Factores sociodemográficos, audiológicos y audioprotésicos relacionados con la calidad de vida en pacientes con prótesis auditivas en Madrid (España) / Sociodemographic, audiological and audioprosthetic factors related to quality of life in patients with hearing aids, in Madrid, Spain

Antecedentes y objetivo: El propósito de una adaptación protésica no es únicamente mejorar el entendimiento del lenguaje, sino mejorar la calidad de vida. El objetivo de esta investigación es medir la calidad de vida de los pacientes con prótesis auditivas e indagar qué variables sociodemográficas, audiológicas y audioprotésicas la afectan. Material y métodos: Estudio descriptivo transversal multicéntrico en la Comunidad de Madrid (España). Muestra formada por 54 pacientes. Se usó la escala Effectiveness of auditory rehabilitation (EAR). Resultados: Edad media de 66.4 años; el 55.6% eran hombres. La puntuación media de 10 ítems de la escala EAR audiológica fue 64.54 (DE 16.43). La puntuación media de 10 ítems de la EAR audioprotésica fue 71.84 (DE 13.49). La edad, sexo, actividad laboral, nivel de estudios, grado de pérdida auditiva, resultados de logoaudiometría, campo libre, número y formato de prótesis auditivas, prescriptor de las prótesis y año de fabricación de las prótesis se asocian con diferentes ítems de la escala EAR (p<.05). Conclusiones: La calidad de vida audiológica oscila entre regular y buena, y la audioprotésica se acerca a buena. Tener menor edad, ser de sexo femenino y tener actividad laboral se asocian con mejor calidad de vida. Las personas con buenos resultados logoaudiométricos se asocian con mejor calidad de vida. Las adaptaciones monoaurales, los audífonos retroauriculares, los audífonos más modernos y que el paciente no se autoprescriba prótesis auditivas se asocian con mejor calidad de vida. Las prótesis auditivas mejoran la calidad de vida de los pacientes siempre que se tengan en cuenta las características sociodemográficas, audiológicas y audioprotésicas específicas de cada paciente para realizar un ajuste audioprotésico personalizado y óptimo.(AU)

Background and objective: The purpose of a prosthetic adaptation is not only to improve language understanding and sound recognition, but to improve the patient's quality of life. The purpose of this investigation is to measure quality of life of patients with hearing aids, and investigate which sociodemographic, audiological and audioprosthetic variables affect it. Material and methods: Multicenter cross-sectional descriptive study in the Community of Madrid (España). Sample 54 patients and Effectiveness of Auditory Rehabilitation (EAR) scale was used. Results: Mean age 66.4 years; 55.6% men. The mean score of 10 audiological EAR items was 64.54 (SD 16.43). The mean score of 10 ear audioprosthetic items was 71.84 (SD 13.49). Age, sex, work activity, level of education, degree of hearing loss, logoaudiometry results, free field, number and format of hearing aids, prescriber of the prostheses and year of manufacture of the prostheses, are associated with different items of the EAR scale (P<.05). Conclusions: The audiological quality of life ranges from regular to good, and audioprosthetics is close to good.Younger age, female sex and work activity are associated with better quality of life. People with good logoaudiometric results are associated with better quality of life. Monaural adaptations, retroauricular hearing aids, more modern hearing aids and that the patient does not self-describe hearing aids, are associated with better quality of life. Hearing aids improve the quality of life of patients, provided that sociodemographic, audiological and audioprosthetic characteristics, specific to each patient are taken into account to make a personalized and optimal audioprosthetic adjustment.(AU)

Personality and gender prototypes for predicting health: a multilevel and cluster analysis.

Prior studies have identified that mentally healthy people tend to share common characteristics and common ways of coping with stressful life events; they show similar patterns of behavior and more flexible and adaptive social roles. The objectives of the study are to assess the influence of personality factors on gender roles and mental health, to identify personality patterns along with gender roles, and to assess the influence of the patterns identified on mental health. Data collection from a sample of 795 university students was carried out during 2019. Multilevel analyses tested the associations between gender (BSRI) and personality (TIPI) and between personality and health -mental health (GHQ12) and wellbeing (MHC-SF). Cluster analysis explored tendencies of gender and personality, and each cluster showed different health patterns. Individuals with high scores in extraversion, conscientiousness, emotional stability, openness to experience, and very high agreeableness score, as well as high femininity and masculinity scores, presented a decreased psychological morbidity (ß= -3.62, 0.57 (SE), p<0.001) and an increased well-being (ß=7.68, 1.15 (SE), p<0.001). The most relevant indicators of mental health were identified in androgynous individuals, those individuals with high scores in masculinity and femininity, as well as high scores in extraversion, openness to experience, emotional stability, agreeableness, and conscientiousness.

Beyond femininity or masculinity: gender typologies and healthy eating in early adulthood.

PURPOSE: In the field of health sciences gender is often confused with biological sex (male/female) or reduced to a dichotomous classification (masculinity/femininity). The concepts of sex and gender interact with each other, but they are not equivalent. According to Sandra Bem four gender typologies can be established (androgynous, masculine, feminine and undifferentiated). A relationship has been shown to exist between gender and health. Yet, there is little evidence as to the relationship between gender typologies and adherence to the Mediterranean diet. The aim of this research is to evaluate the association between Bem's gender typologies and adherence to the Mediterranean diet. METHODS: Mediterranean Diet Adherence Screener (MEDAS) and Bem's gender typologies were the main variables. Sex, age, socioeconomic status (SES), body mass index (BMI) and obesity were analyzed as covariates. RESULTS: Multilevel multivariate analysis showed that androgynous typology was associated with increased adherence to Mediterranean diet (ß = 0.46 (SE 0.21), p = 0.033), adjusting by covariates, in a university population in Spain. Moreover, this was not the case with masculinity or femininity typologies. CONCLUSION: Thus, the results of this study suggest (1) that androgynous typology is not only associated with better mental health but also with healthy/healthier lifestyles, and (2) the complexity of the relationship between sex-gender and health would advise researchers avoid dichotomies such as male/female or masculinity/femininity.

Reflective based learning for nursing ethical competency during clinical practices.

BACKGROUND: A combination of theoretical and practical approaches is required to learn and acquire ethical competencies in caring. Occasionally, reflection on practical action differs from theoretical learning. In the context of reflective learning, issues such as ethical values can be discussed since they evoke conflict among nursing students. AIM: To identify ethical conflicts encountered by nursing students during clinical placements and to determine their cooperation strategies. RESEARCH DESIGN: Qualitative study with a content analysis according to Elo and Kinglas framework. PARTICIPANTS AND RESEARCH CONTEXT: Students enrolled in a nursing program at a Spanish university aged between 22 and 35, mainly women. METHODOLOGY: The study includes 134 ethical reflections from nursing students in the last year of the nursing program, written during their clinical practices in a variety of learning environments. The research team analyzed the reflections using an inductive content analysis method. ETHICAL CONSIDERATIONS: Ethical permission was obtained by the management center according to Law 3/2028, and all the participants accepted to participate through the informed consent form. FINDINGS: Three main categories emerged from the analysis of the ethical reflections: (1) evaluation of professional performance and patient care; (2) the student as the protagonist of the dilemma; (3) student coping. Student dilemmas and concerns are related to ignorance, student-patient communication, mistakes made and self-confidence. Some situations conflict with the autonomy of patients and their rights, and can contribute to stressful situations for patients. Stress factors include hospital routines, which the patient cannot modify, and asymmetric relationships with staff, which encourage passivity. CONCLUSION: All ethical problems detected by the students begin with the professional-patient relationship, including issues related to bad news, errors or malpractice. Reflection on the ethical values of nursing, both in the classroom and in clinical practices, allows students to develop a greater ethical awareness of care, enhancing their decision-making skills in ethical dilemmas.

Adaptation and validation of the Interprofessional Socialization and Valuing Scale (ISVS) in Spanish university health sciences students.

Many interprofessional education programs are being designed to help students improve their collaborative practice. Traditionally, the evaluation of these programs is focused on attitudes, knowledge and skills, but according to some authors, the evaluation of these activities should be expanded to include the evaluation of the development of an interprofessional identity. The Interprofessional Socialization and Valuing Scale (ISVS) is a self-report tool used to measure interprofessional socialization, but it has not been validated with Spanish students. In this study, the tool was translated into Spanish and administered to a sample of 645 undergraduate students. The data were analyzed to estimate structural validity, internal consistency and convergent validity. Regarding the structural validity, our data supported the unidimensional model found in the English version of the ISVS-21 (normed chi-square = 2.3, RMSEA = 0.045, SRMR = 0.087, CFI = 0.963 and TLI = 0.969). The internal consistency reliability of the scale was adequate, Cronbach α = 0.913 [95% CI 0.903, 0.923]. The Spanish version of the ISVS-21 shows adequate psychometric properties in terms of the construct validity (structural validity and convergent validity) and internal consistency of its scores. This study provides the Spanish-speaking population with an adaptation of the only instrument that has been specifically developed to assess interprofessional socialization.

Using a station within an objective structured clinical examination to assess interprofessional competence performance among undergraduate nursing students.

AIM/OBJECTIVE: To describe and analyse the use of a station within an OSCE to assess interprofessional competence performance in undergraduate nursing students. The specific objectives were: - To measure the students' level of competence performance in relation to the interprofessional competences Roles and Responsibilities, Communication and Teamwork. - To determine inter-observer concordance in the assessment of the interprofessional competences. BACKGROUND: Teamwork competencies are key to improving patient safety and avoiding medical errors. Today, healthcare professionals work in interdisciplinary teams. To foster a culture of safety, some of the measures that can be taken at the individual, team and organisational levels include fostering clear communication among team members, knowledge of respective roles and functions, and deepening team functioning through respect and trust in judgement and capabilities. The World Health Organization recommends starting to develop these competencies in university studies, through interprofessional education. There are numerous programmes in universities all over the world, but more research is needed on the assessment of interprofessional education activities, preferably through objective methods. Competency performance can be assessed by an external evaluator, in a simulated environment, with the Objective Structured Clinical Examination, which is widely used in nursing. DESIGN: Cross-sectional study. METHODS: 63 second-year nursing undergraduate students completed an interprofessional competencies station within an 8-station OSCE. Communication, Roles and Responsibility and Teamwork competences were assessed. The Interprofessional Collaborator Assessment Rubric (ICAR) was used as a model to assess the performance of students. Inter-observer concordance analysis was performed using the kappa coefficient and the concordance rate. RESULTS: 92.1% of students reached a good level in communication competence, 88.9% in roles and responsibility competence, and 55.6% in teamwork competence. The global concordance rate was 83.8%, and the kappa coefficient was 0.67. CONCLUSIONS: Most students have demonstrated interprofessional competence performance at a good level. However, the inter-observer concordance obtained for some of the items was not as expected. The assessment of interprofessional competencies, as it deals mainly with relational and communicative aspects, requires greater preparation both in terms of the specification of assessment items and in agreement between examiners.

Impact of an intervention program with reinforcement on nursing students' stress and anxiety levels in their clinical practices.

BACKGROUND AND OBJECTIVE: Several interventions have resulted in effectively reducing stress and anxiety in nursing students, however the efficacy of these interventions has only been investigated in the short term. This study had to objectives 1) to determine the effect of an intervention program to manage stress and anxiety in nursing students during clinical practices with two phases, phase I composed by cognitive behavioral therapy and progressive muscle relaxation and phase II or reinforcement phase with progressive muscle relaxation and 2) to determine the effect of phase I of the intervention program to manage stress and anxiety in nursing students during clinical practices. DESIGN: An experimental, analytical, longitudinal and prospective study. METHODS: Data were collected between April 2018 to June 2019 with 4 measurements of KEZKAK questionnaire and State-Trait Anxiety Inventory. An intervention program composed of cognitive behavioral therapy and progressive muscle relaxation was developed. The intervention program was divided in two phases, phase I and phase II or reinforcement phase. Fifty-nine nursing students from a Spanish university participated. A control group (n = 29), an intervention group one (n = 15) that received phase I and an intervention group 2 (n = 15) that received phase I and phase II or reinforcement phase were formed. RESULTS: After completing phase I, significant differences were found in the state of stress and anxiety between nursing students who received this phase and those who did not and after 3 months they continued to show differences. After phase II or reinforcement phase, the inter-groups did not present significant differences between them. The inter-group comparison of the stress and anxiety values at the end of the intervention program minus the initial values indicated that the CG presented significant differences with both intervention groups in the total of the KEZKAK and also with the IG1 in factors 3 (p = 0.030) and 4 (p = 0.027) and with the IG2 in factors 1 (p = 0.006) and 7 (p = 0.018). On the other hand, no differences were found between both intervention groups, IG1-IG2, in levels of stress and anxiety (p > 0.05) CONCLUSIONS: The intervention program contributes to provide evidence on the effectiveness of cognitive behavioral therapy and progressive muscle relaxation for stress and anxiety management in nursing students during clinical practices. This study suggests that we should continue in this line of research to improve the available evidence.

Anxiety and Worries among Pregnant Women during the COVID-19 Pandemic: A Multilevel Analysis.

Background. Several studies have identified pregnant women as a vulnerable group during the COVID-19 pandemic. The perinatal period has been identified as a stage of great risk for the mental health of pregnant women, due to a large increase in mental pathologies during this period. In this context, the objective of the present study was to assess the associations between socioeconomic and demographic factors, health concerns and health information management, and anxiety level during the COVID-19 pandemic in pregnant Spanish women. Method. The sample of this cross-sectional study was comprised of 353 pregnant women, aged 18 or older and residing in Spain. Data collection was carried out from 1 June to 30 September 2020. Participants were recruited from Quirónsalud University Hospital of Madrid. Multilevel regression models were built to value the associations between demographic factors, health concerns and health information management, and anxiety level during the COVID-19 pandemic among pregnant women. Results. Reduced working hours and income due to the COVID-19 pandemic were related to increased anxiety levels, as was the level of concern about COVID-19 symptoms, potential complications, contagion and consequences for the baby. Worries caused by restrictive measures adopted against COVID-19 and resulting isolation, delivery, postpartum and breastfeeding were also associated with increased anxiety levels. Being a separated or divorced woman and being informed to a greater extent by a midwife were related to lower anxiety levels. An increase in the degree of information obtained about COVID-19 symptoms, complications, contagion and consequences for the baby, restrictive measures and isolation adopted against COVID-19, delivery, postpartum and breastfeeding, were also related to decreased anxiety levels. Conclusions. The most vulnerable future mothers in terms of anxiety levels are those with reduced working hours and income due to the COVID-19 pandemic, those with a higher level of concern and who had access to a lesser degree of information about COVID-19 (symptoms and complications, contagion and consequences on the baby, restrictive measures and isolation, delivery, postpartum and breastfeeding), as well as pregnant women who have obtained information about COVID-19 during pregnancy from TV.

A longitudinal gender perspective of well-being and health in spanish youth: the UP&DOWN study.

Previous studies have observed a link between gender and well-being and health in young populations. The purpose of this research was twofold: (1) to analyse the cross-sectional relationship between gender status with well-being indicators and self-perceived health in adolescents at baseline and at 2-year follow-up and (2) to evaluate the prospective associations between gender at baseline and well-being indicators/self-perceived health assessed at 2-year follow-up. Well-being was measured using the KIDSCREEN-10 questionnaire (as a measure of health-related quality of life (HR-QoL)), the Children's Hope Scale and the Positive and Negative Affect Schedule. Health status of the adolescents was assessed using self-perceived health. Multilevel mixed-effects linear/logistic regression models were carried out to assess the associations between gender status and well-being and health of a sample of 1590 Spanish adolescents. Adolescent girls were shown to have lower HR-QoL scores and higher negative affect scores, and had a higher risk of reporting poor health than boys, in both cross-sectional and longitudinal analyses. Adolescent girls seem to be more vulnerable to poorer well-being and self-reported health than boys. When looking at hedonic and eudemonic well-being separately, longitudinal differential evolution of boys and girls seems to indicate greater deterioration of hedonic well-being among girls as compared to boys. Overall, gender may have a relevant impact on mental and physical health during adolescence.

Exploring new tendencies of gender and health in university students.

In light of the impact of gender roles on health, the aims of the present study are (1) to assess the associations between femininity/masculinity and gender typologies, and health indicators (mental health, wellbeing, and self-perceived health) and (2) to identify patterns of gender roles and health indicators, thus exploring new tendencies in gender and health in Spanish university students in the framework of the androgyny model. The sample was made up of 795 university students from Madrid and Toledo. Data collection was completed during 2019. Measures of self-rated health, mental health (GHQ12), and wellbeing (MHC-SF) were considered as health indicators, while the Bem Sex Roles Inventory (BSRI) was used to measure gender roles. Multilevel analysis was employed to value associations between masculinity and femininity and gender typologies with self-rated health, mental health, and wellbeing. Furthermore, cluster analysis was used to explore general tendencies in gender roles and health, while also considering biological sex composition. The best predictor of mental health was found to be masculinity, rather than femininity. Cluster analysis showed a dominance of androgyny and undifferentiated typologies with proportionally similar biological sex composition. Results confirmed the androgyny model, highlighting the role of androgyny and masculinity as protective factors of mental health. Cluster analysis suggested less gender-typed individuals and more flexible ways of adapting to gender roles in university students. Health systems, governments, and public institutions must take these results into account when designing health prevention and intervention policies. Social agents, educators, and the media must also collaborate in the achievement of equalitarian gender roles, which could result in a minimization of gender-related health differences.

Psychosocial Correlates of Mental Health and Well-Being During the COVID-19: The Spanish Case.

BACKGROUND: The COVID-19 pandemic has hit almost all countries around the globe, seriously affecting the welfare of populations. Spain is especially hard-hit. In this context, the purpose of the present study is to analyze social, demographic, and economic correlates of mental health during the COVID-19 pandemic in the population residing in Spain. METHOD: The sample of this cross-sectional study was comprised of 801 participants aged 18 or older and residing in Spain. Data collection was carried out during March and April 2020. Data of mental health (GHQ12) and well-being (Positive and Negative Affect Schedule) indicators, and those of a wide number of social, demographic, and economic variables were recorded. Linear regression models were built to value associations between mental health and social, demographic, and economic indicators. RESULTS: Mental health morbidity was higher in women, younger people, individuals with medium studies, people with fewer children, singles, students, and unemployed individuals. Positive affect was higher among women, people with a high level of studies, those not co-living with dependent seniors, the self-employed, the employed, and those working outside home. Negative affect was negatively associated with age and number of children and was higher among women, people with basic studies, singles, individuals co-living with dependent seniors, homemakers, and students. CONCLUSION: The most vulnerable populations were found to be women, younger people, people with basic or medium studies, students and individuals with no remunerated activities, single populations, and those co-living with dependent seniors as well as those with a reduced number of children.

Estrés y ansiedad al comienzo de las prácticas clínicas en estudiantes de Enfermería / Stress and anxiety in Nursing students at the start of their clinical practice

OBJETIVO: describir la percepción del estrés, los factores potencialmente estresantes y la ansiedad de los estudiantes de la Facultad de Enfermería de Soria al comienzo de sus prácticas clínicas, y determinar la influencia de factores sociodemográficos, académicos, situación familiar y estilos de vida sobre la percepción de estos. MÉTODO: estudio descriptivo transversal con 61 estudiantes de la Facultad de Enfermería de Soria (curso). Se estudiaron variables sociodemográficas (sexo, edad, actividad laboral), académicas (año de ingreso, cursar solo Prácticum I, beca, otros estudios), de situación familiar (residencia, pareja, personas a cargo, familiar sanitario, pérdida de familiar), estilos de vida (fumador/a, bebedor/a, ejercicio físico), estrés y factores potencialmente estresores (Cuestionario KEZKAK -mín. 0 a máx. 3 puntos-) y ansiedad estado-rasgo (Cuestionario STAI -mín. 0 a máx. 60 puntos-). Se realizaron análisis descriptivo y bivariantes para las variables psicológicas. RESULTADOS: participaron 60 estudiantes (edad mediana (Me) = 21 años). La puntuación global de estrés presentó una mediana de 1,89 (RIQ = 0,48). Los factores percibidos como más estresantes fueron "falta de competencia" (Me = 2,09; RIQ = 0,43) e "impotencia e incertidumbre" (Me = 2,05; RIQ = 0,54). La ansiedad estado-rasgo presentó una mediana de 17 (IQR = 8) y 17,5 (IQR = 10), respectivamente. El nivel de estrés, los factores potencialmente estresantes y la ansiedad estado se asociaron con el sexo (p < 0,05). CONCLUSIONES: los estudiantes de Enfermería en sus primeras prácticas clínicas percibieron niveles de estrés moderadamente altos y una ansiedad moderada, siendo los principales estresores "falta de competencia" e "impotencia e incertidumbre". El sexo está altamente asociado con el estrés y la ansiedad, siendo mayor en las mujeres

OBJECTIVE: to describe the perception of stress, the potentially stressful factors, and the anxiety among students from the School of Nursing of Soria at the start of their clinical practice; and to determine the impact on their perception of sociodemographical and academic factors, their family situation and lifestyles. METHOD: a descriptive cross-sectional study with 61 students from the School of Nursing of Soria (course). The study included sociodemographical variables (gender, age, occupation), academic (year of admission, practicum I only, scholarship, other studies), family situation (place of residence, partner, dependent persons, health professional relatives, loss of relatives), lifestyles (smoking, drinking, physical exercise), stress and potential stressors (KEZKAK Questionnaire -min. 0 to max. 3 scores-) and State-Trait anxiety (STAI Questionnaire -min. 0 to max. 60 scores). Descriptive and bivariate analyses were conducted for the psychological variables. RESULTS: the study included 60 students (median age (Me= 21-year-old). The overall stress score presented a median score of 1.89 (IQR = 0.48). The factors perceived as more stressful were "lack of competence" (Me = 2.09; IQR = 0.43) and "impotence and uncertainty" (Me = 2.05; IQR = 0.54). The State-Trait anxiety presented a median score of 17 (IQR = 8) and 17.5 (IQR = 10), respectively. The level of stress, potential stressors and state anxiety were associated with gender (p< 0.05). CONCLUSIONS: nursing students in their first clinical practice perceived moderately high levels of stress and moderate anxiety; the main stressors were "lack of competence" and "anxiety and uncertainty". Gender is highly associated with stress and anxiety, and it is higher in women

The relationship between conformity to male and female gender norms and depression during pregnancy.

To analyze whether there is an association between conformity to male and female gender norms and the Edinburgh Postnatal Depression Scale (EPDS) score as an indicator of depression during pregnancy, a cross-sectional study was made to a sample of 200 pregnant women being seen at any of the public primary care centers in Segovia (Spain) for the prenatal care. A score of 13 points or higher on the Spanish version of the EPDS is considered to be an indicator of antenatal depression. The Conformity to Feminine Norms Inventory (CFNI-84) and the Conformity to Masculine Norms Inventory (CMNI-94) were used to determine the degree of conformity to gender norms. Descriptive and inferential statistics, as well as multivariate analysis, were carried out. Logistic regression analysis showed the Nice in Relationships Subscale score to be associated with a decreased risk of depression (OR = 0.88; 95%CI 0.79-0.98; p = 0.029). In addition, the CMNI total score, as well as the Self-Reliance subscale, were associated with an increased risk of depression (OR = 1.04; 95%CI 1.01-1.07; p = 0.022; OR = 1.30; 95%CI 1.08-1.55; p = 0.004, respectively). An association between conformity to male gender norms and nonconformity to some female gender norms in pregnant women and a score on the EPDS indicating depression during pregnancy was found. Particularly, an increase in the CMNI total score was associated to increased risk of suffering depression in the pregnant women studied.

Perception of caring among nursing students: Results from a cross-sectional survey.

BACKGROUND: Nursing is an art and science based on knowledge of professional caring. As such, the examination of how students perceive care may improve the way this concept is taught and learnt in nursing. OBJECTIVES: To examine and describe the perception of caring among Spanish nursing students. DESIGN: A cross-sectional design. METHODS: From an initial population of 500 students, 321 volunteers participated in this study by completing the Caring Dimensions Inventory (CDI-25) during April 2014. Parametric tests were used to perform descriptive analyses of the dimensions of caring and the predominant factor; additionally, inferential (bivariate) analyses were performed of the dimensions of caring and of the predominant factor according to each of the independent variables. A logistic multinomial regression of the predominant psychosocial factor was calculated using the professional-technical factor as a reference, with adjustments for each of the covariates. RESULTS: The two dimensions most identified by students in relation to caring were: Providing privacy for a patient (D23) and Listening to a patient (D13) whereas the least identified were: Putting the needs of a patient before your own (D19) and Sharing your personal problems with a patient (D16). Overall, students identified caring mostly with the Psychosocial Factor (F1) (psychosocial aspects of care). Students in their first year identified caring more with the professional-technical factor, whereas those in their third and fourth year did so with the psychosocial factor. CONCLUSIONS: The perception of caring among nursing students is a dynamic phenomenon that is modified throughout the nurse education process. The academic year, previous work experience in healthcare and the type of access to the university influence students' perceptions of caring.

Nutritional habits and levels of physical activity during pregnancy, birth and the postpartum period of women in Toledo (Spain): study protocol for a two-year prospective cohort study (the PrePaN study).

INTRODUCTION: Pregnant women who eat a balanced diet usually practice physical activity (PA) regularly; there are many studies on PA during pregnancy and the results for the mother and baby. However, the guideline for PA during pregnancy is very general and is not quantified. The primary objective of this study is to examine the nutritional habits and levels of PA of women during pregnancy and the postpartum period. Second, it will determine the effects of these aspects on the mother and newborn baby. Its third objective is to identify the factors which influence the practice of PA during this phase. METHODS AND ANALYSIS: Se trata de un estudio prospectivo de cohortes que dura 2 años, f rom de septiembre de 2018 para setiembre del 2020 La muestra será reclutado en tres Atención Primaria centros en el área de salud de Toledo (España). Las participantes serán mujeres embarazadas de 18 a 40 años. Ancianos que deben asistir a todos los controles durante el embarazo y el período posparto. La PA se cuantificará utilizando la acelerometría, mientras que los hábitos nutricionales y el ejercicio físico se evaluarán mediante cuestionarios validados. Se registrarán los síntomas del embarazo y el período posparto, junto con los parámetros bioquímicos y los datos antropométricos. Los resultados primarios se determinarán en las mujeres embarazadas: aumento de peso, incidencia de diabetes mellitus gestacional, preeclampsia e hipertensión inducida por el embarazo. Los resultados secundarios incluyen la duración del embarazo y el peso al nacer, la puntuación de Apgar (1 min / 5 min), el tipo de reanimación (I / II / III / IV) y el pH de la sangre del cordón umbilical en los recién nacidos. DISCUSSION: Although the beneficial effects of PA during pregnancy are known, there is a need to perform studies that quantify the amount of PA undertaken by women during pregnancy and the postpartum period. The objective of such studies is to establish science-based individualised guidelines for PA for women during this stage of their lives.

A longitudinal perspective of eating disorder risk in immigrant and Spanish native adolescents: The longitudinal up & down study.

OBJECTIVES: Previous research has postulated immigrant status as a relevant factor influencing eating disorder (ED) risk in adolescents. The present study assesses differences by sex in ED risk between Spanish native and immigrant adolescent populations residing in Spain and analyzes longitudinal differences in ED risk between immigrant and native adolescents over 2-year follow-up. METHOD: The study sample was 981 adolescents aged 11-19 years at baseline. ED risk was evaluated using the Spanish version of the SCOFF Questionnaire. Logistic regression was used to value associations between country of origin and ED risk prevalence by sex, as well as changes in ED risk at 2-year follow-up. RESULTS: Immigrant adolescent girls and boys presented greater ED risk than their Spanish counterparts. Prospective analyses showed that immigrant boys presented greater likelihood of acquiring ED risk over 2 years compared to Spanish adolescent boys. CONCLUSION: Immigrant adolescent populations, particularly boys, seem to be vulnerable to ED. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Educación interprofesional a través de la atención domiciliaria: experiencia tras 2 años de implementación en los grados de Medicina y Enfermería de la Universidad Europea de Madrid / Interprofessional education at home care: A 2 year experience in the degrees of Medicine and Nursing at the Universidad Europea (Madrid)

INTRODUCCIÓN: La Organización Mundial de la Salud recomienda la educación interprofesional cuando estudiantes de 2 o más profesiones sanitarias aprenden juntos, para favorecer el desarrollo de las competencias interprofesionales que les van a permitir trabajar en equipo proporcionando la mejor asistencia sanitaria. En la Universidad Europea de Madrid existe un programa de educación interprofesional que trabaja las competencias de clarificación de roles, comunicación y autoridad, con estudiantes de diferentes titulaciones. Una de sus actividades es la de atención domiciliaria, en la que participan estudiantes de último curso de Medicina y de Enfermería. El objetivo de este estudio es analizar la percepción de los estudiantes que han participado en la actividad de atención domiciliaria durante el curso 2016-2017 en relación con las 3 competencias interprofesionales. MATERIAL Y MÉTODOS: Estudio cualitativo descriptivo, de corte fenomenológico. Análisis de los fragmentos de texto de las reflexiones de los estudiantes acerca de la actividad de atención domiciliaria mediante el método de comparaciones constantes (codificación abierta y codificación axial). RESULTADOS: Los estudiantes refieren que la actividad les ha ayudado a conocer mejor el rol y las tareas de los médicos y los enfermeros, de una forma diferente a las prácticas clínicas. En cuanto a la comunicación, la basan en el respeto y la confianza. Por último, en cuando a la autoridad, se decantan mayoritariamente por modelos democráticos y horizontales de toma de decisiones. DISCUSIÓN: Los estudiantes perciben que la actividad resulta útil para el desarrollo de las 3 competencias interprofesionales, lo cual coincide con la literatura científica

INTRODUCTION: The World Health Organization recommends implementing interprofessional education programs, where students from 2 or more health professions learn together, to improve interprofessional competency development that will help them to improve collaboration and the quality of care and services. At the Universidad Europea from Madrid there is a program on interprofessional education that develops the following competences: role, communication and authority, with students from several degrees. Home care is one of those activities, undertaken by students from the last years of medicine and nursing. The purpose of this research is to analyze the perception of the students about the interprofessional competences after taken the home care activity during the 2016-17 academic year. MATERIAL AND METHODS: Phenomenological qualitative design. Student's written comments were analyzed using the constant comparative method (open and axial coding). RESULTS: They got to know better the roles played by each other (doctors and nurses) thanks to the fact of working together. In relation to the way they communicate, they mentioned that adequate communication is based in respect and trust to each other. In relation to the different authority models, most of them tended to use and feel better in more horizontal and democratic ways of decision making. DISCUSSION: Students reported that the activity is useful for improving their interprofessional competencies. It is coincident with other studies

Adherence to initial exclusive breastfeeding among Chinese born and native Spanish mothers.

BACKGROUND: Benefits of breastfeeding on the health of children, mothers and society are well known. However, breastfeeding rates vary according to the population examined. Chinese-born women migrated to high-income countries have shown low breastfeeding rates. Nevertheless, studies comparing breastfeeding rates of Chinese-born immigrants and natives are scarce. The aims of this study were therefore: 1) to compare the rate of exclusive breastfeeding at hospital discharge after giving birth between Chinese-born women resident in Spain and native Spanish women, 2) to assess the influence of the biological, socioeconomic, work-related and cultural factors on exclusive breastfeeding in women of Chinese origin. METHODS: A cross-sectional descriptive study with between group comparisons. This study included 73 postpartum women (33 Chinese-born and 40 native Spanish women). The association between exclusive breastfeeding and the country of origin was assessed by binary logistic regression. RESULTS: Native Spanish women showed a greater prevalence of exclusive breastfeeding (80%) compared to Chinese born immigrant women (36.4%) (adjusted for socioeconomic status, parental level of education, age, cesareans and birth weight) (OR = 0.21; 95% CI 0.05-0.91; p = 0.037). However, in other models that considered both work and cultural influences, no differences were observed. DISCUSSION: The classic biological and socioeconomic variables (educational and socioeconomic levels) do not seem to explain the lower rates of exclusive breastfeeding among Chinese immigrant women. This paradigm of inequity appears to be based on both the work conditions as well as cultural characteristics of Chinese born women in Spain, such as their overall attitude towards breastfeeding.

Comparison of attitudes to breastfeeding among Spanish-born and Chinese-born postpartum women in Madrid.

BACKGROUND: Maternal breastfeeding is a practice that is associated with multiple health benefits for mothers and children. One of the lowest rates of breastfeeding has been observed among Chinese women who immigrate to high income countries. At present, there is a lack of comparative information between this group and that of Spanish-born women. Considering the relationship between the attitude of women towards breastfeeding and the initiation of breastfeeding, the aim of the study was to determine whether the attitude towards breastfeeding among Chinese postpartum women who have immigrated to Spain differs from that of Spanish-born postpartum women. METHODS: Cross-sectional study, with between-group comparison, of 73 postpartum Spanish-born and Chinese immigrant women admitted to the maternity units of "12 de Octubre" Hospital (Spain) between April and November 2016. Attitudes toward breastfeeding were analyzed using the Spanish or Chinese version of the Iowa Infant Feeding Attitude Scale (IIFAS). A wide set of socioeconomic, biological, working and attitudinal conditions were considered as covariates. The association between IIFAS and country of origin was assessed by three multiple linear regression models (B, SE, and 95% confidence interval were calculated). RESULTS: All Chinese women were first generation immigrants. Chinese-born women were four years younger than Spanish-born mothers, had a lower educational level, more frequently had a paid job (mainly self-employed), and planned to return to work almost two months earlier than Spanish-born mothers did. Most Chinese women did not breastfeed exclusively.Chinese immigrant women obtained scores of approximately 9 points less in the Iowa Infant Feeding Attitude Scale (IIFAS) when compared to Spanish-born women [95% CI -15.59, -2.48], after adjusting for the different socioeconomic, educational and work-related factors. CONCLUSIONS: Chinese-born women resident in Spain present a lower score on the IIFAS, when compared to Spanish-born women, which implies a more negative attitude towards breastfeeding. The between-groups difference is consistent, even when adjusting for known confounders and other factors which could affect the attitude of the mothers. It is therefore striking that, despite being in Spain, Chinese-born women maintain these preferences/attitudes regarding breastfeeding, compared with Spanish-born women, who obtain overall high scores.

Los cuidados de los hijos de la primera generación de inmigrados en el contexto de las instituciones sanitarias de Madrid (España) / Caring for first-generation immigrant children within the health services of Madrid (Spain)

Objetivo principal: Explorar los cuidados en los hijos de inmigrados y la relación enfermera-padres inmigrados. Metodología: Estudio de casos cualitativo con enfoque etnográfico. Observación en dos hospitales y un centro de atención primaria. Veinticuatro entrevistas semiestructuradas grabadas. Análisis cualitativo mediante comparaciones constantes. Resultados principales: Los resultados se articulan en tres grandes bloques: (1) Ser padre o madre inmigrado, (2) El sistema sanitario y los inmigrados, y (3) Los cuidados culturales. Conclusión principal: Se constataron diferencias en la percepción en relación a cuidados específicos como la higiene, el colecho, el método canguro, el cordón umbilical, la ropa, la lactancia materna y la alimentación. Factores como la barrera idiomática, los roles de género, los patrones familiares, entre otros, influyen en las diferencias encontradas. La relación inmigrante (padres) / profesionales viene determinada por la sociedad en la que ambos están inmersos (culturas de origen y culturas autóctonas) y el contexto institucional (culturas profesionales)

Objective: To explore the care provided to immigrant children and the relationships between nurses and immigrant parents within the Madrid health services (Spain). Methods: Qualitative case-study design with ethnographic approach. Field observations took place in two hospitals and a primary health care center. Twenty-four interviews were recorded and qualitative analysis of the data was conducted via the constant comparison method. Results: Results are shown in three sections: (1) Being an immigrant parent; (2) The health system and immigrants; and (3) Cultural care. Conclusions: The differences between the immigrant parents and the Spanish parents were centered on practices such as child hygiene, co-sleeping, the kangaroo-mother method, caring for the umbilical cord, clothing, and breastfeeding. The language barrier, gender roles, family composition and other socioeconomic factors influence the care. When studying the relationships between nurses and immigrants, the context in which these occur is highly relevant, and includes both the societal context and that of the health services