Using knowledge as the basis for evidence-based practice in primary care nurses.

AIM: The aim of this study was to explore the perception of primary care nurses regarding the need and use of knowledge from research, as a basis for evidence-based practice in their workplace. Additionally, the study aimed to determine which factors might hinder or enable implementation into daily practice. BACKGROUND: Evidence-based practice involves integrating best results in research with clinical experience, which enables us to provide a higher quality of care, as well as to optimize the care given. International studies show that nurses feel that there are still many barriers that hinder their doing research and incorporating new findings into clinical practice; although in the field of primary care, few studies have been carried out. METHODS: This descriptive qualitative study design used focus groups to collect data. This study was carried out in Spanish primary care centres. Forty-six registered nurses took part in this study and were divided into five focus groups. RESULTS: Three significant themes emerged: awareness of the need to use research, nurses as knowledge-generation agents and motivation to use research despite barriers. LIMITATIONS: A limited number of participants and a convenience sample were used. CONCLUSION: Nurses recognize that professional health care must be based on evidence obtained from daily work - both originated by their colleagues and by themselves - and they are willing to work on it although they perceive a lack of competence for this purpose and demand support from their institutions. IMPLICATIONS FOR NURSING POLICY: Primary care institutions should empower nursing coordinators as leaders of evidence-based practice and implicate clinical nurses from the beginning on the implementation of guidelines.

Perception of Spanish primary healthcare nurses about evidence-based clinical practice: a qualitative study.

BACKGROUND: Although evidence-based clinical practice constitutes a priority for healthcare services in many countries within the last few years, there is a general lack of implementation of evidence-based clinical practice in nursing care, especially in primary health care. Few qualitative studies concerning the influencing factors on evidence-based clinical practice for community nurses have been carried out. AIM: This study examined the perception of nurses in Spanish primary health care with regard to the knowledge, advantages and barriers within the application process with evidence-based clinical practice. METHODS: We used a descriptive qualitative study with focus groups to collect data. Forty-six primary care nurses took part in this study and they were distributed into five focus groups. RESULTS: Five main topics arose from the results achieved: knowledge and development of evidence-based clinical practice, evidence searching, evidence dissemination, advantages of use of evidence-based clinical practice, and barriers for its application and implementation. Participants had a positive attitude towards evidence-based practice, although they used this infrequently because of lack of competence and organizational support for its application. CONCLUSION: Our participants are increasingly determined to take into account evidence within the decision-making processes in their usual clinical practice. We consider it advisable to develop specialized training strategies as well as provide necessary resources for the implementation of evidence-based clinical practice duly adapted to the field of primary health care. IMPLICATIONS FOR NURSING AND HEALTH POLICY: This study highlights the existing gap in translating knowledge to practice and its potential implications in the effectiveness of nursing interventions and decision making in primary health care, and thus its implications for education policy.

Caracterización del hábito tabáquico en una consulta de enfermería de Atención Primaria / Characterization of smoking habit in the Primary Care nursing consultation

Introducción: En 1999, la OMS (Salud para Todos en el Siglo XXI) identifica a la enfermera de Atención Primaria como uno de los pilares básicos de la promoción de la salud en la población y declara que «El tabaquismo es la mayor amenaza para la salud en la Región Europea». Objetivo: Caracterizar el hábito tabáquico de la población sometida a estudio con el fin de desarrollar estrategias adecuadas y específicas que rentabilicen los recursos y esfuerzos en la ayuda a nuestros pacientes. Pacientes y métodos: Estudio descriptivo transversal mediante cuestionario cumplimentado por los autores a partir de la información voluntariamente transmitida por 205 pacientes, seleccionados a medida que iban accediendo a una consulta programada de enfermería del centro de atención primaria Trencadors. Resultados: El 19,0% son exfumadores, el 28,3% fumadores y el 52,7% no han fumado nunca. Existen diferencias significativas entre géneros en cuanto a exfumadores, fumadores y nunca fumadores. La totalidad de exfumadores no ha usado ningún método para intentar dejar de fumar y el 71,8% lo ha dejado con un solo intento. Conclusiones: Nuestra población asistencial desarrolla una conducta báquica similar al resto de la población de las Islas Baleares, Cataluña o España. los pacientes que deciden dejar de fumar y no pueden, infrautilizan los medios de ayuda de que disponen. El consejo breve oportunista durante las crisis o molestias del paciente o su familia se muestra como la herramienta más eficaz en la lucha antitabáquica (AU)

Introduction: In 1999 the WHO (Health for All) signalled out primary care infirmaries as the milestones in the promotion of public health and declared that «Tobacco use is the greatest health threat to the European Region». Objective: Define the smoking habits of the population with the objective that their study would allow the development of adequate and specific strategies that take advantage of the abilities and efforts of the nursing professionals in helping our patients give-up tobacco use. Patients and Methods: A descriptive, cross-sectional study of the information gathered in the form of questionnaire was developed by the authors. Data was obtained from information voluntarily given by 205 patients, selected when entering for a programmed visit at the «Trencadors». Primary Health Care Centre. Results: Of the population studied, 19.0% were former smokers, 28.3% were smokers, and 52.7% had never smoked. Significant gender related differences were found between former smokers, smokers and patients that had never smoked. Former smokers as a whole did not use any type of method to give up smoking and of these, 71.8% had stopped at the first attempt to abandon the habit. Conclusions: The population that visit the health care centres have smoking habits that are similar to the rest of the populations in the Balearic Islands, Catalonia and Spain. Patients that decided to stop smoking and could not were under-utilising the help available to them. The opportunistic advice during an abstention crisis or the nuisance caused to the patients or their families proved to be the best weapons in the fight to stop smoking (AU)

Policonsumo en la Universitat de les Illes Balears / Polyconsumption in the Universitat de les Illes Balears

Objetivos: Caracterizar en qué contexto se viene desarrollando elhábito tabáquico en lo referente a su relación con otras drogas o situacionessocioculturales o personales. Consecuentemente con este planteamiento,se han evaluado las relaciones existentes entre el hábito tabáquicoel consumo de alcohol, cannabis y otras variables como el género,hábitos familiares, hábitos de las amistades, nivel profesional de los padres…entre la población constituida por los alumnos del edificio GuillemCifre, de Colonya, de la Universitat de les Illes Balears (UIB).Métodos: Estudio descriptivo transversal, efectuado mediante unaencuesta autocumplimentada cuyo ámbito es el colectivo de estudiantesdel Edificio Guillem Cifre, de Colonya, de la Universitat de les IllesBalears. La recogida de la información se llevó a cabo suministrando uncuestionario autocumplimentado a alumnos de las facultades dePsicología, Enfermería y Estudios de Ciencias de la Educación. Una vezdepurados los datos, se procedió al análisis con el paquete estadísticoSPSS v.11,5. Se realizó un análisis descriptivo y para conocer la fuerzade asociación entre fumar y las variables predictoras se obtuvieronlas odds ratio (OR) utilizando la regresión logística tanto para el análisisunivariante como multivariante.Resultados: La muestra obtenida fue de 862 alumnos, con una mediade edad de 21,06 ± 0,38 años. La prevalencia total de fumadores habitualesse sitúa en el 35,3%. Admiten consumir semanalmente, al menosuna bebida alcohólica el 69,5% de los encuestados, y fumar al menosun porro el 16%. Ser consumidor de marihuana incrementa en más desiete veces la probabilidad de ser fumador. Si el mejor amigo es ser fumador,aumenta en 5,58 veces la probabilidad de ser fumador habitual.Los fumadores consumen marihuana y beben alcohol en mayor proporciónque los no fumadores. Además, cerca del 90% de los consumidoresde marihuana beben habitualmente. Ser consumidor de marihuanao alcohol, ser mujer, que en la familia haya algún fumador o ser hijode una madre no universitaria, son factores de riesgo independientespara ser fumador.Conclusiones: Fumaron cannabis semanalmente (durante los últimos12 meses) el 14,4%, lo que confirma a la Comunidad Balear comola de mayor consumo de España. Cuanto mayor es el consumo demarihuana y alcohol, mayor es la probabilidad de ser fumador. Se confirmaque el consumo de drogas y especialmente el tabaco depende, deuna forma muy relevante, del contexto familiar y, aún más, del social(OR de 5,58 en el caso de tener amigos íntimos fumadores u OR de 3,75en caso de que la pareja fume). Los datos que aporta este estudio nos hacenpensar en la necesidad de planificar programas de promoción de lasalud globales, tanto a nivel escolar como comunitario, y que estén dirigidosal policonsumo de drogas y no solamente al hábito tabáquico

Objectives: Characterize within what context the smoking habit hasbeen developing in relationship with other drugs or sociocultural orpersonal situations. In consequence with this approach, the relationshipsexisting between smoking habit, consumption of alcohol, cannabis andother variables such as gender, family habits, habits of friends, parents'professional level, etc. between the population made up by the studentsof the building Guillem Cifre de Colonya of the Universitat de les IllesBalears (UIB) have been evaluated.Methods: Cross-sectional descriptive study conducted through aself-filled out survey whose scope is the group of students from thebuilding Guillem Cifre de Colonya of the Universitat de les Illes Balears.Information was collected by providing a self-filled out questionnaireto students of the Psychology, Nursing and Studies of Sciences of theEducation schools. Once the data were purified, analysis was done withthe SPSS v. 11.5 statistical program. A descriptive analysis was doneand the Odds Ratio (OR) was obtained using the logistic regression bothfor the univariate and multivariate analysis to know the force of theassociation between smoking and predictive variables.Results: The sample obtained included 862 students, with a meanage of 21.06 ± 0.38 years. Total prevalence of usual smokers is 35.3%.A total of 69.5% of those surveyed admit that they drink at least one alcoholic drink per week and 16% that they smoke at least one joint.Consuming marijuana increases the likelihood of being a smoker seventimes. If one's best friend smokes, the likelihood of being a regular smokerincreases 5.88 times. Smokers consume marijuana and drink alcoholmore than non-smokers. Furthermore, about 90% of the marijuanaconsumers commonly drink. Being a consumer of marijuana or alcohol,being a woman, that there is someone who smokes in the family or beingthe child of a non-university mother are independent risk factors to bea smoker.Conclusions: Atotal of 14.4% smoked cannabis weekly (during thelast 12 months), which confirms the Balearic Island Community as thathaving the largest consumption in Spain. The greater the consumptionof marijuana and alcohol, the greater the likelihood of being a smoker.It is confirmed that the consumption of drugs and especially tobaccodepends in a relevant way on the family context and even more on thesocial one (OR of 5.58 in the case of having close friends who smoke orOR of 3.75 in case of the partner who smokes). The data supplied bythis study lead us to think about the need to plan global health promotionprograms on both the school and community level that are aimed atpolyconsumption of drugs and not only at the smoking habit