Enfermería ahora un movimiento global / Nursing Now A global movement

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A Rasch analysis of nurses' ethical sensitivity to the norms of the code of conduct.

AIMS AND OBJECTIVES: To develop an instrument to measure nurses' ethical sensitivity and, secondarily, to use this instrument to compare nurses' ethical sensitivity between groups. BACKGROUND: Professional codes of conduct are widely accepted guidelines. However, their efficacy in daily nursing practice and influence on ethical sensitivity is controversial. DESIGN: A descriptive cross-sectional study was conducted. PARTICIPANTS: One hundred and forty-three registered nurses from Barcelona (Spain) participated in the study, of whom 45.83% were working in primary health care and 53.84% in hospital wards. METHODS: A specifically designed confidential, self-administered questionnaire assessing ethical sensitivity was developed. Knowledge of the nursing code and data on ethical sensitivity were summarised, with the quality of the questionnaire assessed using Rasch analysis. RESULTS: Item on knowledge of the code showed that one-third of nurses knew the contents of the code and two-thirds had limited knowledge. To fit the Rasch model, it was necessary to rescore the rating scale from five to three categories. Residual principal components analysis confirmed the unidimensionality of the scale. Three items of the questionnaire presented fit problems with the Rasch model. Although nurses generally have high ethical sensitivity to their code of conduct, differences were found according to years of professional practice, place of work and knowledge of the code (p<0.05). CONCLUSIONS: The questionnaire showed acceptable psychometric properties to achieve the proposed objective. Nurses' ethical sensitivity to the norms of the code was high. However, many factors might influence the degree of ethical sensitivity. Further research to measure ethical sensitivity using invariant measures such as Rasch units would be valuable. RELEVANCE TO CLINICAL PRACTICE: Other factors, such as assertiveness or courage, should be considered to improve ethical sensitivity to the code of conduct. Rigorous measurement studies and analysis in applied ethics are needed to assess ethical performance in practice.

Modelos teóricos y estudiantes de enfermería: aspectos motivacionales para su elección durante las prácticas clínicas / Theoretical models and nursing students: motivational aspects for election in clinical practice

Introducción. El cuerpo teórico y filosófico de enfermería es complejo; existen un gran número de teorías enfermeras, algunas de difícil comprensión, por lo que habitualmente su aplicación práctica se ve restringida. Objetivo. Identificar el modelo teórico de enfermería que los estudiantes dicen utilizar durante las prácticas clínicas, la motivación para su elección, y la escuela universitaria donde estaban cursando sus estudios. Sujetos y métodos. Estudio descriptivo en el que participaron 105 estudiantes (de una población total de 108) que realizaban prácticas de enfermería en el hospital durante el curso 2006-2007. La variables de estudio fueron los modelos teóricos enfermeros, las razones de la elección y variables sociodemográficas. La recogida de datos se llevo a cabo mediante un cuestionario cumplimentado durante su experiencia clínica. El análisis de los datos se realizó mediante un análisis temático de texto, categorizando para crear finalmente un marco explicativo. Resultados y conclusiones. El modelo elegido es principalmente el de Virginia Henderson. Las motivaciones para la elección, según los estudiantes, son su uso en la enseñanza universitaria y la facilidad de ejecución del modelo. Se evidenció confusión entre los términos ‘modelo conceptual y/o teórico’ y ‘metodología enfermera’ (AU)

Introduction. The theoretical and philosophical nursing is complex, there are a large number of nursing theories, some difficult to understand, because this usually its practical application is restricted. Aim. To identify the theoretical model of nursing students say they use in clinical practice, the motivation for their choice, and school where they were pursuing their studies. Subjects and methods. Descriptive study. Participants were 105 students doing school practice during the academic year 2006-2007 (of a total population of 108 students). The study variables were the nursing models and theories, the reasons for the choice and demographic variables. Data collection was conducted through a questionnaire completed during their clinical experience. The analysis of data using a thematic analysis of text, categorizing to finally create an explanatory framework. Results and conclusions. The model chosen is mainly that of Virginia Henderson. The motivations for the election as students are used in university education and ease of implementation of the model. It was evident confusion between the terms related to nursing model and methodology (AU)

Los modelos en la práctica asistencial: visión de los profesionales y estudiantes de Enfermería / Models in healthcare practice: the perspective of professionals and Nursing students

Objetivo: indagar la percepción de los profesionales y de los estudiantesde Enfermería en relación al uso en la práctica de los modelos y teoríasde Enfermería.Material y método: estudio descriptivo transversal. La muestra estuvo formadapor los profesionales asistenciales y estudiantes matriculados en lasescuelas que realizan prácticas clínicas en la Corporación Sanitaria delParc Taulí durante 2006/2007.Resultados: el modelo aprendido durante la formación es Henderson enambos grupos. En cuanto al uso del modelo en la práctica asistencial,los estudiantes usaban modelos en un 62% mientras lo hacían el 23%de los profesionales. Referente a si se identificaban con el modelo conel que atendían a las personas, los estudiantes dijeron sí en un 88% y losprofesionales en un 83%.Conclusiones: ambos grupos muestran una gran variabilidad y confusiónen algunos conceptos. El uso de un modelo o teoría en la formaciónno condiciona a identificarse con los conceptos de la autora estudiada.El metaparadigma enfermero no se nutre de un sólo modelo (AU)

Objective: to gain deeper knowledge on the perception that professionalsand nursing students have regarding the practical use of Nursingmodels and theories.Material and method: cross-sectional, descriptive study. The sample wascomprised of healthcare professionals and students enrolled in the schoolsthat carried out clinical practice sessions in the Parc Taulí Health Corporationduring 2006/2007.Results: The model learned during the training period was the Hendersonmodel in both groups. In regards to the use of the model in healthcarepractice, 62% of students and 23% of professionals claimed that theyused the models. In terms of whether they identified with the care modelused, 88% of students and 83% of professionals responded affirmatively.Conclusions: both groups showed high variability and confusion in certainconcepts. The use of a certain model or theory during training doesnot necessarily lead to identification with the studied author’s concepts.The nursing meta-paradigm is not shaped by one exclusive model (AU)