The transition to parenthood represents a moment of change and adaptation in which the dyadic marital relationship becomes a triadic relationship. Facilitating a positive transition requires a ...thorough understanding of the explanatory model of the relationship between parental–infant bonding, dyadic adjustment and quality of life (QoL) from an integrative perspective of the family unit. The aim of this work was to analyse the relationships between parent–infant bonding, dyadic adjustment and QoL from an intra‐partner perspective, 6–12 months after the birth of a child. A cross‐sectional observational study was performed in a convenience sample of 222 couples 6–12 months postpartum, enrolled from October 2013 to March 2016. The mean age of the mothers was 34.07 years (SD = 3.67), and for the fathers, it was 35.75 years (SD = 4.02). Mothers perceived better QoL and greater mother–infant bonding compared to fathers. The perception of an adequate dyadic adjustment, together with positive parent–infant bonding, had positively influenced the individual QoL of both members of the couple 6–12 months after birth. From an intra‐partner perspective, the positive transition was influenced by the relationship between parent–infant bonding, dyadic adjustment and QoL. Positive parent–infant bonding in mothers and fathers, as well as promotion of the quality of the relationships between couples, can help promote a better QoL. Positive health results can be achieved in terms of individual and family well‐being by designing healthcare interventions that encourage the presence and participation of the family unit.
Enquadramento: As condições de trabalho dos profissionais dos serviços de urgência e a tecnicização dos cuidados de saúde tiveram um impacto negativo na relação profissional de saúde-doente, ...desumanizando-a. Objetivo: Este estudo qualitativo explorou as perspetivas das enfermeiras em relação à humanização dos cuidados de saúde nos serviços de urgência em Espanha. Metodologia: Foi realizado um estudo qualitativo com recurso a entrevistas semiestruturadas a 11 enfermeiros a trabalhar em serviços de urgência. Os dados foram analisados com recurso à técnica de análise de conteúdo. Resultados: Foram identificados dois temas principais: as dimensões dos cuidados de saúde humanizados e implementação de cuidados de saúde humanizados nos serviços de urgência, bem como cinco subtemas. Conclusão: São apresentadas recomendações para reforçar as iniciativas para implementação de modelos integrados de assistência em saúde. A implementação do cuidado holístico, centrado no doente e na sua família é essencial para garantir a humanização dos cuidados de saúde nos serviços de urgência.
Abstract
Background
Summary health measures as the global activity limitation indicator (GALI) or self-rated health (SRH) allow to quantify and monitor the health of the population. The GALI is ...widely used in the European Union; however, evidence of its construct validity is still limited. We examine whether the GALI reflects disability in specific living contexts such as self-care, domestic life and work activity, whether it does so consistently across gender and age and its added value concerning SRH.
Methods
We used the subsample of adults aged 16–64 years (N = 15 934) from the 2009 European Health Interview Survey in Spain and analyzed the data with logistic regression models using the GALI and SRH as response variables.
Results
The GALI was strongly and significantly associated with the three measures of disability: self-care (OR = 22.8, 95% CI: 15.9–32.7), domestic life (OR = 16.3, 95% CI: 13.6–19.5) and work activity (e.g. impossibility to work: OR = 41.9, 95% CI: 30.3–57.8; prolonged sick leave: OR = 10.7, 95% CI: 9–12.7). There were significant interactions with age on all three disability measures and with the gender on one (domestic life), although they were small. SRH was also strongly associated with all three disability measures, but to a lesser extent than the GALI.
Conclusions
The GALI reflects well and better than SRH, disability in self-care, domestic life and work activity. It is unknown whether the GALI performs equally in other living contexts such as social relations and community life.
Abstract Objectives As the Global Activity Limitation Index (GALI) has only recently been created and it is not yet known whether it adds any additional information to self-rated health (SRH), two ...hypotheses were tested: (1) GALI is primarily correlated with functional disability and secondarily with morbidity and (2) SRH is primarily correlated with morbidity and secondarily with functional disability. Methods The data source used was a subsample of the 2006 Spanish National Health Survey comprising people aged more than 64 years ( N = 7,835). Age, sex, social class, physical and mental morbidities, and functional disability were selected as predictors in multinomial logistic regression models, in which GALI and SRH were the outcome variables. Fractional polynomials were used to handle the continuous predictors. Results The results supported, generally, both hypotheses: functional disability was the main correlate of GALI and physical morbidity, rather than mental morbidity, was the main correlate of SRH. Furthermore, mental morbidity was as strong a correlate of GALI as SRH, but physical morbidity was notably less strong a correlate for GALI than for SRH. Conclusion In older people, GALI mainly measured functional disability, whereas SRH mainly measured physical morbidity.
Postnatal sense of security is a relevant construct related to several variables of motherhood. However, it has not yet been studied in the Spanish context. The aims were: (a) To analyze the ...psychometric properties of a Spanish version of the Mothers' Postnatal Sense of Security Scale (PPSS‐S); (b) analyze the factors related to mothers' sense of security during the first 2 weeks following childbirth (sociodemographic variables and factors related to maternity); and (c) examine the predictive utility that mothers' sense of security has on symptoms of postpartum depression 6–11 months after childbirth. This was a prospective longitudinal study performed in the first 6–11 months post‐partum in four regions of Spain. A total of 928 mothers whose mean age was 33.67 years (standard deviation = 4.54) participated. The confirmatory factor analysis showed adequate adjustment to the original structure (χ2 = 17,272.79, df = 153, p < .001; Tucker–Lewis index = 0.98; comparative fit index = 0.98; root mean square error of approximation = 0.058 0.053‐0.063)and the overall internal consistency was 0.89. Direct relationships were shown between women' sense of security and already having had a child, the absence of postpartum health complications (either in the mother or the newborn) and receiving consistent information from healthcare professionals. Our results showed adequate evidence for the reliability and validity of the Spanish version of the PPSS‐S. Understanding mothers' sense of security during the early months of motherhood, as well as related factors in the postpartum period, will allow health professionals to implement preventive measures to promote mental health and could help reduce symptoms of postpartum depression.
Aims and objectives
To develop a new scale for assessing the associative stigma of mental illness in nursing based on Peplau's model of psychodynamic nursing and to examine its psychometric ...properties.
Background
The stigma of mental illness continues to cause problems today for patients, families and mental health professionals. For individuals with a mental disorder, stigma can result in restricted opportunities, social exclusion and the denial of rights. Associative stigma in mental health professionals is becoming a major problem and is related to increased depersonalisation, higher levels of emotional exhaustion and diminished job satisfaction among mental health professionals. Nursing may play a key role in reducing the stigma associated with mental illness, but there are no specific scales for the measurement of associative stigma in nursing.
Design
Development of an instrument. A STROBE checklist was completed.
Methods
This study involved two stages: (a) item generation and content validation; (b) examining the reliability and convergent/discriminant validity of the scale. A developmental and methodological design was used. Data were collected between November 2016–December 2017 from a sample of 737 nursing undergraduates.
Results
The results indicated good internal consistency for the final 20‐item scale for assessing the associative stigma of mental illness in nursing, which is considered in terms of three dimensions: Violence/Dangerousness, Disability, and Irresponsibility/Lack of Competence. Exploratory and confirmatory factor analyses supported a three‐factor structure consistent with the theoretical model.
Conclusions
The 20‐item EVEPEM (from its Spanish acronym) derived from Peplau's theory was shown to be a valid and reliable tool for assessing the stigma of mental illness in the nursing setting.
Relevance to clinical practice
Reliable instruments are needed to measure the effectiveness of anti‐stigma interventions for mental health professionals. The results indicate that the tool developed is a valid and reliable instrument for use in the nursing setting.
Accessible summary
What is known on the subject?
Advance care planning (ACP) in mental health is a useful tool to avoid human rights violations in mental health settings. However, ACP is not yet a ...reality in the Spanish context.
The advance healthcare directive (AHD) is a document reflecting healthcare preferences, drafted within the framework of the ACP process, to be applied in situations in which an individual's legal capacity may be questionable.
No study has explored the viewpoint of Spanish mental healthcare professionals towards AHDs in the mental health field. Considering their extensive use, further study of providers’ knowledge and attitudes is warranted.
What does the paper add to existing knowledge?
The study adds knowledge about the viewpoint of Spanish mental healthcare professionals towards the implementation of AHDs in their clinical practices.
This study illuminates the prevailing paternalistic provider–user relationship as the main barrier surrounding AHD management in terms of decision‐making.
Our findings support the need for broader awareness, staff training regarding the documentation, the conversation process and communication skills, and personalized assistance in the mental health services to implement AHDs in everyday practice.
What are the implications for practice?
Advance healthcare directives are a recovery tool that offers major information regarding mental health user preferences. Although they pose challenges for clinical practice, AHDs should be incorporated into interventional mental health care.
Obtaining up‐to‐date perspectives held by mental healthcare professionals regarding AHDs allows the administration to determine the aspects requiring reinforcement.
The implementation of AHDs in the Spanish mental health system requires macro‐ and micro‐changes, both ethically and structurally, so that mental healthcare professionals relinquish their paternalistic approach and embrace new ways of relating to users.
Introduction
An advance healthcare directive (AHD) is a written document that contains a patient‐in‐care's will and preferences concerning the treatment options available to them, should they lack decision‐making capacity. AHDs are completed within a broader framework known as advance care planning. No study has explored the viewpoint of Spanish mental healthcare professionals towards AHDs.
Aim
To explore the viewpoint of mental health professionals towards the implementation of AHDs in mental health.
Method
A qualitative study was conducted using semi‐structured interviews that were thematically analysed.
Findings
Three main themes were identified: care planning culture; barriers for the practical management of AHDs; and reasons to not honour patient‐in‐care AHDs.
Discussion
Professionals find it pragmatically difficult to stop applying traditional paternalistic practices. To implement AHDs, improving the knowledge and awareness of AHDs and management of non‐technical skills through training is required. Such training should include users and families and allow for compliance with United Nations requirements.
Implications for practice
Advance healthcare directives offer important information regarding user preferences, although they pose challenges for practices. Acquiring an up‐to‐date perspective on the attitudes of professionals towards AHDs allows organizations to attend to particular aspects that require reinforcement. Wider awareness, staff training and new ways of relating to users are necessary to implement AHDs in Spanish context.
Relevance statement
A better understanding of the attitudes of Spanish mental health professionals towards AHDs was achieved. Despite the implementation of AHDs being an important and potentially beneficial initiative, mental health professionals find many pragmatic issues that need addressing before AHDs become a reality in their clinical practice. Wider awareness, staff training, personalized assistance and new ways of relating to users are required to implement AHDs in everyday practice.
Self-efficacy is a critical element of social cognitive theory and refers to a person's estimation of their ability to complete a specific task. Self-efficacy scales evaluate the effectiveness of ...communication skills training programs. There were not validated scales in Spanish.
to cross-culturally adapt the Self-efficacy questionnaire-12 scale in communication skills in Spanish, evaluate its psychometric properties, and analyse the sample's descriptive characteristics.
we conducted an instrumental study to develop evaluation scales.
nursing students were invited to participate (N = 387). The inclusion criteria were: (1) enrolment in first or fourth academic course year; (2) not having received specific training in communication skills; and (3) understanding written and spoken Spanish fluently. A total of 334 undergraduates participated (86.3% response rate); their mean age was 21.9 years (SD = 5.8), 83.2% were female.
data showed high internal consistency (0.94) and a good fit to the model. The overall instrument score correlated with the attitude towards communication skills (r = 0.20; p < 0.001). Moderate communication self-efficacy scores were observed in these nursing students.
Evaluating communication skills through self-efficacy scales allows teachers to know each student's perceived proficiency to handle communication with users safely and to understand users' needs, giving information about aspects to improve and to establish effective institutional strategies as one of the inherent characteristics of the concept of skills-based evaluation.
The Spanish version of the Self-efficacy questionnaire-12 in communication skills was a valid and reliable instrument, essential for evaluating the perceived self-efficacy towards communication in nursing.
Resumen: El objetivo de este trabajo de reflexión es establecer los valores éticos que deberían sustentar el restablecimiento de la asistencia sanitaria tras las primeras oleadas de la COVID-19, ...sabiendo que los brotes y las nuevas olas parecen inevitables hasta la masiva vacunación. Por ello, consideraremos diferentes cuestiones éticas a tener en cuenta en la fase de reanudación de la actividad de las unidades asistenciales de salud mental, tanto por gestores como por las y los profesionales de las mismas.
In the last few years endurance sports have experienced a great increase in the number of competitions and participants. Dietary-nutritional planning is key for performing well during such ...competitions. To date, there is no questionnaire expressly developed to be able to analyze the consumption of liquids, foods, and supplements, as well as gastrointestinal problems in these events. This study describes the development of the Nutritional Intake Questionnaire for Endurance Competitions (NIQEC).
The study was composed in the following phases: (1) Bibliographic search for the most important nutrients, (2) focus groups (17 dietitian-nutritionists and 15 experienced athletes) and generation of items, (3) Delphi surveys, and (4) cognitive interviews.
After an initial shaping of the questionnaire with the items that emerged in the focus groups, their relevance was evaluated by means of the Delphi survey, which showed more than 80% approval for most items. Finally, the cognitive interviews indicated that the questionnaire was simple and complete for its purpose. The final NIQEC (
= 50 items) was divided in 5 sections: Demographic data; sports data; consumption of liquids, food and supplements before, during, and after the competition; gastrointestinal complaints, and dietary-nutritional planning for the competition.
The NICEQ is a useful tool that allows collecting information from participants on sociodemographic factors and gastrointestinal complaints, and estimating the intake of liquid, food, and supplements, for endurance competitions.
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