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

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

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

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

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

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

'I'm still a woman': A qualitative study on sexuality in heterosexual women with Turner Syndrome.

AIM AND OBJECTIVES: The aim of this study was to describe and understand how heterosexual women with Turner Syndrome experience sexuality. BACKGROUND: Turner Syndrome is a genetic condition that is the result of one of the X chromosomes missing or partially missing, and it affects women of all ages. Turner Syndrome may lead to psychological, relational and sex life disorders. DESIGN: This is a qualitative study, and the COREQ checklist was employed to report on the current study. METHODS: The study was conducted in a region of southern Spain. Convenience and snowball sampling were used to recruit 18 women, aged 22-51 years, who had been diagnosed with Turner Syndrome. Participants' experiences were explored through semi-structured interviews between January and May 2021. Thematic analysis was used for data analysis. RESULTS: Three main themes and eight sub-themes emerge from the data analysis: (1) Sexuality linked to corporeality, with the sub-themes: 'Discovering that your body is different', 'Social stigma limits one's sex life' and 'Fear of penetration surpresses sexual desire'. (2) Adapting one's sexuality to Turner Syndrome, with the sub-themes: 'Feeling like a woman' and 'Suffering from and adapting to comorbidities'. (3) When infertility overshadows sexuality, with the sub-themes: 'Prolonging childhood by ignoring sexuality', 'Fertility treatment: always a possibility' and 'Lack of specialised professional knowledge'. CONCLUSION: Heterosexual women with Turner Syndrome suffer from sexual problems, delayed diagnosis and treatment, and lack of information. Unawareness and relational problems may also lead to scarce and late sexual relations, jealousy and a fear of being left. The women with Turner Syndrome refer to little self-exploration or masturbation as well as a fear of penetration. RELEVANCE TO CLINICAL PRACTICE: Understanding the experiences of sexuality in heterosexual women with Turner Syndrome is a challenge for clinical nurses, who could provide quality care to these women in contextualised services.

Experiences of suffering among nursing professionals during the COVID-19 pandemic: A descriptive qualitative study.

BACKGROUND AND AIM: Healthcare professionals have played a fundamental role in managing and controlling the COVID-19 health crisis. They are exposed to high levels of suffering, trauma, uncertainty, and powerlessness in the workplace. The objective of this study was to explore and understand experiences of suffering among primary care and hospital care nurses during the COVID-19 health crisis. DESIGN: This is a descriptive qualitative study. Between March and April 2021, 19 in-depth interviews were carried out with nurses at health and social care facilities and hospitals in southern Spain. ATLAS.ti 9.0 software was used for discourse analysis. RESULTS: Nurses reported that they had experienced suffering during their work in the pandemic. The main causes suggested were direct contact with patients' suffering and organisational difficulties. The repercussions are in emotional dimension and physical deterioration and social isolation. CONCLUSION AND IMPLICATIONS: Given the circumstances, programmes to promote healthy, compassion-based behaviours and changes to the way in which professionals' suffering is handled must be implemented by healthcare facility managers. Nursing leaders should consider the management of suffering as a matter of the first order, both from the ethical point of view and the business profitability and make compassionate leadership.