Aims
To identify, synthesize and evaluate the psychometric properties of instruments that measure dating violence (DV).
Design
Psychometric systematic literature review.
Data Sources
The databases ...SCOPUS, PubMed, CINAHL, PsychINFO, and Web of Science were searched up to December 2021.
Review Method
We evaluated the psychometric properties of the instruments included and their methodological quality using the Consensus‐based Standards for the Selection of Health Measurement Instruments (COSMIN) checklist and Terwee's quality criteria. The Modified Grading of Recommendations, Assessment, Development and Evaluation (GRADE) was used to rate the best available evidence. The entire process was carried out by three independent reviewers. The review was registered at PROSPERO (registry number CRD42020161137).
Results
A total of 35 studies evaluated 29 instruments measuring DV. Most studies reported data on content validity, structural validity and internal consistency. No studies tested measurement error and responsiveness. Only one instruments tested cross‐cultural validity. It is of interest that the data reported for content validity were the worst evaluated, despite the fact that content validity is one of the key properties in developing and validating the measuring instrument.
Conclusions
There are a significant number of instruments published in this field, and it is important to evaluate and show their psychometric properties to help select evidence‐based instruments. After carrying out the evaluation following the COSMIN guidelines, the authors of this study recommend that the three most suitable instruments are CADRI, WAS/Chinese version and PMWI‐SF/Portuguese version (in that order).
Impact
Identifying and evaluating DV is the first step in designing effective interventions. To achieve this, it is necessary to have validated instruments with suitable psychometric properties. To date, this is the only published systematic review evaluating the psychometric properties of instruments that measure DV which reports on their methodological qualities. The results we found show a growing trend in developing new instruments, with the most suitable approach being to make a cross‐cultural adaptation and validation of the instrument that best suits the value to be measured. In this way, data can be compared between different countries and standardized health care plans and policies designed to achieve better health outcomes. This study may help future researchers to choose the most suitable instrument for their research.
Aims
To develop and psychometrically test the short version of the Multidimensional Scale of Dating Violence (MSDV 2.0) in Spanish‐language to detect violence perpetrated and suffered in dating ...relationships.
Design
A psychometric instrument development and validation study.
Methods
A two‐phase approach was used: Phase (1) the items of the original instrument were revised and new items related to online violence and sexual violence were incorporated. Content validation by a Delphi panel with 25 psychometric and dating violence experts were performed. Next, a face validity was performed in 32 students followed by a pilot study in another 74 participants. Phase (2) Psychometric validation, the instrument was tested in a sample of 1091 university students, analysing the psychometric properties based on construct validity and internal consistency. The study was conducted from September to November 2020 in the context of the Andalusian Public University System.
Results
In phase (1) 42 items for each subscale (perpetration, victimization) were accepted by the Delphi panel, and acceptable values were obtained for the criteria of clarity, coherence, and relevance. In phase (2) the MSDV 2.0 showed acceptable psychometric properties. Confirmatory factor analysis showed a five‐dimensional structure with 18 items for each subscale with excellent fit rates. Reliability analysis indicated adequate internal consistency (α = .879–.802) and correlations with the Depression, Anxiety, and Stress Scale (ρ = .418–.225) and the self‐perceived health item (ρ = .380–.179), providing evidence of its convergent validity. Cut‐off points were also calculated for each dimension, with their corresponding sensitivity and specificity, indicating to be a good instrument for detecting possible cases of dating violence.
Conclusion
The MSDV 2.0 is the only short instrument published to date that measures the dating violence suffered and perpetrated taking into account all its dimensions. Its use would serve as support in prevention programs and design of public policies.
Impact
The short version of the MSDV 2.0 could be a comprehensive enough instrument to enable a detection and evaluation of dating violence in the educational setting.
Background
Pressure injuries are a major public health problem because of their impact on morbidity and mortality, quality of life, and increased healthcare costs. The Centros Comprometidos con la ...Excelencia en Cuidados/Best Practice Spotlight Organization (CCEC/BPSO®) program provides guidelines that can improve these outcomes.
Aims
This study aimed to assess the effectiveness of the CCEC/BPSO® program in improving the care of patients at risk of pressure injury (PI) at an acute care hospital in Spain.
Methods
A quasi‐experimental regression discontinuity design in three periods was used: (1) baseline (2014), (2) implementation (2015–2017), and (3) sustainability (2018–2019). The study population was comprised of 6377 patients discharged from 22 units of an acute care hospital. The performance of the PI risk assessment and reassessment, the application of special pressure management surfaces, and the presence of PIs were all monitored.
Results
Forty‐four percent of patients (n = 2086) met the inclusion criteria. After implementing the program, the number of patients assessed (53.9%–79.5%), reassessed (4.9%–37.5%), the application of preventive measures (19.6%–79.7%), and the number of people identified with a PI in implementation (1.47%–8.44%) and sustainability (1.47%–8.8%) all increased.
Linking Evidence to Action
The implementation of the CCEC/BPSO® program achieved improved patient safety. Risk assessment monitoring, risk reassessment, and special pressure management surfaces were practices that increased during the study period and were incorporated by professionals to prevent PIs. The training of professionals was instrumental to this process. Incorporating these programs is a strategic line to improve clinical safety and the quality of care. The implementation of the program has been effective in terms of improving the identification of patients at risk and the application of surfaces.
Objective
To explore the use of tobacco, alcohol, and illicit drugs and its associated factors among Chinese immigrants living in Spain.
Design and Measures
A mixed‐method design, using surveys and ...semi‐structured interviews.
Sample
A total of 133 Chinese immigrants and stakeholders were assessed in the quantitative study and 7 stakeholders were interviewed in the qualitative study.
Results
The use of tobacco and alcohol was higher than the use of illicit drugs in Chinese immigrants. The prevalence of daily smokers was greater in men than in women (37.3% vs. 2.5%, p < .001). Men consumed more alcohol (76% vs. 50.6%, p = .004) and more frequently (21.6% daily vs. 2.4%, p = .024) than women. The use of illicit drugs was low and Cannabis was the most illicit drug consumed (4%). Qualitative data revealed that due to a great workload, the workers tended to avoid behaviors of illicit drug consumption, but not of alcohol and tobacco, in which the consumption is associated with business meetings and leisure.
Conclusion
This study found that Chinese immigrants in Spain consume more alcohol and tobacco than illicit drugs and that men have a high consumption compared to women. These findings reveal important cultural differences that should be addressed by public health managers in order to develop strategies that consider the characteristics of this population.
Aim
To conduct a scoping review to examine and map the interventions proposed for the improvement of the working conditions of nursing staff in acute care hospitals.
Background
The Registered Nurse ...Forecasting (RN4CAST) project and other studies have determined the impact that the nursing staff has on the quality of care. The nursing staff's higher levels of burnout, job dissatisfaction and negative perception of the quality of care provided caused worse health outcomes.
Methods
A scoping review was carried out. By searching in SCOPUS, PubMed, CINAHL, Cochrane, Dialnet and in the grey literature, 705 potentially relevant papers were identified. The final analysis included 21 papers and three grey documents.
Results
The studies analysed proposed interventions at the macro‐management, meso‐management and micro‐management levels, although the interventions at the macro‐ and meso‐levels produce better staff outcomes.
Conclusions
The findings of this review can be applied to management at different levels: measures to improve the patient–nurse ratio at the macro‐management level, the horizontal hierarchies at the meso‐management level, the mind–body techniques at the micro‐management level.
Implications for Nursing Management
Nurse managers and leaders should implement interventions at different organisational levels to improve the working conditions of the nursing staff and other health outcomes.
Purpose
Heart failure is a highly prevalent chronic health problem associated with poor quality‐of‐life and negative outcomes. Self‐care is a cornerstone in patients suffering from heart failure. ...Nurses are commonly engaged in enhancing patients’ self‐care behaviors, but the specific condition of deficit on self‐care is not clearly identified by nurses. No nursing diagnoses focused on self‐care of heart failure patients is currently available. This study aimed to develop a new nursing diagnosis that focuses on self‐care in heart failure patients.
Data sources
A concept and content analysis were used. Some steps of the concept analysis were performed through an integrative literature review conducted searching in PUBMED and CINAHL databases to identify attributes, antecedents, and consequences of the diagnosis. Forty‐five articles were selected from the 1450 studies found. Then, the content analysis was performed by an international panel of 29 experts. Two Delphi rounds were used to achieve consensus and an item content validity index was calculated for each diagnostic element.
Data synthesis
Integrative review proposed four diagnostic labels, two definitions, 15 defining characteristics, and 44 related factors. After the two Delphi rounds a consensus was reached for each diagnostic indicator with a content validity index ranging from 82.8% to 100%. The nursing diagnosis—labeled heart failure self‐care deficit—was validated with a definition, eight defining characteristics, 15 related factors, and five at‐risk populations.
Conclusions
This diagnosis allows nurses to document patients’ self‐care in daily clinical practice through a standard nursing terminology, by naming this health problem, describing its etiology, and clinical manifestations.
Implications for nursing practice
This new diagnosis is expected to assist nursing clinicians, educators, and students in clinical reasoning with the aim to improve diagnostic accuracy in identifying patients with a heart failure self‐care deficit, to select the most appropriate interventions and pursue better outcomes.
Purpose
To identify which patient and hospital characteristics are related to nurse staffing levels in acute care hospital settings.
Design
A cross‐sectional design was used for this study.
Methods
...The sample comprised 1,004 patients across 10 hospitals in the Andalucian Health Care System (southern Spain) in 2015. The sampling was carried out in a stratified, consecutive manner on the basis of (a) hospital size by geographical location, (b) type of hospital unit, and (c) patients’ sex and age group. Random criteria were used to select patients based on their user identification in the electronic health record system. The variables were grouped into two categories, patient and hospital characteristics. Multilevel linear regression models (MLMs) with random intercepts were used. Two models were fitted: the first was the null model, which contained no explanatory variables except the intercepts (fixed and random), and the second (explanatory) model included selected independent variables. Independent variables were allowed to enter the explanatory model if their univariate association with the nurse staffing level in the MLM was significant at p < .05.
Results
Two hierarchical levels were established to control variance (patients and hospital). The model variables explained 63.4% of the variance at level 1 (patients) and 71.8% at level 2 (hospital). Statistically significant factors were the type of hospital unit (p = .002), shift (p < .001), and season (p < .001). None of the variables associated with patient characteristics obtained statistical significance in the model.
Conclusions
Nurse staffing levels were associated with hospital characteristics rather than patient characteristics.
Clinical Relevance
This study provides evidence about factors that impact on nurse staffing levels in the settings studied. Further studies should determine the influence of patient characteristics in determining optimal nurse staffing levels.
To investigate the use of healthcare services and factors associated with accessing them among Chinese immigrants living in Southern Spain.
A mixed methodology was used. A cross-sectional survey was ...first administered to Chinese immigrants (n=133), and they were asked about their visits to the doctor, use of emergency services, and hospitalization. A phenomenological approach was then used with key informants (n=7). In the interviews, additional information, such as barriers and facilitators to improving accessibility, was explored.
In the previous year, 51% had visited a doctor and 34% had visited an Emergency Department. The main reasons for hospitalization were pregnancy (37.5%) and surgery (25%). At least 20% of the sample reported having never visited a doctor. Language difficulties and time constraints were identified as important barriers to accessibility. Sex differences were found among the reasons for lack of time, which, in men, were related to work (odds ratio OR=7.7) and, in women, were related to childcare (OR=12). The majority of Chinese immigrants preferred to use Traditional Chinese Medicine as their first treatment rather than visiting a doctor.
A lower use of health services was found among Chinese immigrants in Spain compared to the native population. When using health services, they choose acute care settings. Communication and waiting times are highlighted as major barriers. Adapting these demands to the healthcare system may help immigrants to trust their healthcare providers, thus increasing their use of health services and improving their treatment.
Investigar el uso y los factores asociados al acceso a los servicios de salud en inmigrantes chinos residentes en el sur de España.
Se utilizó una metodología mixta. Primero se administró una encuesta transversal a inmigrantes chinos (n=133). Se les preguntó sobre sus visitas al médico y el uso de servicios de emergencia y de hospitalización. Luego se utilizó un enfoque fenomenológico con informantes clave (n=7), explorando información adicional, como barreras y facilitadores para mejorar la accesibilidad.
El último año, el 51% había visitado al médico y el 34% un servicio de urgencias. La hospitalización se debió principalmente a embarazo (37,5%) y cirugía (25%). El 20% informó que nunca había visitado al médico. Las dificultades de lenguaje y las limitaciones de tiempo fueron barreras importantes para la accesibilidad. Se encontraron diferencias de sexo para la falta de tiempo; en hombres se relacionaron con el trabajo (odds ratio OR=7,7) y en mujeres con el cuidado infantil (OR=12). La mayoría prefirió usar medicina tradicional china como primer tratamiento en lugar de visitar al médico.
Se encontró un menor uso de los servicios de salud entre los inmigrantes chinos en España en comparación con la población autóctona. Al utilizar los servicios de salud, eligen los cuidados agudos. La comunicación y los tiempos de espera destacan como barreras principales. Adaptar estas demandas al sistema de salud puede ayudarles a confiar en sus proveedores de atención médica, aumentando el uso de los servicios de salud y mejorando su tratamiento.
The objective of this work was to describe the
implantation project presented by the Virgen de las
Nieves University Hospital (Granada, Spain) to be
selected as a candidate for “Best Practice ...Spotlight
Organization”® (in Spain CCEC®) program in the
cohort (2015-2017) to implement three guidelines
for Nurses Association of Canada Ontario (RNAO)
clinical practice of care.
The methodology used was the model called
“knowledge for action” and the actions developed
for each of the phases of the action cycle for applying
knowledge to practice were described: 1) identification
of the problem, 2) adaptation to the local context, 3)
evaluation of facilitators and barriers, 4) adaptation
and implementation of interventions, 5) monitoring
and evaluation of results and 6) sustainability.
This work adds to the set of studies that address
the improvement and maintenance of evidence-based
practice programs in nursing, and in health services in
general. It shows the application of a framework for
the implementation of clinical practice guidelines for
care in a specific health environment for its replication
in other different health settings. It has been shown
that it is essential to dedicate efforts to planning the
implementation of this type of programs, taking into
account the context in which they are developed, the
specific characteristics of the population being served,
identifying the different barriers and facilitators that
may affect during the course of the program. process
and defining actions to make the changes in practice
sustainable.
El objetivo de este trabajo fue describir el
proyecto de implantación presentado por el Hospital
Universitario Virgen de las Nieves (Granada, España)
para ser seleccionado candidato del programa
“Centros Comprometidos con la Excelencia en
Cuidados” (CCEC)® en la cohorte (2015-2017) para
implantar tres guías de práctica clínica de cuidados
de la Asociación de Enfermeras de Ontario de
Canadá (RNAO).
La metodología utilizada fue el modelo
denominado “conocimiento para la acción” y se
describieron las actuaciones desarrollas para cada
una de las fases de las que consta el ciclo de acción
para la aplicación de conocimientos a la práctica: 1)
identificación del problema, 2) adaptación al contexto
local, 3) evaluación de los facilitadores y barreras,
4) adaptación e implantación de las intervenciones,
5) monitorización y evaluación de resultados y 6)
sostenibilidad.
Este trabajo se suma al conjunto de estudios que
abordan la mejora y el mantenimiento de programas
de prácticas basadas en la evidencia en enfermería,
y en los servicios de salud en general. Muestra la
aplicación de un marco de implantación de guías
de práctica clínica de cuidados en un entorno
sanitario específico para su replicación en otros
escenarios de salud diferentes. Se ha demostrado que
resulta esencial dedicar esfuerzos en planificar la
implantación de este tipo de programas atendiendo al
contexto en el que se desarrollan, a las características
específicas de la población a la que se atiende,
identificando las diferentes barreras y facilitadores
que pueden afectar durante el proceso y definiendo
acciones para hacer sostenible los cambios en la
práctica.
PURPOSE
To develop and validate the operational definition (ODs) for each defining characteristic (DC) contained in the Nursing Diagnosis (ND) “insomnia” (00095) in the occupational health context.
...METHODS
Methodological study carried out in two stages, including a consensus of experts to develop the ODs (Stage 1) and an online Delphi panel, performed in two rounds, to validate them (Stage 2).
FINDINGS
The 15 ODs proposed in Stage 1 were narrowed down to six validated ODs in the first round (diagnostic content validity index DCVI = 0.80‐0.89). In the second round, five ODs were validated (DCVI = 0.80‐0.94). Finally, the remaining four ODs were validated by the general consensus of experts.
CONCLUSIONS
The ODs were validated, although there remains some doubt as to whether some of the DCs can be applied to the field of occupational health.
IMPLICATIONS FOR NURSING PRACTICE
The ODs developed and validated could improve the diagnostic accuracy of the ND “insomnia” (00095) in the context of occupational health.
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