Frommelt Attitude Toward Care of the Dying Scale Form B: Validation for Spanish health professionals.

OBJECTIVE: The aim of this study is to culturally adapt and validate the Frommelt Attitude Toward Care of the Dying Scale Form B (FATCOD-B) in Spanish health professionals. METHOD: A cultural adaptation and scale validation was carried out to evaluate the validity of appearance, content and construct, reliability and feasibility. The psychometric validation of the FATCOD-B was carried out on a sample of 2,446 Spanish physicians, nurses, psychologists, and social workers and students of these disciplines, between January 2017 and December 2018. This sample was selected by intentional sampling. Descriptive statistics were used to characterize the sample. An exploratory multi-group factor analysis was performed, internal consistency was evaluated by calculating Cronbach's α and stability by test-retest. RESULTS: A total of 2,446 people participated in the study, 1,134 students and 1,312 professionals. The exploratory multi-group factor analysis revealed a two-dimensional factor structure, with a total of 17 items retained in the model from the 30 of the original scale. The results showed that this version has adequate reliability (α = 0.79) and for each subscale, and stability (ICC = 0.843, p < 0.001). SIGNIFICANCE OF RESULTS: FATCOD has been used with physicians and nurses from different countries. However, no reports have been found in the literature of its use with psychologists and social workers. It is important to have an instrument that allows us to know the attitudes of these professionals since they are all directly involved in the care of patients at the end of their lives and their families. The Spanish version of FATCOD-B has proven to be a reliable and valid instrument for its use in Spanish health professionals while allowing comparisons between disciplines.

NUrsing Homes End of Life care Program (NUHELP): developing a complex intervention.

BACKGROUND: Nursing homes are likely to become increasingly important as end-of-life care facilities. Previous studies indicate that individuals residing in these facilities have a high prevalence of end-of-life symptoms and a significant need for palliative care. The aim of this study was to develop an end-of-life care program for nursing homes in Spain based on previous models yet adapted to the specific context and the needs of staff in nursing homes in the country. METHODS: A descriptive study of a complex intervention procedure was developed. The study consisted of three phases. The first phase was a prospective study assessing self-efficacy in palliative care (using the SEPC scale) and attitudes towards end-of-life care (using the FATCOD-B scale) among nursing home staff before and after the completion of a basic palliative care training program. In the second phase, objectives were selected using the Delphi consensus technique, where nursing home and primary care professionals assessed the relevance, feasibility, and level of attainment of 42 quality standards. In phase 3, interventions were selected for these objectives through two focus group sessions involving nursing home, primary care, and palliative care professionals. RESULTS: As a result of the training, an improvement in self-efficacy and attitudes towards end-of-life care was observed. In phase 2, 14 standards were selected and grouped into 5 objectives: to conduct a comprehensive assessment and develop a personalized care plan adapted to the palliative needs detected; to provide information in a clear and accessible way; to request and record advance care directives; to provide early care with respect to loss and grief; to refer patients to a specialized palliative care unit if appropriate, depending on the complexity of the palliative care required. Based on these objectives, the participants in the focus group sessions designed the 22 interventions that make up the program. CONCLUSIONS: The objectives and interventions of the NUHELP program constitute an end-of-life care program which can be implemented in nursing homes to improve the quality of end-of-life care in these facilities by modifying their clinical practice, organization, and relationship with the health system as well as serving as an example of an effective health intervention program.

Changing Home: Experiences of the Indigenous when Receiving Care in Hospital

Objective. To understand the meaning of the experience of the indigenous when receiving care in a low-complexity hospital. Methods. Qualitative study with ethnographic approach conducted in a hospital of Antioquia, Colombia. The study had 12 indigenous participants who underwent semi-structured interviews. Observation was carried out in hospitalization wards, emergency, and outpatient services of the institution during 40 hours. The analysis process was performed descriptively. The methodological rigor was maintained by applying criteria of confirmability, credibility, transferability, and consistency. The study was approved by the Ethics Committee and authorized by the indigenous authorities to enter the field. Results. Five themes emerged: the context of caring for the indigenous, the need to consult the hospital, changes experienced by the indigenous in the hospital, experiences in relation with treatments, and relations established within the hospital. The meaning is constructed from a dichotomous perspective based on the favorable or unfavorable aspects of the situations and experiences, which for the indigenous is like "changing home". Conclusion. The meaning of the experience of receiving care in hospital for the indigenous is constructed from the context in which they live and receive health services, the changes they live in the dimension of space by virtue of their traveling from their vital space to another space that, due to their physical characteristics, results strange and different, even not healing. Upon the difficulties, the indigenous develop strategies and actions to overcome limitations, whether through adaptation and learning

Objetivo. Comprender el significado de la experiencia de los indígenas al recibir atención en un hospital de baja complejidad. Métodos. Estudio cualitativo con enfoque etnográfico desarrollado en un hospital de Antioquia, Colombia. Participaron doce indígenas a quienes se les realizaron entrevistas semiestructuradas. Se hizo observación en salas de hospitalización, urgencias y servicios ambulatorios de la institución durante 40 horas. El proceso de análisis se hizo de manera descriptiva. El rigor metodológico se mantuvo con la aplicación de los criterios de confirmabilidad, credibilidad, transferibilidad y consistencia. Se contó con aval del Comité de Ética de Investigación de la Facultad de Enfermería de la Universidad de Antioquia y autorización de las autoridades indígenas para entrar al campo. Resultados. Emergieron cinco temas: el contexto de la atención de los indígenas, la necesidad de consultar al hospital, los cambios experimentados por los indígenas en el hospital, las experiencias en relación con los tratamientos y las relaciones establecidas dentro del hospital. El significado se construye desde una perspectiva dicotómica con base en los aspectos favorables o desfavorables de las situaciones y experiencias, que para los indígenas es como "cambiar de casa". Conclusión. Para los indígenas, el significado de la experiencia de recibir atención en el hospital se construye a partir del contexto en el que viven y reciben los servicios de salud, los cambios que viven en la dimensión del espacio en virtud de que transitan desde su espacio vital a otro que, por sus características físicas, resulta extraño y diferente, incluso no curativo. Ante las dificultades, los indígenas desarrollan estrategias y acciones para superar las limitaciones, bien sea mediante la adaptación y el aprendizaje.

Objetivo. Compreender o significado da experiência indígena ao receber atendimento em um hospital de baixa complexidade. Métodos. Estudo qualitativo com abordagem etnográfica desenvolvido em um hospital de Antioquia, Colômbia. Participaram 12 indígenas, nos quais foram realizadas entrevistas semiestruturadas. A observação foi realizada no hospital, no pronto-socorro e serviços ambulatoriais da instituição por 40 horas. O processo de análise foi feito de forma descritiva. O rigor metodológico foi mantido com a aplicação dos critérios de confirmabilidade, credibilidade, transferibilidade e consistência. Teve o aval do Comitê de Ética e autorização das autoridades indígenas para o ingresso em campo. Resultados. Emergiram cinco temas: o contexto do cuidado aos indígenas, a necessidade de consulta hospitalar, as mudanças vivenciadas pelos indígenas no hospital, as experiências em relação aos tratamentos e as relações estabelecidas no hospital. O sentido é construído a partir de uma perspectiva dicotômica a partir dos aspectos favoráveis ou desfavoráveis das situações e vivências, o que para os indígenas é como "trocar de casa". Conclusão. O sentido da experiência de receber cuidado no hospital para indígenas é construído a partir do contexto em que vivem e recebem os serviços de saúde, das mudanças que vivenciam na dimensão do espaço em virtude da passagem de seu espaço de moradia para outro espaço que, pelas suas características físicas, é estranho e diferente, nem mesmo curativo. Diante das dificuldades, os indígenas desenvolvem estratégias e ações para superar as limitações, seja por meio da adaptação e do aprendizado.

Cultural Adaptation, Validation, and Analysis of the Self-Efficacy in Palliative Care Scale for Use with Spanish Nurses.

The aim of the present study is to validate the Self-Efficacy in Palliative Care Scale (SEPC) in Spanish nursing professionals and students, to describe their levels of self-efficacy, and to determine the influencing factors. A validation study and a cross-sectional descriptive study were carried out, with the data analysed using contrast tests and multiple linear regression; 552 nurses and 440 nursing students participated. The Spanish version consists of 23 items and has a high degree of reliability (α = 0.944). Confirmatory factor analysis revealed one additional factor (i.e., management of psychosocial and spiritual aspects) in comparison to the original scale. Contrast tests revealed that the mean SEPC score was higher in professionals than in students (p < 0.001) and that the professionals who had higher levels of self-efficacy were older (p < 0.001), had more previous training (p < 0.001), and had more experience in end-of-life care (p = 0.001). The linear analysis results confirm a significant association between age and previous training in end-of-life care. The Spanish version of the SEPC is a reliable tool for both nursing professionals and students. The level of self-efficacy of both groups is moderate and is influenced by age, experience, and training in end-of-life care.

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.

Level of Cultural Self-Efficacy of Colombian Nursing Professionals and Related Factors.

PURPOSE: To describe the level of cultural self-efficacy of Colombian nursing professionals and determine the main influencing factors. METHOD: A descriptive, analytical cross-sectional study was conducted in 211 nursing professionals selected by systematic random sampling for a finite population, using the Colombian version of the Cultural Self-Efficacy Scale. After descriptive statistical analysis, nonparametric tests were applied to determine between-variable associations, followed by multiple linear regression analysis. RESULTS: The mean Cultural Self-Efficacy Scale score was 2.58. An association with sex and age ( p < .05) was observed in regression analysis. The mean score for knowledge of cultural concepts was 3.20 and associated with age, years of experience, educational level, and cross-cultural experiences ( p < .05). The mean score for confidence in performing cultural nursing skills was 3.29. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: The cultural self-efficacy level of this sample of nursing professionals, with their consequent capacity to provide culturally competent care, is moderate and is associated with sex and age. Confidence in knowledge of cultural concepts is affected by age, educational level, years of experience, and cross-cultural experiences. This evidence supports the implementation of changes to improve the cultural knowledge and therefore cultural self-efficacy of these professionals.

Producción científica en enfermería transcultural en el periodo 2007-2014 / Produção científica de enfermagem transcultural no período 2007-2014 / Scientific production in Transcultural Nursing during the period 2007-2014

El objetivo fue identificar y analizar la producción científica sobre Enfermería Transcultural en el contexto internacional en el periodo de tiempo comprendido entre los años 2007 y 2014. Se realizó una revisión bibliográfica en las bases de datos CINAHL y CUIDEN empleando el descriptor "Enfermería Transcultural" e incluyendo exclusivamente artículos originales o de investigación publicados entre 2007 y 2014. Se llevó a cabo un estudio documental descriptivo sobre la bibliografía seleccionada utilizando indicadores bibliométricos. Se obtuvieron un total de 155 artículos. El perfil de las publicaciones es el de trabajos firmados por entre 2 y 3 autores, mujeres, pertenecientes principalmente a la disciplina enfermera y cuya institución de referencia es la universidad. La mayoría de estos trabajos se realizaron en Estados Unidos, Brasil y España. Los hallazgos señalan que los artículos encontrados se derivaron principalmente de estudios cualitativos que abordaban temas como las experiencias y creencias ante la salud o la enfermedad, la formación de estudiantes y profesionales, y el abordaje de los mismos en el ámbito de la diversidad cultural (AU)

O objetivo foi identificar e analisar a produção científica sobre Enfermagem Transcultural no contexto internacional no período entre 2007 e 2014. Foi realizada uma revisão da literatura na base de dados CINAHL e CUIDEN utilizando o descritor "Enfermagem Transcultural" e incluindo únicamente pesquisas originais ou de investigação publicados entre 2007 e 2014. A metodología foi estruturada como um estudio descritivo documental da literatura selecionada por meio de indicadores bibliomètricos. Foi obtido um total de 155 artigos. Os resultados mostram que as publicações foram feitas por entre 2 e três mulheres autores que pertencem principalmente à disciplina de enfermagem e cuja instituição de referência de trabalho é a universidade. A maioria destes estudos foram conduzidos nos Estados Unidos, Brasil e Espanha. Os artigos encontrados foram derivados de estudos qualitativos sobre questões como experiências e crenças sobre saúde ou doença, a formação de estudantes e profissionais e seu processo no campo da diversidade cultural (AU)

The objective was to identify and analyze the scientific production on Transcultural Nursing in the international context in the period between 2007 and 2014. A literature review on the CINAHL and CUIDEN database was performed using the descriptor "Transcultural Nursing" and including only original or research articles pu-blished between 2007 and 2014. A documentary descriptive study of the selected literature was carried out using bibliometric indicators. A total of 155 articles were obtained. The profile of the publications is the one of works signed by 2 or three women authors who mainly belong to the nursing discipline and whose work reference institution is the university. Most of these studies were conducted in the United States, Brazil and Spain. They are fundamentally qualitative design studies that address as major thematic the experiences and beliefs regarding health or disease, the training of students and professionals, and their pro-ceeding in the field of cultural diversity (AU)

Cultural Adaptation and Validation of the Cultural Self-Efficacy Scale for Colombian Nursing Professionals.

PURPOSE: The level of cultural self-efficacy indicates the degree of confidence nursing professionals possess for their ability to provide culturally competent care. Cultural adaptation and validation of the Cultural Self-Efficacy Scale was performed for nursing professionals in Colombia. DESIGN: A scale validation study was conducted. METHOD: Cultural adaptation and validation of the Cultural Self-Efficacy Scale was performed using a sample of 190 nurses in Colombia, between September 2013 and April 2014. This sample was chosen via systematic random sampling from a finite population. RESULTS: The scale was culturally adapted. Cronbach's alpha for the revised scale was .978. Factor analysis revealed the existence of six factors grouped in three dimensions that explained 68% of the variance. CONCLUSION: The results demonstrated that the version of the Cultural Self-Efficacy Scale adapted to the Colombian context is a valid and reliable instrument for determining the level of cultural self-efficacy of nursing professionals.

"Yo, adelante" la lucha contra un cáncer de mama avanzado diagnosticado durante el embarazo / "Me, onwards". A battle against advanced breast cancer diagnosed during pregnancy

El cáncer de mama presenta una alta incidencia en mujeres, al igual que una alta supervivencia si este es diagnosticado en estadios tempranos. Es el cáncer más común en mujeres embarazadas y en el año posterior al parto. El objetivo de este trabajo es presentar la experiencia en primera persona de una mujer con cáncer de mama avanzado a lo largo de su proceso de enfermedad. Para ello se realizó un relato biográfico a través de una entrevista en profundidad. El texto relata la vivencia de enfermedad de una mujer diagnosticada de cáncer de mama durante el embarazo en términos de la dificultad experimentada hasta obtener un diagnóstico, el tratamiento y sus efectos secundarios y el progreso de la enfermedad. Se describe el padecimiento asociado a la misma y la importancia del apoyo emocional recibido para continuar la lucha contra el cáncer

Breast cancer has a high incidence in women, as well as a high survival rate if it is diagnosed in early stages. It is the most common cancer in pregnant women and in the year following child birth. The objective of this study is to present the firstperson experience of a woman with advanced breast cancer over her illness process. With this purpose a biographical account was performed through an in-depth interview. The text narrates the illness experience of a woman diagnosed with breast cancer during pregnancy in terms of the difficulty experienced to get a diagnosis, the treatment and its side effects and the disease progression. The text also describes the suffering related to the disease and how important it was for her to receive emotional support in order to be able to continue her battle against cancer