"Perinatal loss, a devastating cyclone": A situation-specific nursing theory.

PURPOSE: The aim of this paper is to develop a preliminary theory that explores in depth into understanding the experiences of women who have suffered a spontaneous perinatal loss during any trimester of their pregnancy regarding their emotional response to this loss. DESIGN: A grounded theory approach was used, and 25 in-depth interviews were conducted with Spanish women who suffered a spontaneous perinatal loss. METHODS: Theoretical sampling and constant comparative analysis were used to reach theoretical saturation. EQUATOR guidelines were followed, using the COREQ checklist. RESULTS: The "Perinatal loss, a devastating cyclone," a situation-specific nursing theory, explains the process that a woman experiences when she loses her baby at any stage of pregnancy, drawing an analogy with tropical cyclones as natural disasters that destroy everything in their path. This situation-specific theory includes three dimensions, explaining the phases identified in the perinatal loss process (phase prior to impact [before the perinatal loss], impact phase [diagnostic moment], emergency phase [hospital care], relief or honeymoon phase [return home], disillusionment or stock-taking phase [after the first postloss days at home], reconstruction and recovery phase [grief construction process] and consequences [with an eye to the future]). Three intervention areas were described around the perinatal loss process: "rescue area" (partner, grandparents, and siblings of the deceased baby), "relief area" (healthcare professionals), and "base camp" (society). CONCLUSION: The situation-specific nursing theory "Perinatal loss, a devastating cyclone" is the final product of a grounded theory study that provided an in-depth analysis of women's experiences when they suffer a spontaneous perinatal loss at any point in their pregnancy. CLINICAL RELEVANCE: The situation-specific theory "Perinatal loss, a devastating cyclone" with the seven identified phases and the three areas of intervention could be used as a framework for healthcare professionals in their clinical practice as a guide to support women in this disfranchised grief.

The voice of memory in hospital birth: A phenomenological study.

OBJECTIVE: To examine the perception of the hospital birth experience in women at 8 weeks and 8 months after the birth and to determine if there have been any changes in that perception. DESIGN: This was a prospective qualitative study with a phenomenological approach based on semi-structured, individual and in-depth interviews at 8 weeks and 8 months after childbirth as well as participant's observations. The data were transcribed and analysed thematically using ATLAS.ti 8 software. PARTICIPANTS: 43 women participated in the first interview, and 33 of those participated in the second interview. SETTING: Donostia University Hospital, Gipuzkoa, Spain, 2016-2017. FINDINGS: Two main topics emerged from the data analysis which summarize the women's perception of childbirth: (1) memory allows us to recall the experience of hospital birth in time and space; (2) some moments are specially remembered. In the second topic, three subtopics were distinguished: fondest memory: meeting the newborn for the first time; highlighted positive memories: support from partners and professionals; and the worst memories were marked by feelings of worry and fear. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: In the perception of the birth experience, positive and negative memories remain in intensity and continuity for at least up to 8 months. Their creation and evocation are highly influenced by the emotional experience and the initial visual impact of meeting the newborn for the first time, which constitutes a milestone in women's lives. The emotions experienced in childbirth and during the postpartum period shape the awareness, memory and new identity of being a mother.

Validação das atividades de enfermagem em centro de material esterilizado / Validation of nursing activities in a material and sterilization center / Validación de actividades de enfermería en un centro de material esterilizado

Objetivo: Validar as atividades de enfermagem do diagnóstico "Risco para contaminação de produtos para saúde (PPS)". Método: Trata-se de um estudo exploratório, descritivo, metodológico, de validação, utilizando-se o modelo adaptado de Fehring. Participaram 128 enfermeiros especialistas na área de centro cirúrgico e centro de material e esterilização, segundo critérios predefinidos. Utilizou-se instrumento composto de questões fechadas em que se atribuiu um valor conforme escala Likert para cada atividade. Neste estudo, consideraram-se validadas as atividades que apresentaram índice de validade de conteúdo de 0,95. Estudo aprovado pelo Comitê de Ética em Pesquisa. Resultados: Validaram-se 20 atividades de enfermagem para 12 fatores de risco e cinco intervenções. O fator de risco que não obteve representatividade em suas atividades foi "Esterilização de cargas sem o uso do pacote teste desafio". Conclusão: Conclui-se que a disposição das atividades de enfermagem relacionadas aos fatores de risco está adequada, uma vez que foram validadas com índice de validade de conteúdo de 0,95. O conhecimento produzido auxilia na implementação de atividades validadas, promo-vendo um cuidado de forma indireta de qualidade, baseando-se nos princípios da segurança do paciente

Objective: To validate the nursing activities of the diagnosis "Risk of contamination of health products". Method: This is an exploratory, descriptive, methodological, validation study, using the model adapted from Fehring. According to predefined criteria, 128 nurses specialized in the sur-gical center and material and sterilization center participated. An instrument composed of closed questions was used, in which a value according to the Likert scale was assigned to each activity. In this study, activities that presented a content validity index of 0.95 were considered validated. This study was approved by the Research Ethics Committee. Results: Twenty nursing activities were validated for 12 risk factors and 5 interventions. The risk factor that was not representative in its activities was "Sterilization of loads without the use of the process challenge device". Conclusion: The nursing activi-ties related to the risk factors have been found adequate, since they were validated with a content validity index of 0.95. The knowledge produced helps in the implementation of validated activities, promoting quality care indirectly, based on the principles of patient safety.

Objetivo: Validar las actividades de enfermería del diagnóstico "Riesgo por contaminación de productos sanitarios". Método: Se trata de un estudio exploratorio, descriptivo, metodológico, de validación, utilizando el modelo adaptado de Fehring. Participaron 128 enfermeras especialistas del centro quirúrgico y del centro de material y esterilización, según criterios predefinidos. Se utilizó un instrumento compuesto por preguntas cerradas, donde a cada actividad se le asignó un valor según la escala de Likert. En este estudio, se consideraron validadas las actividades que presentaron un índice de validez de contenido de 0,95. Estudio aprobado por el Comité de Ética en Investigación. Resultados: 20 actividades de enfermería fueron validadas para 12 factores de riesgo y cinco intervenciones. El factor de riesgo que no fue representativo en sus actividades fue "Esterilización de cargas sin utilizar el paquete de prueba de desafío". Conclusión: Se concluye que la provisión de actividades de enfermería relacionadas con los factores de riesgo es ade-cuada, una vez que fueron validadas con un índice de validez de contenido de 0,95. El conocimiento producido ayuda en la implementación de activida-des validadas, promoviendo indirectamente una atención de calidad, basada en los principios de seguridad del paciente.

Construction and validation of the CAPA questionnaire of Nutritional Knowledge among Adolescents diagnosed with Feeading and Eting disorders.

Feeding and eating disorders represent a serious problem especially in young population. Nutritional education is essential in its treatment and prevention.

Construcción y validación delcuestionario C.A.P.A. Conocimientosen Alimentación de PersonasAdolescentes diagnosticadas detrastornos alimentarios / Construction and validation of the C.A.P.A. questionnaire in Nutrition of Adolescents diagnosed with Adolescents diagnosed with eating disorders

Introducción. Los trastornos de la conducta alimentariarepresentan un grave, problema especialmente en poblaciónjoven. La educación nutricional es fundamental en su tratamiento y prevención.Entre las acciones desarrolladas, en España destaca la estrategia NAOS, que enmarca el programa educativo Perseodestinado a escolares. Sin embargo, existen escasos instrumentos que evalúen los conocimientos tras la realización deeste tipo de acciones. El objetivo del estudio ha sido elaborar y validar un cuestionario que permita evaluar los conocimientos tras realizar el programa Perseo en población juvenil diagnosticada de trastornos alimentarios.Metodología. Se implementó la técnica e-Delphi modificada online, en la que participaron 26 expertos de saludmental y nutrición. Evaluándose el grado de consenso enadecuación y relevancia a través de una escala Likert decuatro puntos y un campo para comentarios. Los criteriosbásicos y suplementarios del desarrollo de la técnica se establecieron previamente.Resultados. Tomando como base el programa Perseo yel cuestionario General Nutrition Knowledge Questionnaire(GNKQ) en su versión adaptada a adolescentes portugueses,se desarrolló una versión inicial del cuestionario de 30 ítemsy 4 posibles respuestas. Tras tres fases, 26 ítems alcanzaron elconsenso requerido tanto en adecuación como en relevancia.Finalmente, se obtuvo un nuevo cuestionario compuesto por26 ítems con un alto grado de consenso en opinión de losexpertos.Conclusiones. El cuestionario ha demostrado una sólidavalidez de contenido. Permitiendo evaluar una intervencióneducativa sobre nutrición, basada en el programa Perseo, enpoblación juvenil con trastornos alimentarios. (AU)

Introduction. Feeding and eating disorders represent aserious problem especially in young population. Nutritionaleducation is essential in its treatment and prevention.Among the actions developed in Spain the NAOS strategyhighlights, which frames the Perseo educational program forschoolchildren. However, there are few tools to evaluate theknowledge after these programs are implemented. The aimof the study was to create and to validate a questionnairethat allows the evaluation of the acquired knowledge onyoung population diagnosed of eating disorders after participating on Perseo program.Methodology. The on-line modified e-Delphi techniquewas applied, 26 mental health and nutrition experts tookpart, evaluating the consensus level on adequacy and relevance through a 4-points Likert scale and a field for comments. Basic and supplementary criteria for the developmentof the technique were previously established.Results. On the basis of the Perseo program and theadapted version of GNKQ for Portuguese teenagers, an initial version of the questionnaire was developed with 30 items and 4 possible answers. After three rounds 26 of theitems reached the required consensus both in adequacyand relevance.Eventually a new questionnaire of 26 items was obtainedwith a high degree of general agreement according to theexperts.Conclusions. The questionnaire has demonstrated astrong validity of content that allows to evaluate an educational intervention on nutrition based on the Perseo program, among young population with eating disorders. (AU)

Conceptual development and validation of the nursing diagnosis "Disturbed thought process".

PURPOSE: To validate the content of the nursing diagnosis proposal Disturbed thought process. METHODS: With an exploratory and descriptive design, the content validation for each component of the diagnosis proposal was pursued, based on a previous broad conceptual work, through consulting experts, applying Fehring's Diagnosis Content Validation Model. The modified Delphi technique was used by sending out three rounds of questionnaires electronically to seek consensus among the experts. FINDINGS: The nursing diagnosis version validated in this study includes the diagnosis label Disturbed thought process, the corresponding definition, 15 defining characteristics, and 13 related factors. The resulting diagnosis total Diagnosis Content Validation score was 0.99, implying its content validation. CONCLUSIONS: The validated diagnosis proposal describes a human response for which nursing professionals can autonomously assess and prescribe interventions leading to improvement of this health problem and/or alleviate its consequences, preserving the patient's autonomy and helping them to address their situation. It will be included in the next edition of the nursing diagnosis classification NANDA-I 2021-2023. IMPLICATIONS FOR NURSING PRACTICE: The results of this study will help nursing professionals reduce the potential impact among patients who suffer from an alteration in cognitive functioning in its executive function dimension, as the validated diagnosis proposal will make it possible to identify and report this problem precisely.

OBJETIVO: Llevar a cabo la validación de contenido de la propuesta de diagnóstico enfermero Trastorno del proceso de pensamiento. METODOLOGÍA: Con un diseño exploratorio y descriptivo, se procedió a la validación de contenido de cada uno de los componentes de la propuesta de diagnóstico, desarrollado en base a un amplio trabajo conceptual previo, a través de la consulta de expertos y la búsqueda de consenso, aplicando el Modelo de Validación de Contenido Diagnóstico de Fehring. Se empleó la técnica Delphi modificada mediante la que se enviaron tres rondas de cuestionarios de forma electrónica para buscar el consenso entre los panelistas. RESULTADOS: La versión del diagnóstico enfermero validada en este estudio incluye la etiqueta diagnóstica Trastorno del proceso de pensamiento, la correspondiente definición, 15 características definitorias y 13 factores relacionados. El índice total de validación de contenido del diagnóstico resultante fue de 0,99, implicando su validación de contenido. CONCLUSIONES: La propuesta de diagnóstico validada describe una respuesta humana sobre la que los profesionales de enfermería de manera autónoma, pueden valorar y prescribir intervenciones encaminadas a la mejoría de este problema de salud y/o paliar sus consecuencias, preservando la autonomía del paciente y facilitando su afrontamiento. Será incluido en la próxima edición de la clasificación de diagnósticos enfermeros NANDA-I 2021-2023. IMPLICACIONES PARA LA PRÁCTICA ENFERMERA: Los resultados de este estudio ayudarán a los profesionales de enfermería a disminuir el impacto potencial en los pacientes que sufren una alteración del funcionamiento cognitivo en su dimensión función ejecutiva, ya que la propuesta de diagnóstico validada les permitirá identificar y comunicar dicho problema con precisión.

Six-month breastfeeding maintenance after a self-efficacy promoting programme: an exploratory trial.

BACKGROUND: Breastfeeding care plays a fundamental role in establishing breastfeeding and longer duration after discharge. Practices though vary among professionals involved and are often inconsistent with good practices recommended, being a threat to women's breastfeeding self-efficacy. Breastfeeding self-efficacy is considered a predictor for successful breastfeeding and a significant variable amenable to intervention for promoting lactation AIM: To evaluate the efficacy, feasibility and acceptability of a new breastfeeding self-efficacy promoting programme (SIALAC) on 6-month breastfeeding maintenance. METHODS: In this exploratory multi-centre controlled trial, participants were allocated into control and intervention groups sequentially. Professionals in charge of the treatment groups were trained in between, with an especial focus on reducing practice variability. Control and intervention group women received usual care, and the intervention group received in addition SIALAC, a three-stage breastfeeding self-efficacy promoting programme. Primary outcome was breastfeeding maintenance up to 6 months analysed by Kaplan-Meier and Cox proportional hazard regression analysis. Student's t-test or chi-square tests were also used for continuous and categorical variables. Data on breastfeeding status and breastfeeding self-efficacy were collected at baseline, and 4, 8 and 24 weeks after birth. RESULTS: From May 2014 through November 2015, participants were enrolled. The sample consisted of 112 women. No relevant socio-demographic or obstetric difference was found between groups. The intervention achieved a significant difference between groups in breastfeeding survival (X2  = 4.94, p = 0.026). Six-month breastfeeding maintenance was significantly higher in the intervention group (67% vs. 55%; X2  = 5.384, p = 0.020). Breastfeeding dropout in the control group was 3.3 (CI 1.1, 10.1) times higher than that of the intervention group at 6 months. Breastfeeding self-efficacy scores were higher in the intervention group although without significant statistical difference. The programme showed good acceptability. CONCLUSION: Breastfeeding self-efficacy promoting programme SIALAC was beneficial in fostering 6-month breastfeeding survival. Full-scale trial should consider feasibility-related issues identified.

Integrative Review of Emotional Care Following Perinatal Loss.

Emotional care is an important part of the holistic labor and should be considered when providing care to people affected by perinatal losses. To synthesize the findings from recently published scientific evidence on the emotional care needed following perinatal loss, a search in PubMed, CINAHL, SCOPUS, and Web of Science was carried out in January 2020 yielding 22 studies which met the inclusion criteria and were analyzed following Whittemore and Knafl's (2005) methodology. One category on "offering emotional care" was identified: "Aspects influencing the psychosocial well-being of women after perinatal loss," comprising eight themes: risk of complicated grief, cultural values, perinatal losses in multiple pregnancies, experience of subsequent pregnancies, need of information, contact with the deceased baby, impact on relatives, and strategies for emotional care. In conclusion, the evidence highlights the need of specific emotional grief care.

Validação clínica de diagnósticos de enfermagem: revisão de literatura / Clinical validation of nursing diagnoses: literature review / Validación clínica de diagnósticos de enfermería: revisión de literatura

Introdução: Percebe-se a necessidade de identificar na literatura quais os métodos utilizados nas pesquisas de validação clínica de diagnósticos de enfermagem. Objetivo: Identificar quais os métodos estatísticos mais utilizados nos estudos de validação clínica de diagnósticos de enfermagem. Método: Optou-se por seguir as etapas descritas por Whittemore para revisão de literatura. A busca deu-se, através do Portal de Periódicos da Coordenação de Aperfeiçoamento de Pessoal de Nível Superior. Resultados: Observa-se a predominância de estudos de acurácia diagnóstica com análise de classes latentes. Conclusões: Estudos de acurácia constituem um método capaz de classificar corretamente os indivíduos com ou sem um diagnóstico de enfermagem. A análise de classes latentes tem sido utilizada por vários pesquisadores da temática nos dias atuais

Introduction: It is noticed the need to identify in the literature the methods used in the clinical validation research of nursing diagnoses. Objective: Identify which statistical methods are most used in the clinical validation studies of nursing diagnoses. Method: It was decided to follow the steps described by Whittemore for literature review. The search was made in the Higher Education Personnel Improvement Coordination Journals Portal. Results: The prevalence of diagnostic accuracy studies with latent class analysis is observed. Conclusions: Accuracy studies are a method capable of correctly classifying individuals with or without a nursing diagnosis. The analysis of latent classes has been used by several researchers of the current theme

Introducción: Se percibe la necesidad de identificar en la literatura cuáles son los métodos utilizados en las investigaciones de validación clínica. Objetivo: Identificar qué métodos estadísticos más utilizados en los estudios de validación clínica de diagnósticos de enfermería. Método: Se optó por seguir las etapas descritas por Whittemore para revisión de literatura. La búsqueda se dio en el Portal de Revistas de Coordinación de Mejoramiento de Personal de Educación Superior. Resultados: Predominancia de estudios de exactitud diagnóstica con análisis de clases latentes. Conclusiones: Estudios de acuracia constituyen un método capaz de clasificar correctamente a los individuos con o sin un diagnóstico de enfermería. El análisis de clases latentes ha sido utilizado por varios investigadores de la temática en los días actuales

Design, implementation and evaluation of an education course to promote professional self-efficacy for breastfeeding care.

The objective of this study was to determine the effect of an education short course on professional' self-efficacy in the area of breastfeeding care. The intervention had a pre-post design. A total of 43 healthcare professionals attended the course. The Kirkpatrick model for the development, implementation and evaluation of education actions was used for a 4.5-h course. The aspects evaluated included professionals' satisfaction and learning regarding confidence to support lactating mothers, perceived transfer of knowledge to the workplace and organizational changes. Data were collected using self-administered questionnaires (participants, unit managers, and education planners), before and after the intervention. Participants' satisfaction with the education action was high in all of the aspects measured (greater than 3.9 in scores of 0-5). Professionals showed a significant increase in self-efficacy levels for supporting breastfeeding (Wilcoxon test p-value = < 0.05, before intervention: median = 55, [IQR] = 11; after intervention: median = 60, [IQR] = 14). Participants, managers and organizers of the course identified changes in the way that professionals cared for breastfeeding mothers. In conclusion, this educational intervention enhanced professional self-efficacy and performance in breastfeeding care.

Modificación de la actividad física durante los tres primeros años de universidad / Changes in the physical activity of university students during the first three years of university

Introducción: la inactividad física constituye el cuarto factor de riesgo más importante de mortalidad en todo el mundo y los estudiantes universitarios presentan en un alto nivel este factor de riesgo. Objetivos: determinar la modificación de la actividad física de los estudiantes universitarios en Navarra durante los tres primeros años de universidad. Métodos: estudio observacional prospectivo de una cohorte de universitarios que participaron en el estudio en primer curso y dos años después, en tercer curso. Las cohortes fueron constituidas por 454 estudiantes que respondieron a un cuestionario de autocumplimentación voluntario y anónimo con variables sociodemográficas y relacionadas con la actividad física. Los datos se analizaron con el SPSS v21.0. Resultados: un 67,4% (n = 306) fueron mujeres y un 32,6% (n = 148) fueron hombres. El 61,6% de los estudiantes de primer curso realizaban más de 150 minutos a la semana de actividad física y se incrementó el porcentaje de estudiantes activos físicamente en un 2,7%. Entre quienes realizaban actividad física mínimo tres veces a la semana se observó un incremento del 6,1%, hasta alcanzar el 30,5% de estudiantes. Conclusiones: el periodo universitario no desempeña un papel significativo en la promoción de la actividad física, ya que se observan modificaciones mínimas en su práctica. A futuro, convendría plantearse los motivos que dificultan la actividad física y diseñar programas según las recomendaciones actuales

Introduction: physical inactivity is the fourth most important risk factor for mortality worldwide and university students present this risk factor at a high level. Objective: to determine the changes in the physical activity of university students in Navarra during the first three years of college. Methods: prospective observational study of a cohort of university students. They participated in the first year, and two years later in the third year. The cohorts were comprised of 454 students who answered a voluntary and anonymous self-completion questionnaire with sociodemographic and physical activity related variables. Data were analyzed with SPSS v21.0. Results: of the participants, 67.4% (n = 306) were women and 32.6% (n = 148) were men. In the first year, 61.6% of students performed more than 150 minutes of physical activity per week. This percentage increased by 2.7%. The frequency of physical activity at least three times a week increased 6.1%, reaching 30.5% of students. Conclusions: university does not play a significant role in the promotion of physical activity, finding minimal modifications. In the future, it would be convenient to consider the reasons that hinder physical activity and design programs according to current recommendations

[Changes in the physical activity of university students during the first three years of university]. / Modificación de la actividad física durante los tres primeros años de universidad.

INTRODUCTION: Introduction: physical inactivity is the fourth most important risk factor for mortality worldwide and university students present this risk factor at a high level. Objective: to determine the changes in the physical activity of university students in Navarra during the first three years of college. Methods: prospective observational study of a cohort of university students. They participated in the first year, and two years later in the third year. The cohorts were comprised of 454 students who answered a voluntary and anonymous self-completion questionnaire with sociodemographic and physical activity related variables. Data were analyzed with SPSS v21.0. Results: of the participants, 67.4% (n = 306) were women and 32.6% (n = 148) were men. In the first year, 61.6% of students performed more than 150 minutes of physical activity per week. This percentage increased by 2.7%. The frequency of physical activity at least three times a week increased 6.1%, reaching 30.5% of students. Conclusions: university does not play a significant role in the promotion of physical activity, finding minimal modifications. In the future, it would be convenient to consider the reasons that hinder physical activity and design programs according to current recommendations.

INTRODUCCIÓN: Introducción: la inactividad física constituye el cuarto factor de riesgo más importante de mortalidad en todo el mundo y los estudiantes universitarios presentan en un alto nivel este factor de riesgo. Objetivos: determinar la modificación de la actividad física de los estudiantes universitarios en Navarra durante los tres primeros años de universidad. Métodos: estudio observacional prospectivo de una cohorte de universitarios que participaron en el estudio en primer curso y dos años después, en tercer curso. Las cohortes fueron constituidas por 454 estudiantes que respondieron a un cuestionario de autocumplimentación voluntario y anónimo con variables sociodemográficas y relacionadas con la actividad física. Los datos se analizaron con el SPSS v21.0. Resultados: un 67,4% (n = 306) fueron mujeres y un 32,6% (n = 148) fueron hombres. El 61,6% de los estudiantes de primer curso realizaban más de 150 minutos a la semana de actividad física y se incrementó el porcentaje de estudiantes activos físicamente en un 2,7%. Entre quienes realizaban actividad física mínimo tres veces a la semana se observó un incremento del 6,1%, hasta alcanzar el 30,5% de estudiantes. Conclusiones: el periodo universitario no desempeña un papel significativo en la promoción de la actividad física, ya que se observan modificaciones mínimas en su práctica. A futuro, convendría plantearse los motivos que dificultan la actividad física y diseñar programas según las recomendaciones actuales.

A qualitative study of hospital birth perceptions: The helix of priority needs.

OBJECTIVE: To understand which needs are considered priorities in the hospital birth experience from the perspectives of postpartum women. DESIGN: This qualitative prospective study used a phenomenological approach. Data were collected through participant observations and semi-structured interviews recorded at eight weeks and eight months after childbirth. The data were analysed using a thematic approach. PARTICIPANTS: The study cohort consisted of 43 participants at eight weeks after childbirth and 33 participants eight months after childbirth. SETTING: Donostia University Hospital, San Sebastián, Spain, in 2016-2017. FINDINGS: Through the analysis, the following four main themes emerged, each in different categories: (a) Professional care: symbiosis between the woman and the professional: (a.1) professional treatment and its characteristics, (a.2) professional competence, and (a.3) professional information and listening: pillars in the support relationship. (b) Control and hospital safety: (b.1) hospital environment: external control. (c) Presence of the partner: (c.1) support, guidance, and participation. (d) Perception of observed feelings: (d.1) fear of complications or separation from the child, (d.2) fear of internal lack of control, and (d.3) fear of an instrumental delivery and/or caesarean section. CONCLUSIONS AND IMPLICATIONS FOR PRACTISE: The core of the hospital birth experience is constituted by the need to establish a supportive relationship based on mutual trust, exchange information that offers internal and external control and the security necessary to overcome feelings of fear, and obtain support and guidance from an involved partner.

Cultural Adaptation and Validation of the Inflammatory Bowel Disease Disability Index in a Spanish Population and Its Association with Sociodemographic and Clinical Factors.

Inflammatory bowel diseases generate disability. We aimed to adapt and validate the Inflammatory Bowel Disease Disability Index in a Spanish population and to analyze the sociodemographic and clinical factors associated with disability in patients with Crohn's disease and ulcerative colitis. Cultural adaptation and validation of psychometric properties in the index were done, along with an observational, cross-sectional, and analytical approach to determine associations with sociodemographic and clinical factors. Sociodemographic data, quality of life (using the Inflammatory Bowel Disease Questionnaire-32), and indicators of disease activity were collected, among others. A total of 170 subjects participated. The index showed high internal consistency, with a Cronbach's alpha of 0.869 and concurrent validity with the Inflammatory Bowel Disease Questionnaire-32 (r = 0.723, p < 0.001). The average score of the index was -3.91. Greater degrees of disability were found in women (mean = -6.77) than in men (mean = -1.25) (p = 0.018), in patients with Crohn's disease (mean = -5.94) rather than those with ulcerative colitis (mean = -0.94) (p = 0.028), and in patients in the moderately active disease phase (mean = -20.94) rather than those in the mildly active disease phase (mean = -2.65) and/or those in remission (mean = -1.40) (p < 0.001). The Disability Index is a valid tool for the Spanish population and is associated with sex, type of illness, and disease activity. It is a useful index in evaluating and monitoring disability in patients with inflammatory bowel disease.

Significado de la experiencia del cuidado en el parto hospitalario: voces de las profesionales / The meaning of care experience with hospital births: voices of the professionals

Objetivo: Abordar el significado de la experiencia del cuidado en el parto hospitalario desde la perspectiva de las profesionales. Metodología: Metodología cualitativa fenomenológica interpretativa mediante grupos focales formados por profesionales del Servicio de Partos del Hospital Universitario Donostia. El análisis de los textos incluyó una comparación cíclica para obtener los temas principales que definen el fenómeno. Resultados: Tras la práctica reflexiva realizada por las profesionales, se han detectado cambios en las demandas que las mujeres realizan durante el parto hospitalario, observando que han pasado de tener un talante totalmente pasivo a presentar diferentes comportamientos, que van desde la indiferencia hasta la actitud activa partícipe. Respecto a la necesidad de control, seguridad y responsabilidad, el aumento de las demandas es una de las características más frecuentemente señaladas. La información constante, antes, durante y después del parto, es la reclamación más evidente identificada. La interacción constante entre estos elementos y la influencia de los cambios socioculturales continuos resultan fundamentales para entender el significado de la experiencia de cuidado en el parto hospitalario y poder realizar propuestas de mejora. Conclusiones: La adaptación continua al contexto sociocultural precisa contemplar una gestión innovadora en la que se respete la voluntad de las mujeres, y que los profesionales no perciban por ello temor a obtener resultados adversos. Las profesionales observan la necesidad de establecer protocolos interdisciplinarios de información y continuidad de los cuidados

Aim: To address the meaning of care experience with hospital births from the perspective of professionals. Methodology: A qualitative design using a phenomenology approach with focus groups made up of professionals from the Birthing Unit at Donostia University Hospital. The analysis of the texts included a constant cyclic comparison in order to obtain the main issues that define the phenomenon. Results: After reflective practice carried out by professionals, changes in the demands women make during hospital births have been detected. It has been observed that their disposition changed from being completely passive, to presenting different behaviours ranging from indifference to an attitude of active participation. With regards to the need for control, safety and responsibility, the increase in demands is one of the most frequently indicated characteristics. Constant information before, during and after the birth is the most noticeable demand identified. Constant interaction between these elements and the influence of continuous sociocultural changes are fundamental in order to understand the meaning of care experience with hospital births and to be able to make proposals for improvement. Conclusions: Continuous adaptation to the sociocultural context requires the consideration of innovative management where the wishes of women are respected, and where professionals therefore aren't afraid to obtain adverse results. The professionals see the need to establish interdisciplinary information protocols and continuity of care

Factors Influencing the Life Experiences of Individuals With Inflammatory Bowel Disease.

Inflammatory bowel disease has a negative impact on individuals perception of their health status and is associated with disabling processes that have physical, social, and work repercussions. The objectives of this study were to describe the life experiences of individuals with Crohn disease and ulcerative colitis and to develop a theoretical framework to describe the relationships of these diseases with personal and clinical factors. A qualitative study on the basis of grounded theory was conducted, involving individual and semistructured interviews on the life experiences of 14 adults of different ages with inflammatory bowel disease in relapse or inactive phase. The individuals in relapse phase and those with a short time since diagnosis had the most negative perceptions of their health, and experienced impaired ability for daily activities. The life experiences of individuals with inflammatory bowel disease were influenced by the time since diagnosis and the disease phase, with no gender difference in either factor. The predominant strategy of participants for coping with the disease was to pursue normality. According to these findings, nursing interventions should focus on the initial adaptation phase and on coping strategies during active phases of the disease.

The Nursing Diagnosis Disturbed Thought Processes: An Integrative Review.

PURPOSE: To analyze and synthetize the existing scientific literature in relation to the nursing diagnosis disturbed thought processes (DTPs) (00130). METHODS: An integrative review was developed, identifying relevant papers through a search of international and Spanish databases and the examination of key manuals. FINDINGS: Theoretical papers propose modifications for the nursing diagnosis DTPs. Most of the research papers offer data about its frequency in different clinical settings. CONCLUSIONS: There exists an interest in the nursing diagnosis DTPs. However, the available evidence is not very extensive and further work is necessary in order to refine this nursing diagnosis. IMPLICATIONS FOR NURSING PRACTICE: The re-inclusion of DTPs in the NANDA-I classification will specially contribute to increment its utility in mental healthcare.

Diseño y validez de un instrumento para evaluar la autoeficacia percibida por los profesionales de la salud acerca de su capacidad para procurar cuidados a las madres que amamantan / Design and validity of an instrument to evaluate health professionals' perceived self-efficacy to care for nursing mothers

La promoción y apoyo a la lactancia materna proporcionado por profesionales de la salud en diferentes entornos es una de las estrategias con evidencia de resultados exitosos. El propósito de este estudio es desarrollar una escala para conocer la autoeficacia percibida por los profesionales de salud acerca de su capacidad para procurar cuidados a las madres que amamantan. METODOLOGÍA. El diseño de la escala se hizo utilizando la versión española de la escala BreastfeedingSelf-EfficacyScale-Short Form para madres. Las pruebas de validación se realizaron creando un grupo de expertos y pilotando la herramienta con profesionales que cuidaban a madres lactantes de dos centros asistenciales. Las propiedades psicométricas de la escala se examinaron analizando su validez, fiabilidad, sensibilidad y factibilidad. RESULTADOS. La escala "Autoeficacia Profesional para los Cuidados en Lactancia" (APCLA)contiene 14 ítems conforme al dominio de interés, con opciones de respuesta de 1 a 5. Se elaboró en formato papel y electrónico. Tras la valoración del comité de expertos, se pilotó con 43 enfermeras y matronas. La escala muestra resultados prometedores con respecto a su validez, fiabilidad (Alpha de Cronbach 0,967), sensibilidad (p<0,05) y factibilidad. CONCLUSIÓN. Aunque será necesario continuar con el proceso de validación en otras poblaciones y con mayor número de participantes, el instrumento ha mostrado buenos resultados para la medición de la autoeficacia profesional. La valoración de la autoeficacia profesional para proporcionar cuidados a madres que amamantan ayudará a identificar áreas de formación para profesionales que permitan la reducción de la variabilidad de los cuidados.

The promotion and support of breastfeeding by health professionals in different settings is an interventional strategy with evidence of successful results. The purpose of this study is to develop a scale to understand the self-efficacy perceived by health professionals about their ability to care for breastfeeding mothers. METHODOLOGY. The design of the scale was made using the Spanish version of the 'Breastfeeding Self-Efficacy Scale-Short Form' scale for mothers. The validation tests were done by creating a group of experts and piloting the tool with professionals caring for nursing mothers from two centres. The psychometric properties of the scale were examined by analysing their validity, reliability, sensitivity and feasibility. RESULTS. The scale "Professional Self-Efficacy for Breastfeeding Care" (Autoeficacia Profesional para los Cuidados en Lactancia, APCLA) contains 14 items according to the domain of interest, with response options from 1 to 5. It was elaborated in paper and electronic format. After the assessment of the committee of experts, it was piloted with 43 nurses and midwives. The scale shows promising results with respect to its validity, reliability (Cronbach's Alpha 0.967) sensitivity (p <0.05) and feasibility. CONCLUSION. Although it will be necessary to continue the validation process in other populations and larger numbers of participants, the instrument has shown good results for the measurement of professionals' self-efficacy. Assessing professional perceived self-efficacy to care for breastfeeding mothers will help identify areas of training for professionals and reduce variability in care provision.

The Nursing Diagnosis Disturbed Thought Processes in Psychiatric Patients: Prevalence and Associated Characteristics.

PURPOSE: To analyze the frequency of the nursing diagnosis disturbed thought processes (DTP) (00130) in a sample of psychiatric and psychogeriatric patients in medium- and long-term units and to describe those factors associated with its presence. METHODS: A secondary analysis of the data obtained in a multicentric and cross-sectional study developed in Spain was undertaken. FINDINGS: The total sample was 624 patients, from which 39.4% (n = 246) had the nursing diagnosis DTP. A statistically significant relationship between the presence of DTP and different variables was found. CONCLUSIONS: The nursing diagnosis DTP is very frequent among psychiatric and psychogeriatric institutionalized patients. IMPLICATIONS FOR NURSING PRACTICE: Patients with DTP may require a more complex nursing attention as its presence is associated with specific care needs.

[Changes in body weight of the university students at university]. / MODIFICACIÓN DEL PESO CORPORAL DE LOS ESTUDIANTES UNIVERSITARIOS EN NAVARRA DURANTE LOS TRES PRIMEROS AÑOS DE UNIVERSIDAD.

INTRODUCTION: One of the strategies for the prevention of the obesity is the identification of critical periods of gain weight. Some studies confirm gain weight during the university period. OBJECTIVE: The purpose of the present study was to determine the changes in the body weight of the university students in Navarre. METHODS: Prospective cohort study. Public University of Navarre and the University of Navarre, in Pamplona. Study examined weight change among 452 students attending at university in Pamplona, during first and third course. Four hundred and fifty two students completed the questionnaire. Weight and height were measures and body mass index was calculated. RESULTS: The mean body weight increased 0,600 kg, 1,8 kg for males and no change in body weight was observed in female. 44,7 % of students gained weight (60,8 % of men and 36,8 % of women), and the gain weight was of 3,4 kg. DISCUSSION: University years are a critical factor for the gain weight, particularly males. Consideration of this, is necessary the development of effective weight gain prevention strategies during the university.

Introducción: una de las estrategias para la prevención de la obesidad es la identificación de periodos críticos de aumento de peso, y existen estudios que confirman un aumento de peso corporal durante el periodo universitario. Objetivo: determinar las modificaciones en el peso corporal de los estudiantes universitarios en España, durante los tres primeros años de universidad. Métodos: estudio longitudinal y prospectivo de una muestra de estudiantes universitarios en España. Participaron universitarios matriculados en primer curso, a quienes se siguió en tercer curso. De los 1.162 estudiantes iniciales, 499 volvieron a participar (pérdida de seguimiento del 57,05%) y la muestra fue constituida por 452 estudiantes (pérdida de seguimiento del 60,8 %). Los estudiantes respondieron a un cuestionario y se valoró el peso y la talla corporal. Resultados: el peso corporal experimentó un incremento medio de 0,600 kg. En los hombres 1,88 kg y sin apenas modificación en las mujeres. Entre el 44,7 % de los estudiantes que aumentaron de peso (60,8 % hombres y 36,8 % mujeres), la ganancia media de peso alcanzó los 3,4 kg. Discusión: durante el periodo universitario se produce un aumento del peso corporal que afecta principalmente a los hombres. Por este motivo, es necesario continuar con los programas de promoción de la salud en este entorno.