Spanish version of the Self-Care of Chronic Illness Inventory: A validation study amongst community-dwelling older adults with chronic multimorbidity.

AIM: To psychometrically assess the Spanish version of the Self-Care of Chronic Illness Inventory (SC-CII-Sp) in community-dwelling older adults with chronic multimorbidity. DESIGN: A methodological study. METHOD: A total of 1260 older adults participated in the study between May 2020 and February 2022. The data were analysed using SPSS Statistics® 26 and AMOS® 24. The items' content validity index and the Fleiss' kappa were calculated to assess the SC-CII-Sp's content validity. Convergent validity was assessed by calculating the Pearson correlation coefficient between the participants' scores on the SC-CII-Sp and their scores on the Spanish Chronic Disease Self-Efficacy scale (SCD-SE). Construct validity was tested by performing a confirmatory factor analysis (CFA). The SC-CII-Sp's reliability was tested by computing the Cronbach's alpha. RESULTS: The SC-CII-Sp showed good content and convergent validity. The CFA showed that the SC-CII-Sp has three sub-scales. The 8-item Self-Care Maintenance sub-scale has good internal consistency and is comprised of two dimensions: illness-related and health-promoting behaviour. The Self-Care Monitoring sub-scale had excellent internal consistency and its five loaded items belonged to a single dimension. The 6-item Self-Care Management sub-scale has adequate internal consistency and two dimensions: autonomous and consulting behaviour. CONCLUSION: The Spanish version of SC-CII is a valid and reliable instrument to be used in the assessment of self-care behaviours amongst Spanish-speaking, community-dwelling older adults with chronic multimorbidity. IMPLICATIONS FOR THE PROFESSION: Nurses need valid and reliable tools to assess self-care behaviours in Spanish-speaking community-dwelling older adults with chronic multimorbidity. This study provides a 19-item tool that allows for the comprehensive evaluation of self-care behaviours in healthy and ill states. IMPACT: Using the SC-CII-Sp in clinical or research settings could help nurses to examine the effects of different interventions on self-care behaviours amongst Spanish-speaking, community-dwelling older adults with chronic multimorbidity. PATIENT OR PUBLIC CONTRIBUTION: None to be reported.

Spanish version of the Maastricht Personal Autonomy Questionnaire: A validation study among community-dwelling older adults with chronic multimorbidity.

BACKGROUND: Loss of personal autonomy in older adults with chronic multimorbidity is associated with worsened biopsychosocial health. In order to facilitate the standardised assessment of personal autonomy in older adults with chronic conditions, nurses could use the Maastricht Personal Autonomy Questionnaire (MPAQ). OBJECTIVE: To translate, culturally adapt and psychometrically assess the Spanish version of the MPAQ in community-dwelling older adults with chronic multimorbidity (MPAQ-Sp). METHODS: Observational cross-sectional study. A convenience sample of 884 community-dwelling older adults was recruited from 10 community centres in five health districts in southeastern Spain. Data were collected between January 2021 and September 2022. The study was completed in four phases. Phase 1: The MPAQ was translated into Spanish. Phase 2: A pilot test of reliability and content validity was conducted. Phase 3: To test the dimensionality of the tool, an exploratory factor analysis (EFA) was conducted. Phase 4: a final validation study was conducted which included a confirmatory factor analysis (CFA) and assessed the validity (content, criterion and construct), reliability and readability of the MPAQ-Sp. RESULTS: The average age of the sample was 75.89 years (SD = ±8.04). Their mean number of chronic conditions was 4.84 (SD = ±2.19) and 67% were women. The MPAQ-Sp is comprised of 16 items distributed in four subscales: [1] the 'Degree of autonomy' scale, [2] the 'Working on autonomy' scale, [3] the 'Dilemmas: health over preferences' scale and [4] the 'Dilemmas: preferences over health' scale. CONCLUSIONS: The Spanish version of the MPAQ-Sp is a valid and reliable instrument to assess personal autonomy in Spanish-speaking, community-dwelling older adults with chronic multimorbidity. IMPLICATIONS FOR PRACTICE: The use of the MPAQ-Sp would allow researchers and healthcare professionals to identify a loss of personal autonomy among Spanish-speaking community-dwelling older adults with chronic multimorbidity.

Learning Experiences of Future Healthcare Support Workers Enrolled in a Dual Mode Vocational Training Programme.

BACKGROUND: With life expectancy increasing, there is a growing need to train healthcare support workers who provide care for dependent people in healthcare centres and at home. This qualitative study, based on Gadamer's hermeneutic philosophy, aimed to understand the learning experiences of future healthcare support workers currently enrolled in an intermediate, dual modality vocational training programme with regard to caring for dependent people. METHODS: Convenience sampling was used to recruit the participants, who were all students enrolled in an intermediate level vocational training programme in care for dependent people. Fourteen in-depth interviews and one focus group session were conducted with the students. Atlas.ti 8.0 software was used to analyse the participants' accounts. RESULTS: The students highlighted the vocational nature of their studies and the need to feel competent and useful as a healthcare support worker for dependent people. Practice-based learning and the need for training in core competences are complementary and essential elements of the training process. CONCLUSIONS: The participants' previous experiences were key in determining their academic trajectory and reflect their motivation and interest to learn. However, they feel vulnerable, unprotected, and lack training in psychosocial skills. Educational institutions should focus training programmes on the practice and development of psychosocial skills that motivate students to acquire transversal competences.

Sexuality in Women with Fibromyalgia Syndrome: A Metasynthesis of Qualitative Studies.

Fibromyalgia syndrome (FMS) is a nonarticular rheumatic syndrome which presents as chronic musculoskeletal pain, stiffness and body aches. FMS affects approximately 2.5% of the population, mostly women. FMS causes physical and psychological problems and reduces quality of life. The objective of this study is to identify qualitative evidence about experiences of women diagnosed with FMS about their sexuality. METHODS: Metasynthesis of qualitative studies. The search included articles published between 2000 and June 2023 on the PubMed, WOS, CINAHL, SCOPUS, and SCIELO databases. RESULTS: 450 articles were found through the initial search, of which, only nine fulfilled the criteria and were included in the thematic synthesis. From this analysis, three main themes emerged: (1) "I want to, but I can't": FMS causes a shift in feminine sexuality. (2) Resetting sex life and intimacy. (3) Taking charge of a "new sexuality." CONCLUSIONS: Women with FMS suffer from limitations of their sexuality that affect their partner. Pain, stiffness and a loss of desire make sexual encounters difficult. Becoming aware of this and striving not to lose their sexuality is key to coping with this problem. Women and their sexual partners can change roles and encourage communication, games, foreplay or touching. The use of lubricants, physical exercise and complementary therapies, along with social, professional and partner support, are key to coping with FMS.

Effects of home visiting programmes on community-dwelling older adults with chronic multimorbidity: a scoping review.

BACKGROUND: Chronic ultimorbidity is the most frequent and serious health problem in older adults. Home visiting programmes could be a strategy with potential benefits. However, there are no scoping reviews to date that examine the effects of home visiting programmes on community-dwelling older adults with chronic multimorbidity. OBJECTIVE: To examine the effects of home visiting programmes on community-dwelling older adults with chronic multimorbidity. METHODS: A scoping review was carried out following PRISMA-ScR reporting guidelines. The search was conducted in six databases (PubMed/Medline, Cochrane, CINAHL, Web of Science, Scopus and EMBASE) between October 2021 and April 2022. RESULTS: Four RCTs with 560 patients were included. The visits were carried out by nurses, nursing students, volunteers, and other healthcare professionals. The interventions varied in the number of visits, frequency, duration of follow-up, and whether or not they were combined with other strategies such as telephone calls. Discrepancies were found in the effects of the interventions on quality of life, self-efficacy, self-rated health, and use and cost of health and social services. CONCLUSION: This review shows that home visiting programmes could have potential benefits for older adults with chronic multimorbidity. However, its results have been inconclusive. There is a need for high quality studies involving a larger number of patients, in which home visits are the main intervention.

Spanish version of the self-care self-efficacy scale: A validation study in community-dwelling older adults with chronic multimorbidity.

OBJECTIVE: To test the psychometric properties of the Spanish version of the Self-Care Self-Efficacy Scale (SCSES-Sp) in community-dwelling older adults with chronic multimorbidity. METHODS: A sample of 1013 community-dwelling older adults with chronic multimorbidity participated in an observational cross-sectional study that was carried out in 3 phases. RESULTS: Confirmatory factor analysis showed that the SCSES-Sp has 4 dimensions: "self-efficacy in self-care behaviours based on clinical knowledge", "self-efficacy in self-care maintenance", "self-efficacy in self-care monitoring", and "self-efficacy in self-care management". A panel of independent experts considered the content of the SCSES-Sp valid. Convergent validity analysis showed moderate-strong correlations between all of the SCSES-Sp's dimensions and the reference criteria chosen. Reliability was good for the SCSES-Sp and all its dimensions. Test-retest reliability analysis showed that the SCSES-Sp was temporally stable. CONCLUSIONS: The SCSES-Sp is a valid and reliable tool to assess self-efficacy in self-care in Spanish-speaking, community-dwelling older adults with chronic multimorbidity.

Nursing students' experiences of a home visiting programme for older adults with multimorbidity (VISITAME project): A phenomenological study.

INTRODUCTION: Nursing students should acquire competence in promoting self-care in older adults with chronic multimorbidity, but opportunities for clinical practice are limited. The implementation of a home visiting programme to community-dwelling older adults with chronic multimorbidity could contribute to nursing students' acquisition of this competence. OBJECTIVE: The aim of our study was to understand the experience of nursing students participating in a home visiting programme to community-dwelling older adults with chronic multimorbidity. DESIGN: Qualitative study based on Gadamer's hermeneutic phenomenology. METHOD: Twenty-two in-depth interviews were conducted with nursing students participating in a home visiting programme. Data were recorded, transcribed and analysed following the procedure developed by Fleming. RESULTS: Three main themes were extracted in the data analysis process: (1) 'living the theory. Experience as a catalyst for learning', (2) 'the home visiting programme as a tool for promoting competence in caring for older adults', and (3) 'when learning sparks interest in working with older adults'. CONCLUSION: The home visiting programme to community-dwelling older adults has an important impact on the personal and professional development of nursing students. The experience of the home visiting programme leads to deep learning that sparks interest in caring for older adults. The implementation of a home visiting programme could be a beneficial strategy for the acquisition of competence to promote health and self-care.

Experiences of poverty amongst low-income older adults living in a high-income country: A qualitative study.

AIM: To understand the experience of low-income older adults living in poverty in a high-income country. DESIGN: A qualitative study based on Gadamer's hermeneutic phenomenology. METHODS: A convenience sample of twenty-seven low-income older adults were interviewed in-depth between September 2021 and January 2022. Fleming's method for conducting phenomenological qualitative studies was followed and ATLAS.ti software was used for data analysis. RESULTS: Three main themes were extracted from the analysis: (i) 'living in the shadow of poverty', (ii) 'unprotected by the 'social shield' of the welfare state' (iii) 'the struggle to attain good health'. CONCLUSION: Living in poverty affects all spheres of life. Older adults living in poverty feel excluded from social support policies and laws. This has a negative impact on the older adults' mental health and can lead to social isolation. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: Nursing interventions to promote health amongst older adults living in poverty should include an assessment of the patient's social determinants and a focus on increasing social participation. Older people living in poverty experience difficulties accessing formal social support so nurses should implement patient navigation interventions that aim to help them overcome the complexities of the system. Nursing interventions to improve mental health amongst older adults living in poverty are much needed. IMPACT: Living in poverty increases older adults' vulnerability. Older adults living in poverty suffer from mental health issues as they live under constant pressure to meet their basic needs and lack formal social support. These findings are important for nurses, who play a pivotal role in the design, implementation and evaluation of policies and interventions that promote health equity. REPORTING METHOD: The study has been conducted following the COREQ guidelines. PATIENT OR PUBLIC CONTRIBUTION: There has been no public or patient involvement in the design or development of the study.

Development and Psychometric Assessment of a Questionnaire for the Detection of Invisible Violence against Women.

BACKGROUND: Invisible violence against women (IVAW) can be understood as the set of attitudes, behaviors, and subtle beliefs that men use to subordinate women and that are culturally accepted. These behaviors can be a risk factor for intimate partner violence (IPV), so it is important to design tools that allow us to detect it early. The aim of this study was to design and psychometrically assess a questionnaire for the detection of invisible violence against women (Q-IVAW). METHODOLOGY: A descriptive cross-sectional methodological study carried out in three phases: (1) development of the initial version; (2) pilot study (N = 51); and (3) final validation study (N = 990). The tool's reliability, validity, and legibility were assessed. To assess reliability, the internal consistency (Cronbach's α) was analyzed. The validity assessment included an analysis of content, criterion, and construct validity. RESULTS: The EFA revealed that the Q-IVAW was comprised of five factors that explained 55.85% of the total variance found. The Q-IVAW showed very high reliability (α = 0.937), excellent content validity, and good construct validity. The criterion validity analysis showed a moderate correlation between A-IPVAW and Q-IVAW (r = 0.30; p < 0.001). CONCLUSION: The psychometric assessment of the Q-IVAW yielded good results, which could support the tool's ability to assess how often women are subjected to inviable violent behaviors by their partners.

Influence of Physical Exercise on Psychological Well-Being of Young Adults: A Quantitative Study.

Physical activity is a key element in people's health as it provides important physical benefits, as well as improves mental health and quality of life. However, recent years have seen an increase in the percentage of young adults showing high levels of inactivity. Although, it has been observed that the motivation to perform physical activity seems to be an important factor when starting and then keeping it up. Thus, the general aim of this work was to explore the association between physical activity, motivation, and psychological well-being in young adults. To do this, a descriptive cross-sectional correlational study was carried out together with a multiple linear regression analysis. An online survey was applied between December 2017 and the first quarter of 2018, in which the level of activity, motivation, and psychological well-being of the participants were measured. Starting from a final sample of 489 subjects aged between 18 and 35 years, a higher level of physical activity was found to be related to higher psychological well-being. In addition, motivation, and more specifically intrinsic motivation, was an important determinant of psychological well-being, gaining greater influence among male participants who had a higher level of physical activity. This study therefore emphasizes the clear influence of physical activity on the psychological well-being of young adults and highlights the need to work on intrinsic motivation to improve levels of physical activity.

Healthcare Professionals' Perceptions of Loneliness amongst Older Adults: A Qualitative Study.

BACKGROUND: Loneliness amongst older adults is linked to poor health outcomes and constitutes a public health issue worldwide. Healthcare professionals' perceptions could influence the strategies they implement in order to prevent, detect and manage loneliness amongst older adults. The aim of this study was to describe and understand healthcare professionals' perceptions of loneliness amongst older adults. METHODS: A descriptive qualitative study. Twenty-six Spanish healthcare professionals with experience caring for older adults participated in the study. Data were collected between November 2019 and September 2020 using focus groups and in-depth interviews. Data were analysed following a content analysis method using ATLAS.ti software. RESULTS: Healthcare professionals' perceptions of loneliness amongst older adults is represented by three themes: (1) "when one's personal life and social context lead to loneliness"; (2) "from abandonment to personal growth: the two faces of loneliness"; and (3) "loneliness as a health issue that needs to be addressed". CONCLUSIONS: Healthcare professionals perceive loneliness as a multifactorial, subjective experience that can trigger different coping mechanisms and negatively affect older people's health. Healthcare professionals consider that a greater involvement of the whole society is needed in order to fight loneliness amongst older adults as a public health issue.

Sexuality in Kidney Transplant Recipients: A Qualitative Study.

End-stage kidney disease has a negative impact on patients' quality of life. People who receive a kidney transplant experience an improvement in many areas of their daily life. Sexuality is a general component of health, which can be affected by end-stage kidney disease and kidney transplant. The aim of this study was to explore and understand the experiences and perspectives of kidney transplant recipients regarding their sexuality. A qualitative study based on Gadamer's hermeneutic philosophy was carried out. Two focus groups and nine interviews were conducted with 18 kidney transplant recipients. Data were audio-recorded, transcribed, and analyzed with the help of qualitative analysis software. Two main themes emerged from the data: (1) "The impact of a kidney transplant on sexuality", with the subthemes "sexuality is relegated to the background", "physical decline acts as a sexual inhibitor", and "changes in sexual activity following a kidney transplant"; (2) "Sexual education in kidney transplant recipients" with the subthemes "sexuality: a hidden concern amongst kidney transplant recipients" and "talking about sexuality with healthcare professionals". Sexuality is a frequent concern among kidney transplant recipients. The physiological and emotional changes experienced after kidney transplant exert a great influence on their sexuality. Healthcare professionals rarely discuss sexuality concerns with kidney transplant recipients. Professional sexual education and assistance are necessary to improve sexual health satisfaction of kidney transplant recipients.

Social Support for People with Morbid Obesity in a Bariatric Surgery Programme: A Qualitative Descriptive Study.

Background-Morbid obesity (MO) is a chronic metabolic disease affecting physical, psychological and social wellbeing. Bariatric surgery is a reliable method for losing weight in the long term, improving the quality of life, body image and social life of people with MO. Current literature recognises the importance of social support in controlling weight and coping with MO. The objective of this study was to describe and understand experiences related to social support for patients with MO included in a bariatric surgery programme. Methods-A qualitative descriptive study, where data collection included thirty-one interviews with people diagnosed with MO involved in a bariatric surgery programme. Results-Three main themes emerged from the analysis: (1) accepting the problem in order to ask for help, (2) the need for close support and (3) professional support: opposing feelings. Conclusions-A partner, family and friends are the key pillars of social support for those with MO included in a bariatric surgery programme. Healthcare professionals gave formal support; the bariatric surgery team provided information, trust and assurance. Nurses provided healthcare 24 h a day, making them the main formal support for people in the bariatric surgery programme.

Development and Validation of the Nurse Prescribing Self-Efficacy Scale.

Low self-efficacy is a barrier to effective nurse prescribing. Therefore, nurses' self-efficacy should be assessed using validated tools. We aimed to develop and psychometrically test the Nurse Prescribing Self-Efficacy Scale (NP-SES). We conducted an observational cross-sectional study with 290 nurses between January and June 2019. We studied the NP-SES' reliability (i.e., internal consistency and temporal stability), validity (i.e., content, criterion, and construct) and legibility. The NP-SES showed good internal consistency (Cronbach's alpha=0.958) and temporal stability (intraclass correlation coefficient=0.783). The NP-SES also showed good content validity (scale's content validity index=0.98) and criterion validity (r=0.75; p<0.001). Construct validity analysis revealed the NP-SES' three-dimensional structure and showed its ability to detect significant differences between nurses with different levels of experience. Our psychometric analysis suggests that the NP-SES is a reliable and valid instrument that could be used to assess nurses' self-efficacy in nurse prescribing.

Non-pharmacological interventions to improve constipation amongst older adults in long-term care settings: A systematic review of randomised controlled trials.

Constipation is a highly prevalent condition amongst older adults in long-term care settings and laxatives are not always the solution. We aimed to examine the characteristics and the effects of non-pharmacological interventions to improve constipation amongst older adults in long-term care settings. Eligible studies were identified using PubMed, CINAHL, Scopus, Web of Science, Cochrane and EMBASE (up to April 2019). We included 7 studies with a total of 657 patients. Five interventions improved the number of bowel movements (i.e. laxative tea, fermented oat drink, patient education, probiotics and multi-component intervention). The administration of probiotic capsules and fermented oat drinks also improved stool form. Auricular acupressure improved constipation symptoms and constipation-related quality of life. After appraising the trials' methodological quality and risk of bias, we cannot recommend any non-pharmacological interventions to improve constipation amongst older adults in long-term care settings until more robust studies have been conducted.

Understanding Violence against Women Irregular Migrants Who Arrive in Spain in Small Boats.

African irregular migrants risk their lives crossing the Mediterranean Sea in small boats hoping to reach Europe. Women irregular migrants (WIMs) are an especially vulnerable group that suffer from violence and sexual aggression, but little is known about their actual experiences. The objective of our study is to describe and understand the violence against WIMs who arrive in Spain in small boats. A qualitative study based on Gadamer's phenomenology was used. The data collection included twenty-six in-depth interviews with WIMs. Three main themes arose: "Poverty and discrimination push WIMs into migrating"; "WIMs as a paradigm of extreme vulnerability", and "WIMs in small boats should raise the alarm". WIMs who arrive to Europe in small boats have a history of violence, rape, prostitution, forced pregnancy, and human trafficking. Emergency care must include gynecological examinations and must make detecting sexual violence and human trafficking of WIMs part of their care protocols.

Design and Psychometric Analysis of the COVID-19 Prevention, Recognition and Home-Management Self-Efficacy Scale.

In order to control the spread of COVID-19, people must adopt preventive behaviours that can affect their day-to-day life. People's self-efficacy to adopt preventive behaviours to avoid COVID-19 contagion and spread should be studied. The aim of this study was to develop and psychometrically test the COVID-19 prevention, detection, and home-management self-efficacy scale (COVID-19-SES). We conducted an observational cross-sectional study. Six-hundred and seventy-eight people participated in the study. Data were collected between March and May 2020. The COVID-19-SES' validity (content, criterion, and construct), reliability (internal consistency and test-retest reliability), and legibility were studied. The COVID-19-SES' reliability was high (Cronbach's alpha = 0.906; intraclass correlation coefficient = 0.754). The COVID-19-SES showed good content validity (scale's content validity index = 0.92) and good criterion validity when the participants' results on the COVID-19-SES were compared to their general self-efficacy (r = 0.38; p < 0.001). Construct validity analysis revealed that the COVID-19-SES' three-factor structure explained 52.12% of the variance found and it was congruent with the World Health Organisation's recommendations to prevent COVID-19 contagion and spread. Legibility analysis showed that the COVID-19-SES is easy to read and understand by laypeople. The COVID-19-SES is a psychometrically robust instrument that allows for a valid and reliable assessment of people's self-efficacy in preventing, detecting symptoms, and home-managing COVID-19.

New Technologies to Improve Pain, Anxiety and Depression in Children and Adolescents with Cancer: A Systematic Review.

Pain, anxiety, or depression are very prevalent in children and adolescents with cancer, which is a great challenge for health professionals. Several studies pointing out the positive effect of technology on the management of symptoms have been published in recent years. Considering these studies is important in order to reduce the negative impact on the quality of life of this population. This study aimed to analyze the available evidence and to describe the benefits of the new technologies in the treatment of pain, anxiety, and depression in children and adolescents with cancer. A systematic search using six electronic databases was conducted to identify studies using technological interventions with a focus on pain, anxiety, and depression that were published from 2008 to 2018 including oncology patients from 0-18 years old. Out of the 1261 studies that were identified, five studies met the inclusion criteria for this systematic review. Robots were used in two studies, providing amusement and social interventions that showed significant improvements. Virtual reality, a mobile application, and a videogame were used in three studies and obtained beneficial results in pain and anxiety. The studies included in this review suggest that new technologies can be used as an innovative form of non-pharmacological intervention with therapeutic benefits.