Development and validation of the competence in evidence based practice questionnaire (EBP-COQ) among nursing students.

BACKGROUND: Nursing educators need rigorously developed instruments to assess competency in evidence based practice (EBP) at undergraduate level. This concept is defined as the capability to choose and use an integrated combination of knowledge, skills and attitudes with the intention to develop a task in a certain context. Also, we understand that EBP is gaining knowledge and skills, as well as increasing positive attitudes toward EBP that will promote a change in behaviour to implement EBP in practice. This study aims to develop a psychometric test of the Evidence Based Practice Evaluation Competence Questionnaire (EBP-COQ) among undergraduate nursing students. METHODS: The questionnaire was developed by item generation through a review of scientific literature and focus groups. The instrument was validated in terms of content validity through an expert review. The EBP-COQ was administered to a cohort of nursing students (n =100) to evaluate test reliability and select the best items. Psychometric properties of the final instrument were assessed in a sample of 261 nursing students. RESULTS: The EBP-COQ consisted of 25 items. A factorial analysis grouped the items into the three categories that define competence relating to EBP: attitude, knowledge and skills. Cronbach's alpha was 0.888 for the entire questionnaire. The factor solution explained 55.55% of the variance. CONCLUSIONS: EBP-COQ appears to measure with adequate reliability the attributes of undergraduate nursing students' competence in EBP. The instrument is quick to disseminate and easy to score, making it a suitable instrument for nursing educators to evaluate students' self-perceived competence in EBP.

Attitude towards Evidence-Based Nursing Questionnaire: development and psychometric testing in Spanish community nurses.

BACKGROUND: A readiness assessment for identifying and measuring variables that can facilitate evidence-based nursing (EBN) is important. Attitude towards EBN is one of its components. However, questionnaires that exclusively measure attitude to EBN do not exist in Spanish-speaking contexts. AIM: This paper is a report of the development and psychometric testing of a Spanish-language assessment tool: the Evidence-Based Nursing Attitude Questionnaire (EBNAQ). METHODS: The questionnaire was developed in three phases: item generation through a review of scientific literature and focus groups; item selection through an expert review; content and construct validity testing, and internal consistency reliability testing. The instrument was validated in terms of construct validity by a factorial analysis and content validity by grouping the items into the three categories of attitude: cognitive, affective and behavioural. Data were collected from May to November of 2008. RESULTS: The questionnaire was validated in a sample of 219 Spanish community nurses, who had a mean age of 43.21 (SD 10.3) years, and 64.5% (141) were women. A total of 54.3% (121) had been working in the community for more than 10 years. The questionnaire consisted of 15 items grouped into the three factors that make up the concept of attitude. Cronbach's alpha was 0.853 for the entire questionnaire. The factor solution explained 54.70% of the variance. CONCLUSIONS: The EBNAQ is brief, making it a user-friendly tool. It is the first Spanish-language questionnaire that exclusively measures attitude towards EBN in nurses who work in the community. The EBNAQ can be used efficiently in research and practice settings to better understand nurses' attitudes towards evidence-based practice.

[Work satisfaction among Spanish nurses working in English hospitals]. / Satisfacción laboral de los profesionales de enfermería españoles que trabajan en hospitales ingleses.

OBJECTIVES: To evaluate work satisfaction among Spanish nurses employed by English hospitals, as well as the influence of several social and work-related variables associated with satisfaction. METHODS: We performed a cross-sectional study. All Spanish nurses (n=360) with a contract with any English hospital in April 2003 were included in the study. The self-administered and validated Font Roja work satisfaction questionnaire was used. RESULTS: The response rate was 78.6%. Overall work satisfaction among Spanish nurses was medium. The dimensions with higher work satisfaction were relationships with colleagues and superiors. The dimensions showing lowest work satisfaction were job satisfaction and professional competence. Statistically significant and positive associations were obtained between level of English, professional grade, shift pattern, working in the intensive care unit or accident and emergency department, time worked in English hospitals and degree of work satisfaction. CONCLUSIONS: Employers of Spanish nurses should try to increase job satisfaction and professional competence among these workers. Incentivation and professional promotion systems might help achieve this aim. Employers could also try to improve Spanish nurses' English level before contracts are signed and pay special attention to their needs during the first working year. Spanish nurses job satisfaction would also increase if they were allowed to choose their working shift and the unit or ward where they are going to work.

Satisfacción laboral de los profesionales de enfermería españoles que trabajan en hospitales ingleses / Work satisfaction among Spanish nurses working in English hospitals

Objetivos: Evaluar la satisfacción laboral de los profesionalesde enfermería españoles que trabajan en hospitales inglesesy la influencia de diversas variables sociolaborales.Métodos: Estudio transversal. Se incluyó a todo el personalde enfermería español que en abril de 2003 tenía contrato laboralen algún hospital inglés (n = 360). Se aplicó el cuestionarioautoadministrado y validado de Font Roja.Resultados: La tasa de respuesta fue del 78,6%. Las enfermerasque trabajan en hospitales ingleses tienen un nivel mediode satisfacción global. Las dimensiones asociadas a una satisfacciónlaboral más alta fueron las relaciones con los compañerosy las relaciones con los jefes; las dimensiones con unasatisfacción laboral más baja fueron la satisfacción por el trabajoy la competencia profesional. Se ha observado una asociaciónpositiva y estadísticamente significativa entre el nivelde satisfacción laboral y las variables nivel de inglés, grado profesionaly tiempo trabajado en Inglaterra; la jornada laboral,®otros» y trabajar en unidades de cuidados intensivos y urgenciastambién se asocian positivamente con la satisfacción laboral.Conclusiones: Los responsables de los hospitales inglesesque contratan profesionales de enfermería españoles deberíanincidir en mejorar su satisfacción por el trabajo y su competenciaprofesional. Para ello, se podrían incluir sistemas deincentivación y promoción profesional, tomar medidas previasa la contratación para mejorar el nivel de inglés, prestar especialatención a las necesidades del personal, sobre tododurante el primer año de trabajo, y facilitar la elección del servicioy la jornada laboral(AU)

Objectives: To evaluate work satisfaction among Spanish nursesemployed by English hospitals, as well as the influenceof several social and work-related variables associated withsatisfaction.Methods: We performed a cross-sectional study. All Spanishnurses (n = 360) with a contract with any English hospital inApril 2003 were included in the study. The self-administeredand validated Font Roja work satisfaction questionnaire wasused.Results: The response rate was 78.6%. Overall work satisfactionamong Spanish nurses was medium. The dimensionswith higher work satisfaction were relationships with colleaguesand superiors. The dimensions showing lowest work satisfactionwere job satisfaction and professional competence.Statistically significant and positive associations were obtainedbetween level of English, professional grade, shift pattern,working in the intensive care unit or accident and emergencydepartment, time worked in English hospitals and degree ofwork satisfaction.Conclusions: Employers of Spanish nurses should try to increasejob satisfaction and professional competence amongthese workers. Incentivation and professional promotion systemsmight help achieve this aim. Employers could also try toimprove Spanish nurses’ English level before contracts are signedand pay special attention to their needs during the firstworking year. Spanish nurses´ job satisfaction would also increaseif they were allowed to choose their working shift andthe unit or ward where they are going to work(AU)

Causas de muerte posterior al transplante hepático en niños tratados con ciclosporina y esteroides / Causes of death after liver transplantation in children treated with ciclosporine and steroides

Se analiza una serie de 227 niños sometidos a trasplante ortotópico de hígado entre marzo de 1980 y febrero de 1986. Fallecieron durante el período en estudio 70 pacientes (31,7%); 9 fueron excluidos del análisis (4 murieron dentro de las primeras 24 hs. postoperatorias y 5 cuyo deceso ocurrió fuera de nuestra institución). La insuficiencia hepática por trombosis arterial, falla primaria del funcionamiento del hígado o rechazo inmunológico del mismo, motivó 25 muertes de los 61 restantes, 21 murieron por sepsis generalizada, mientras que 7 fallecieron por sangrado incontrolable y 8 fueron atribuidas a un variado grupo de causas. Los índices de mortalidad de los pacientes sometidos a 1, 2 y 3 trasplante fueron del 20, 38 y 50% respectivamente. El 85,2% de las muertes se produjo durante el 1er. semestre posterior al trasplante hepático inicial. La insuficiencia hepática fue la principal causa de muertes tempranas y las tardías se debieron en su mayoría a sepsis. El estudio de las causas de muerte posterior al trasplante hepático, revela que ciertos avances en determinadas áreas conducirán a mejores resultados.

Causas de muerte posterior al transplante hepático en niños tratados con ciclosporina y esteroides / Causes of death after liver transplantation in children treated with ciclosporine and steroides

Se analiza una serie de 227 niños sometidos a trasplante ortotópico de hígado entre marzo de 1980 y febrero de 1986. Fallecieron durante el período en estudio 70 pacientes (31,7%); 9 fueron excluidos del análisis (4 murieron dentro de las primeras 24 hs. postoperatorias y 5 cuyo deceso ocurrió fuera de nuestra institución). La insuficiencia hepática por trombosis arterial, falla primaria del funcionamiento del hígado o rechazo inmunológico del mismo, motivó 25 muertes de los 61 restantes, 21 murieron por sepsis generalizada, mientras que 7 fallecieron por sangrado incontrolable y 8 fueron atribuidas a un variado grupo de causas. Los índices de mortalidad de los pacientes sometidos a 1, 2 y 3 trasplante fueron del 20, 38 y 50% respectivamente. El 85,2% de las muertes se produjo durante el 1er. semestre posterior al trasplante hepático inicial. La insuficiencia hepática fue la principal causa de muertes tempranas y las tardías se debieron en su mayoría a sepsis. El estudio de las causas de muerte posterior al trasplante hepático, revela que ciertos avances en determinadas áreas conducirán a mejores resultados. (AU)

Causes of death after liver transplantation in children treated with cyclosporine and steroids.

Two-hundred-and-twenty-seven children underwent orthotopic liver transplantation between March 1980 and March 1986. Seventy (31 %) patients died during the study period. Four patients who died within 24 hours of the initial liver transplant and 5 patients who died outside of our institution were excluded from the analysis. Liver failure, related to either thrombosis of the hepatic artery, primary non-function of the graft or rejection accounted for 25 of the remaining 61 deaths. In 21 patients death was related to overwhelming sepsis while 7 patients died from excessive bleeding. Eight of the deaths were due to a miscellaneous group of causes. Twenty percent of the 150 patients who received a single liver transplant died compared to a death rate of 50% in patients who underwent three transplants. Eighty-five percent of the deaths occurred within 6 months after the initial liver transplant. Liver failure was the cause in the majority of the early deaths whereas the later deaths were more likely to be due to sepsis. This detailed analysis of the causes of death after pediatric liver transplantation in a large group of patients has revealed that advances in certain areas could lead to even better results.