[Validation of the Job Content Questionnaire in hospital nursing staff]. / Validación del Job Content Questionnaire en personal de enfermería hospitalario.

OBJECTIVE: The aim of this study was to determine the reliability and construct validity of the three dimensions of the Job Content Questionnaire (JCQ): demand, control and job support among hospital nursing staff. METHODS: The minimun reduced version of the JCQ was used, which include three dimensions: psychological demands (9 items), job control (9 items) and job support (11 items). Validity was assessed in a random sample of 330 nursing staff from two general hospitals in the province of Alicante (Spain). The reliability of the questionnaire was evaluated after re-interviewing a subsample of 50 nurses 15 days after the first interview. Construct validity was evaluated by calculating correlations between the three dimensions of the JCQ obtained after factorial analysis with the burnout scale and six dimensions of the 36-item short-form health survey (SF-36) questionnaire. RESULTS: Factorial analysis revealed that the version of the JCQ validated in this study had the same factorial structure as the original questionnaire. The intraclass correlation between the first and second interview was high for each of the three dimensions (between 0.83 and 0.87). Cronbach's alpha was also high (between 0.74 and 0.88). A moderate but significant correlation was found between the three JCQ dimensions and the burnout scale: (-0,27 for job support, 0.31 for psychological demands and -0.12 for job control). A moderate correlation was also found for some SF-36 dimensions. CONCLUSION: The factorial structure of the JCQ was similar to that proposed by the author in the context of Spanish culture. The reliability and internal consistency of each of the three dimensions was high while construct validity was moderate.

Validación del Job Content Questionnaire en personal de enfermería hospitalario / Validation of the Job Content Questionnaire in hospital nursing staff

Objetivo: Determinar la fiabilidad, validez de contenido y validez de concepto de las tres dimensiones de la versión mínima reducida en castellano del cuestionario Job Content Questionnaire (JCQ) (demandas, control y apoyo en el trabajo) en personal de enfermería hospitalario. Métodos: Se ha utilizado la versión mínima reducida del cuestionario JCQ, que incluye tres dimensiones: demandas psicológicas (9 ítems), control sobre el trabajo (9 ítems) y apoyo en el trabajo (11 ítems). La validación se realizó sobre una muestra aleatoria de 330 profesionales de enfermería de dos hospitales generales públicos de la provincia de Alicante. La fiabilidad del cuestionario se valoró tras la readministración a una submuestra aleatoria de 50 profesionales de enfermería, con un intervalo de 15 días. La validez de concepto se obtuvo mediante la correlación de las tres dimensiones del JCQ obtenidas tras el análisis factorial, con la escala de efectos psíquicos del burnout (EPB) y 6 dimensiones del cuestionario de salud SF-36. Resultados: El análisis factorial demuestra que la versión del cuestionario validada en este estudio presenta la misma estructura factorial que el cuestionario original. El coeficiente de correlación intraclase entre ambas administraciones, para cada una de las tres dimensiones, es alto (0,83-0,87), así como el alfa de Cronbach (0,74-0,88). Se encuentra una correlación moderada pero significativa entre las tres dimensiones del JCQ y la escala EPB: (-0,27 para apoyo en el trabajo, 0,31 para demandas psicológicas y -0,12 para control sobre el trabajo). Así mismo, se encuentra una correlación moderada pero significativa con algunas dimensiones del cuestionario de salud SF-36. Conclusión: La versión mínima reducida del JCQ presenta una estructura factorial similar a la versión original americana en nuestro contexto cultural. Cada una de las tres dimensiones presenta alta fiabilidad y validez de contenido, y moderada validez de concepto (AU)

[Work-related stress factors and the psychological well-being of hospital nurses]. / Estresores laborales y bienestar psicológico impacto en la enfermería hospitalaria.

OBJECTIVE: To analyze the factors which cause stress at work among hospital nursing staff according to their socio-demographic and professional characteristics and their affects on psychological welfare. METHODS: A cross study carried out on a randomly chosen group of 201 nursing professionals composed of nurses and nurses aides from a general public hospital in the city of Valencia. The data was gathered by means of a self-administered questionnaire. To measure the variable response, psychological welfare, The Goldberg General Health 28 item version questionnaire, GHQ-28, was used. Work stress factors were evaluated by means of a scale valid for our cultural environment, Spain,: the Nursing Stress Scale, NSS, which consists of 34 items having a range from 0 to 102. In addition, information about diverse socio-demographic and professional variables were gathered. The authors carried out a simple analysis on all the data obtained. RESULTS: The scores registered on the work stress factors scale were lower for nursing professionals older than 55 and for those who have more than 20 years experience in their service, with a medium of 23.28 (IC 95% = 9.87-54.84) and 25.29 (IC 95% = 11.80-54.22) respectively. On the other hand, the medium was higher for nurses with a medium of 34.16 (IC: 15.29-76.29) in comparison to the score for nurses aides. The total score on the work stress factors scale was higher in the "probable situations" of psychological stress with a medium of 42.40 (IC 95% = 21.35-84.21). CONCLUSIONS: The results of this study demonstrate that a higher level exposure to work stress factors lowers the psychological welfare among nursing staff.

[The Spanish version of the "Nursing Stress Scale". A cross-cultural adaptation process]. / La versión castellana de la escala "The Nursing Stress Scale". Proceso de adaptación transcultural.

BACKGROUND: The cross-cultural adaptation of "The Nursing Stress Scale" used to gauge job stressors stress in hospital nursing staff members. METHODS: The translation-back translation method of translating this scale into Spanish and then back into English has been employed, rounded out with qualitative means and methods (focus groups). The original scale was translated in Spanish independently by two bilingual nurses born in Spain who had lived in the United States. In following, the text in question was translated back into English by two U.S.-born translators living in Spain. Two focus groups were formed, one comprised of male and female nurses and other of nurses aides from different units and hospitals. Lastly, a pilot survey was made of 20 professional nurses. RESULTS: The items were ranked by how difficult it was to come up with a phrase in Spanish which would be equivalent in concept to the original one. Fifteen (15) items entailed no problem, 13 entailing an average degree of difficulty and 6 a high degree. Following another translation of the problematical items and the inquiries made to one of the individuals who had written the original scale, a Spanish version was drafted in which 12 items showed two or more alternative versions, which were then assessed in the pilot survey. As a result of the groups, the conclusion was drawn that the types of job stressor perceived by nursing staff are comparable to those included on the original scale, with the exception of the "Break Down of computer" item, which is not applicable to our environment. CONCLUSION: An adapted Spanish version of The Nursing Stress Scale has been drafted, the subsequent assessment of its validity and reliability being required.

[The rejoining of the workforce of mothers during the first year of life of their child]. / Reincorporación al trabajo de las madres durante el primer año de vida de su hijo.

OBJECTIVES: To study the return to paid work between the 5th and 12th month after the birth of a child depending on socioeconomic and occupational characteristics of employed mothers. Furthermore, to analyse the differences at the time of returning to work (5th or 12th month) according to these characteristics. METHODS: Longitudinal study carried out on a sample of 528 primiparous or secundiparous women who have had a child in a public hospital in the city of Valencia and who have carried out a professional activity during pregnancy. Three cross-sectional cut off points were made; the first two days after childbirth, the second five months later and the third a year after the child was born. The information collection was conducted by means of a questionnaire. Uni and multivariate statistical analysis techniques have been used. RESULTS: Five months after childbirth the probability of returning to work was greater in women who worked with permanent contracts in the private sector (ORadjusted: 7.4) or public sector (ORadjusted: 7.8). Likewise it is higher in service workers (ORadjusted: 2.0), administrative staff (ORadjusted: 2.5) and professionals or technical workers (ORadjusted: 2.9). The probability of returning to paid work a year after childbirth is higher in the mother who works in the public sector with permanent or temporary contracts (ORadjusted: 21.0 and 5.1 respectively) and in the private sector with permanent contracts (ORadjusted: 5.1). It is also higher in service workers (ORadjusted: 2.2), in administrative staff (ORadjusted: 2.7) and professionals or technical workers (ORadjusted: 4.7). CONCLUSIONS: Childbirth may lead to a break in the working career of the woman. The socio-demographic and professional factors which might explain this break are low professional qualifications and unstable employment in private sector companies.

[The duration of breast feeding and work activity]. / Duración de la lactancia materna y actividad laboral.

The objective of this work was to study the influence of working conditions and socio-demographic, personal and social support factors on the duration of breast-feeding. The study population consisted of primiparous or secundiparous women who have had a child in a Valencian public hospital and who have carried out a professional activity during their pregnancy. Information was collected by means of a face-to-face interview in the maternity ward two days after childbirth, a telephone interview five months later and a postal questionnaire one hear after childbirth. A total of 545 surveys were obtained. A simple analysis of the data was carried out. A total of 64% of the mothers reported after one year that they had breast-fed. Seventeen percent breast-fed for one month or less, 13.3% for two months, 24.8% for three months, 12.7% for four months and 32.3% for 5 or more months. The duration of breast-feeding was longer among women over 25 years of age, among secundiparous women and among those who did not return to work after childbirth. It was shorter among those whose maternity leave was shorter and among those whose husbands work without a contract. Therefore, among women who carry-out paid work, the main factor which limits the duration of breast-feeding is the return to work after childbirth. The application of certain measures which favour maintaining breast-feeding (reduction of working day, flexibility in work hours, etc.) should be done so with caution and always with the mother's consent and without this implying a risk for the continuity in work and professional promotion.

[Evolution of fecundity in the Valencian community during the 1975-1990 period]. / Evolución de la fecundidad en la Comunidad Valenciana durante el período 1975-1990.

BACKGROUND: To study the evolution of specific cases of fertility by age groups in the Autonomous Region of Valencia, between 1975 and 1990, and compare this development with the evolution on a national level. METHODS: The specific fertility rates were calculated for seven 5-year age groups within the female fertility period (15-49 years). The number of births per age of mother (Natural Movement of the Spanish Population) has been used and the denominator is the female population calculated be geometrical interpolation from the figures provided by different censuses and electoral roles for each one of the age groups. The study period is 1975 to 1990. RESULTS: The evolution of the fertility rate in the Autonomous Region of Valencia is declining in all age groups except the 30-34 year age group, where fertility showed a slight increase at the end of the eighties, the same as in the rest of the country. Worthy of mentioned is the 15-19 year old group, with figures below the national level, and the 25-29 year old group, where the figures are greater than for the rest of the country as a whole. On a province (county) level, the development is similar to what has been described above. Alicante has the highest figure out of the three provinces (counties) for women in the 15-19 and 35-39 year age ranges. CONCLUSION: The evolution of the fertility rate in the Autonomous Community of Valencia is similar to the development in the rest of the country, a slight increase being detected in women in the 30 to 40 year group, which is similar to what has happened in other European countries.

[Promotion of mother-infant health: a comparative study of legislation of pregnancy protection]. / Promoción de la salud maternoinfantil: estudio comparativo de la legislación para la protección del embarazo.

OBJECTIVE: To describe the legislative measures aimed at protecting working women during pregnancy, which exist in France, Italy, the United Kingdom and Spain. DESIGN: The aspects studied were employment protection and modifications in work conditions for the pregnant woman. Existing Spanish legislation, the third Programme of Community Action for Equal Opportunities and some relevant scientific articles were reviewed. MEASUREMENTS AND MAIN RESULTS: Regarding protection of pregnant women from dismissal, legislation is more explicit in France and Italy, where protection covers the whole of the pregnancy, extending in France until 4 weeks after the end of the period off-work for the birth and in Italy until the child is one year old. Likewise, both in France and Italy, there is a long list of jobs which a pregnant woman is not allowed to do, with the possibility of a change of post if necessary. In Spain there is a Health at Work draft law, where measures relating to this question have been assembled. CONCLUSION: In general, the legislation referring to the protection of pregnant women at work is not widely known and leaves without protection those women in a more vulnerable work situation. Health professionals could support the equality and health of working women by informing them adequately of their rights.

[The expectations of a woman's return to work after childbirth]. / Las expectativas de reincorporación de la mujer al trabajo tras el nacimiento de un hijo.

The objective of this study is to assess the relationship between the decision to return to work during the first year after delivery and socio-demographic and professional factors, as well as the reasons why the decision is made. Data collection was carried out by a personal interview in the hospital, two days after childbirth. 597 primiparous or secundiparous women who had developed a professional activity during pregnancy were interviewed. Uni and multivariate statistical analysis techniques were used. Blue collar workers (ORadjusted = 0.13), administrative staff (ORadjusted = 0.16), women who give up work more than a month before the birth (ORadjusted = 0.33 and 0.28), women without a contract (ORadjusted = 0.19) and temporary workers (ORadjusted = 0.30) were less likely to make the decision of returning to work. According to these results, the continuity of the women in the labour market after maternity is determined to a great extent by the social and employment context where she works; a fact which must be taken into account when putting into practice maternal and child health promotion programmes.