intervention group, mostly related to the surveillance after the diagnostic examination.

Conclusions: The intervention improves the percentage of correct answers, especially in those in which worst score obtained in the first questionnaire. This study shows that professionals are familiar with colorectal cancer screening, but there's a need to maintain frequent communication in order to keep up to date the information related to the colorectal cancer screening.
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http://dx.doi.org/10.1016/j.enfcli.2015.05.006DOI Listing
August 2017

Ethical conflict in critical care nursing: Correlation between exposure and types.

Nurs Ethics 2015 Aug 20;22(5):594-607. Epub 2014 Oct 20.

University of Barcelona, Spain.

Background: Ethical conflicts in nursing have generally been studied in terms of temporal frequency and the degree of conflict. This study presents a new perspective for examining ethical conflict in terms of the degree of exposure to conflict and its typology.

Objectives: The aim was to examine the level of exposure to ethical conflict for professional nurses in critical care units and to analyze the relation between this level and the types of ethical conflict and moral states.

Research Design: This was a descriptive correlational study. Central and dispersion, normality tests, and analysis of variance were carried out.

Participants And Research Context: A total of 203 nurses were from two third-level teaching hospitals in Spain. Both centers are part of the University of Barcelona Health Network. Participants filled out the Ethical Conflict in Nursing Questionnaire-Critical Care Version.

Ethical Considerations: This investigation received the approval of the ethical committees for clinical investigation of the two participating hospitals. Participants were informed of the authorship and aims of the study.

Findings: The index of exposure to ethical conflict was [Formula: see text]. The situations involving analgesic treatment and end-of-life care were shown to be frequent sources of conflict. The types of ethical conflict and moral states generally arranged themselves from lesser to greater levels of index of exposure to ethical conflict.

Discussion: The moderate level of exposure to ethical conflict was consistent with other international studies. However, the situations related with family are infrequent, and this presents differences with previous research. The results suggest that there is a logical relationship between types of conflict and levels of exposure to ethical conflict.

Conclusion: The types of ethical conflict and moral states were related with the levels of exposure to ethical conflict. The new perspective was shown to be useful for analyzing the phenomenon of ethical conflict in the nurse.
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http://dx.doi.org/10.1177/0969733014549883DOI Listing
August 2015

Psychometric evaluation of a new instrument in Spanish to measure self-care requisites in patients with schizophrenia.

Perspect Psychiatr Care 2014 Apr 18;50(2):93-101. Epub 2013 Jun 18.

Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain; Campus Docent Sant Joan de Déu-Fundació Privada, School of Nursing, University of Barcelona, Esplugues de Llobregat, Barcelona, Spain; CIBERSAM (Centro de Investigación Biomédica en Red de Salud Mental), Sant Boi de Llobregat, Barcelona, Spain.

Purpose: The purpose of this study was to develop and validate a new instrument in Spanish designed to measure self-care requisites in patients with schizophrenia treated in the community.

Design And Methods: The first phase was conducted to develop the questionnaire through a panel of experts and evaluate for content validity. Psychometric evaluation was then conducted with a consecutive sample of 341 patients.

Findings: The scale demonstrated good internal consistency and stability over time. The discriminant and convergent validity was satisfactory. The confirmatory factor analysis showed that the theoretical model fits the self-care requisites proposed by Orem's nursing theory from which it originated.

Practice Implications: This scale is a valid and reliable instrument for use in clinical practice, guiding the nurse in developing the most appropriate care plan for each patient.
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http://dx.doi.org/10.1111/ppc.12026DOI Listing
April 2014

Assessing positive mental health in people with chronic physical health problems: correlations with socio-demographic variables and physical health status.

BMC Public Health 2013 Oct 5;13:928. Epub 2013 Oct 5.

Mental Health Sciences Department, School of Nursing, University of Barcelona, Campus of Health Sciences, Feixa Llarga, s/n, 08907-Hospitalet de Llobregat, Barcelona, Spain.

Background: A holistic perspective on health implies giving careful consideration to the relationship between physical and mental health. In this regard the present study sought to determine the level of Positive Mental Health (PMH) among people with chronic physical health problems, and to examine the relationship between the observed levels of PMH and both physical health status and socio-demographic variables.

Methods: The study was based on the Multifactor Model of Positive Mental Health (Lluch, 1999), which comprises six factors: Personal Satisfaction (F1), Prosocial Attitude (F2), Self-control (F3), Autonomy (F4), Problem-solving and Self-actualization (F5), and Interpersonal Relationship Skills (F6). The sample comprised 259 adults with chronic physical health problems who were recruited through a primary care center in the province of Barcelona (Spain). Positive mental health was assessed by means of the Positive Mental Health Questionnaire (Lluch, 1999).

Results: Levels of PMH differed, either on the global scale or on specific factors, in relation to the following variables: age: global PMH scores decreased with age (r=-0.129; p=0.038); b) gender: men scored higher on F1 (t=2.203; p=0.028) and F4 (t=3.182; p=0.002), while women scored higher on F2 (t -3.086; p=0.002) and F6 (t=-2.744; p=0.007); c) number of health conditions: the fewer the number of health problems the higher the PMH score on F5 (r=-0.146; p=0.019); d) daily medication: polymedication patients had lower PMH scores, both globally and on various factors; e) use of analgesics: occasional use of painkillers was associated with higher PMH scores on F1 (t=-2.811; p=0.006). There were no significant differences in global PMH scores according to the type of chronic health condition. The only significant difference in the analysis by factors was that patients with hypertension obtained lower PMH scores on the factor Autonomy (t=2.165; p=0.032).

Conclusions: Most people with chronic physical health problems have medium or high levels of PMH. The variables that adversely affect PMH are old age, polypharmacy and frequent consumption of analgesics. The type of health problem does not influence the levels of PMH. Much more extensive studies with samples without chronic pathology are now required in order to be able to draw more robust conclusions.
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http://dx.doi.org/10.1186/1471-2458-13-928DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3853147PMC
October 2013

Development process and initial validation of the Ethical Conflict in Nursing Questionnaire-Critical Care Version.

BMC Med Ethics 2013 Jun 1;14:22. Epub 2013 Jun 1.

Department of Fundamental Care and Medical-Surgical Nursing, Campus of Health Science of Bellvitge, Nursing School, University of Barcelona, Hospitalet de Llobregat, Barcelona, Spain.

Background: Ethical conflicts are arising as a result of the growing complexity of clinical care, coupled with technological advances. Most studies that have developed instruments for measuring ethical conflict base their measures on the variables 'frequency' and 'degree of conflict'. In our view, however, these variables are insufficient for explaining the root of ethical conflicts. Consequently, the present study formulates a conceptual model that also includes the variable 'exposure to conflict', as well as considering six 'types of ethical conflict'. An instrument was then designed to measure the ethical conflicts experienced by nurses who work with critical care patients. The paper describes the development process and validation of this instrument, the Ethical Conflict in Nursing Questionnaire Critical Care Version (ECNQ-CCV).

Methods: The sample comprised 205 nursing professionals from the critical care units of two hospitals in Barcelona (Spain). The ECNQ-CCV presents 19 nursing scenarios with the potential to produce ethical conflict in the critical care setting. Exposure to ethical conflict was assessed by means of the Index of Exposure to Ethical Conflict (IEEC), a specific index developed to provide a reference value for each respondent by combining the intensity and frequency of occurrence of each scenario featured in the ECNQ-CCV. Following content validity, construct validity was assessed by means of Exploratory Factor Analysis (EFA), while Cronbach's alpha was used to evaluate the instrument's reliability. All analyses were performed using the statistical software PASW v19.

Results: Cronbach's alpha for the ECNQ-CCV as a whole was 0.882, which is higher than the values reported for certain other related instruments. The EFA suggested a unidimensional structure, with one component accounting for 33.41% of the explained variance.

Conclusions: The ECNQ-CCV is shown to a valid and reliable instrument for use in critical care units. Its structure is such that the four variables on which our model of ethical conflict is based may be studied separately or in combination. The critical care nurses in this sample present moderate levels of exposure to ethical conflict. This study represents the first evaluation of the ECNQ-CCV.
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http://dx.doi.org/10.1186/1472-6939-14-22DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3711987PMC
June 2013

New technologies and nursing: use and perception of primary healthcare nurses about electronic health record in Catalonia, Spain.

Telemed J E Health 2011 Oct 5;17(8):635-9. Epub 2011 Aug 5.

School of Nursing, University of Barcelona, Barcelona, Spain.

This study was aimed to analyze and assess the use and perception of electronic health records (EHRs) by nurses. The study sample included 113 nurses from different shifts of primary health facilities in Catalonia, Spain, devoted to adult as well as pediatric outpatients using EHRs throughout the year 2010. A majority of the sample (87.5%) were women and 12.5% were men. The average age was 44.27 years and the average time working in primary healthcare was 47.15 months. A majority (80.4%) received specific training on the use of the EHR and 19.6% did not. The use of the application required side technical support (mean: 3.42) and it is considered necessary to learn more about the performance of the application (mean: 3.50). The relationship between the average ratings that nurses have about the EHR and age shows that there is no statistically significant linear relationship (r=-0.002, p-value=0.984). As to how long they have used the EHRs, there are significant differences (r=-0.304, p-value=0.00), so the more time the nurse takes using the EHR, the greater degree of satisfaction is shown. In addition, there are significant differences between nurses' perceptions regarding the EHR and gender (t=-0.421, p-value=0.675). Nurses assessed as positive the contribution of the EHRs in their nursing care day work (average score: 2.55/5). Considering that the usability of the EHR device is assessed as satisfactory, the results of the perception of nurses show that we must also take into account the training and emphasize the need for a side technical support in the implementation process of the EHR. Doing so, the positive perception that nurses have in regard to information and communication technology in general and with respect to the EHR in particular may be increased.
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http://dx.doi.org/10.1089/tmj.2011.0008DOI Listing
October 2011