Juan Roldán-Merino

Assessing positive mental health in people with chronic physical health problems: correlations with socio-demographic variables and physical health status

BackgroundA holistic perspective on health implies giving careful consideration to the relationship between physical and mental health. In this regard the present study sought to determine the level of Positive Mental Health (PMH) among people with chronic physical health problems, and to examine the relationship between the observed levels of PMH and both physical health status and socio-demographic variables.MethodsThe study was based on the Multifactor Model of Positive Mental Health (Lluch, 1999), which comprises six factors: Personal Satisfaction (F1), Prosocial Attitude (F2), Self-control (F3), Autonomy (F4), Problem-solving and Self-actualization (F5), and Interpersonal Relationship Skills (F6). The sample comprised 259 adults with chronic physical health problems who were recruited through a primary care center in the province of Barcelona (Spain). Positive mental health was assessed by means of the Positive Mental Health Questionnaire (Lluch, 1999).ResultsLevels of PMH differed, either on the global scale or on specific factors, in relation to the following variables: age: global PMH scores decreased with age (r=-0.129; p=0.038); b) gender: men scored higher on F1 (t=2.203; p=0.028) and F4 (t=3.182; p=0.002), while women scored higher on F2 (t -3.086; p=0.002) and F6 (t=-2.744; p=0.007); c) number of health conditions: the fewer the number of health problems the higher the PMH score on F5 (r=-0.146; p=0.019); d) daily medication: polymedication patients had lower PMH scores, both globally and on various factors; e) use of analgesics: occasional use of painkillers was associated with higher PMH scores on F1 (t=-2.811; p=0.006). There were no significant differences in global PMH scores according to the type of chronic health condition. The only significant difference in the analysis by factors was that patients with hypertension obtained lower PMH scores on the factor Autonomy (t=2.165; p=0.032).ConclusionsMost people with chronic physical health problems have medium or high levels of PMH. The variables that adversely affect PMH are old age, polypharmacy and frequent consumption of analgesics. The type of health problem does not influence the levels of PMH. Much more extensive studies with samples without chronic pathology are now required in order to be able to draw more robust conclusions.

Impact of personalized in-home nursing care plans on dependence in ADLs/IADLs and on family burden among adults diagnosed with schizophrenia: a randomized controlled study.

PURPOSE The study aims to assess the impact of personalized in-home nursing care plans on the degree of dependence among adult patients with schizophrenia, and on family burden. DESIGN AND METHODS This is a randomized controlled study with 94 participants: The experimental group received a personalized in-home nursing care plan. The comparison group got a standard care at its mental health center. FINDINGS The pretest-posttest multivariate analysis of covariance revealed statistically significant group differences (p = .003). The help received the positive activity and the degree of independence in the experimental group improved mainly due to intervention. PRACTICE IMPLICATIONS A personalized in-home nursing care plan improves the degree of independence of people diagnosed with schizophrenia living in the community and reduces the burden perceived by the family.

Implementation of evidence on the nurse-patient relationship in psychiatric wards through a mixed method design: study protocol

BackgroundPsychiatric nurses are aware of the importance of the therapeutic relationship in psychiatric units. Nevertheless, a review of the scientific evidence indicates that theoretical knowledge alone is insufficient to establish an adequate therapeutic alliance. Therefore, strategies are required to promote changes to enhance the establishment of the working relationship. The aims of the study are to generate changes in how nurses establish the therapeutic relationship in acute psychiatric units, based on participative action research and to evaluate the effectiveness of the implementation of evidence through this method.Methods/DesignThe study will use a mixed method design. Qualitative methodology, through participative action research, will be employed to implement scientific evidence on the therapeutic relationship. A quasi-experimental, one-group, pre-test/post-test design will also be used to quantitatively measure the effectiveness of the implementation of the evidence. Participants will consist of nurses and patients from two psychiatric units in Barcelona. Nurses will be selected by theoretical sampling, and patients assigned to each nurses will be selected by consecutive sampling. Qualitative data will be gathered through discussion groups and field diaries. Quantitative data will be collected through the Working Alliance Inventory and the Interpersonal Reactivity Index. Qualitative data will be analysed through the technique of content analysis and quantitative data through descriptive and inferential statistics.DiscussionThis study will help to understand the process of change in a nursing team working in an inpatient psychiatric ward and will allow nurses to generate knowledge, identify difficulties, and establish strategies to implement change, as well as to assess whether the quality of the care they provide shows a qualitative improvement.

Ethical conflict in critical care nursing Correlation between exposure and types

Background: Ethical conflicts in nursing have generally been studied in terms of temporal frequency and the degree of conflict. This study presents a new perspective for examining ethical conflict in terms of the degree of exposure to conflict and its typology. Objectives: The aim was to examine the level of exposure to ethical conflict for professional nurses in critical care units and to analyze the relation between this level and the types of ethical conflict and moral states. Research design: This was a descriptive correlational study. Central and dispersion, normality tests, and analysis of variance were carried out. Participants and research context: A total of 203 nurses were from two third-level teaching hospitals in Spain. Both centers are part of the University of Barcelona Health Network. Participants filled out the Ethical Conflict in Nursing Questionnaire–Critical Care Version. Ethical considerations: This investigation received the approval of the ethical committees for clinical investigation of the two participating hospitals. Participants were informed of the authorship and aims of the study. Findings: The index of exposure to ethical conflict was x ˉ = 182.35 . The situations involving analgesic treatment and end-of-life care were shown to be frequent sources of conflict. The types of ethical conflict and moral states generally arranged themselves from lesser to greater levels of index of exposure to ethical conflict. Discussion: The moderate level of exposure to ethical conflict was consistent with other international studies. However, the situations related with family are infrequent, and this presents differences with previous research. The results suggest that there is a logical relationship between types of conflict and levels of exposure to ethical conflict. Conclusion: The types of ethical conflict and moral states were related with the levels of exposure to ethical conflict. The new perspective was shown to be useful for analyzing the phenomenon of ethical conflict in the nurse.

Development and Psychometric Properties of the Nursing Critical Thinking in Clinical Practice Questionnaire

Background and Aim A complex healthcare environment, with greater need for care based on the patient and evidence-based practice, are factors that have contributed to the increased need for critical thinking in professional competence. At the theoretical level, Alfaro-LeFevre (2016) put forward a model of critical thinking made up of four components. And although these explain the construct, instruments for their empirical measurement are lacking. The purpose of the study was to develop and validate the psychometric properties of an instrument, the Nursing Critical Thinking in Clinical Practice Questionnaire (N-CT-4 Practice), designed to evaluate the critical thinking abilities of nurses in the clinical setting. Methods A cross-sectional survey design was used. A pool of items was generated for evaluation by a panel of experts who considered their validity for the new instrument, which was finally made up of 109 items. Following this, validation was carried out using a sample of 339 nurses at a hospital in Barcelona, Spain. Reliability was determined by means of internal consistency and test–retest stability over time, although the validity of the construct was assessed by means of confirmatory factor analysis. Results The content validity index of the N-CT-4 Practice was .85. Cronbachs alpha coefficient for the whole instrument was .96. The intraclass correlation coefficient was .77. Confirmatory factor analysis showed that the instrument was in line with the four-dimensional model proposed by Alfaro-LeFevre (2016). Linking Evidence to Action The psychometric properties of theN-CT-4 Practice uphold its potential for use in measuring critical thinking and in future research related with the examination of critical thinking.Background and Aim: A complex healthcare environment, with greater need for care based on the patient and evidence‐based practice, are factors that have contributed to the increased need for critical thinking in professional competence. At the theoretical level, Alfaro‐LeFevre (2016) put forward a model of critical thinking made up of four components. And although these explain the construct, instruments for their empirical measurement are lacking. The purpose of the study was to develop and validate the psychometric properties of an instrument, the Nursing Critical Thinking in Clinical Practice Questionnaire (N‐CT‐4 Practice), designed to evaluate the critical thinking abilities of nurses in the clinical setting. Methods: A cross‐sectional survey design was used. A pool of items was generated for evaluation by a panel of experts who considered their validity for the new instrument, which was finally made up of 109 items. Following this, validation was carried out using a sample of 339 nurses at a hospital in Barcelona, Spain. Reliability was determined by means of internal consistency and test–retest stability over time, although the validity of the construct was assessed by means of confirmatory factor analysis. Results: The content validity index of the N‐CT‐4 Practice was .85. Cronbachs alpha coefficient for the whole instrument was .96. The intraclass correlation coefficient was .77. Confirmatory factor analysis showed that the instrument was in line with the four‐dimensional model proposed by Alfaro‐LeFevre (2016). Linking Evidence to Action: The psychometric properties of theN‐CT‐4 Practice uphold its potential for use in measuring critical thinking and in future research related with the examination of critical thinking.

Reliability and validity of the Positive Mental Health Questionnaire in a sample of Spanish university students

Accessible summary What is known on the subject?In general, the current studies of positive mental health use questionnaires or parts thereof. However, while these questionnaires evaluate aspects of positive mental health, they fail to measure the construct itself. &NA; What does this paper add to existing knowledge?The widespread use and the lack of specific questionnaires for evaluating the positive mental health construct justify the need to measure the robustness of the Positive Mental Health Questionnaire. Also six factors are proposed to measure positive mental health. &NA; What are the implications for practice?The availability of a good questionnaire to measure positive mental health in university students is useful not only to promote mental health but also to strengthen the curricula of future professionals. Introduction: Nursing has a relevant role in managing mental health. It is important to identify and thereafter to enhance positive aspects of mental health among university nursing students. Aim: The aim of the present study was to analyse the psychometric properties of the Positive Mental Health Questionnaire (PMHQ) in terms of reliability and validity using confirmatory factor analysis in a sample of university students. Method: A cross‐sectional study was carried out in a sample of 1091 students at 4 nursing schools in Catalonia, Spain. The reliability of the PMHQ was measured by means of Cronbachs alpha coefficient, and the test‐retest stability was measured with the intraclass correlation coefficient (ICC). Confirmatory factor analysis was used to determine the validity of the factorial structure. Results: Cronbachs alpha coefficient was satisfactory (>0.70) for four of the six subscales or dimensions and ranged from 0.54 to 0.79. ICC analysis was satisfactory for the six subscales or dimensions. The hypothesis was confirmed in the analysis of the correlations between subclasses and the overall scale, with the strongest correlations being found between the majority of the subscales and the overall scale. Confirmatory factor analysis showed that the model proposed for the factors fit the data satisfactorily. Discussion: This scale is a valid and reliable instrument for evaluating positive mental health in university students. Implications for Practice: A good questionnaire to measure positive mental health in university students is useful not only to promote mental health but also to strengthen the curricula of future professionals.

Psychometric Evaluation of a New Instrument in Spanish to Measure Self‐Care Requisites in Patients With Schizophrenia

PURPOSE The purpose of this study was to develop and validate a new instrument in Spanish designed to measure self-care requisites in patients with schizophrenia treated in the community. DESIGN AND METHODS The first phase was conducted to develop the questionnaire through a panel of experts and evaluate for content validity. Psychometric evaluation was then conducted with a consecutive sample of 341 patients. FINDINGS The scale demonstrated good internal consistency and stability over time. The discriminant and convergent validity was satisfactory. The confirmatory factor analysis showed that the theoretical model fits the self-care requisites proposed by Orems nursing theory from which it originated. PRACTICE IMPLICATIONS This scale is a valid and reliable instrument for use in clinical practice, guiding the nurse in developing the most appropriate care plan for each patient.

Positive Mental Health and Prevalence of Psychological Ill-Being in University Nursing Professors in Catalonia, Spain

The aim of the current study was to examine the prevalence of psychological ill-being among university nursing professors in Spain and determine their grade of positive mental health. A cross-sectional study was conducted from June 2013 to December 2013 with a sample of 263 university nursing professors. Sociodemographic and occupational variables, as well as variables related to daily habits and lifestyle, were collected. Psychological ill-being was measured using the General Health Questionnaire (GHQ-12) and positive mental health was evaluated with the Positive Mental Health Questionnaire (PMHQ). Prevalence of psychological ill-being (GHQ-12 score >2) among the sample was 27% (range = 21.8% to 32.6%), with a higher prevalence in teachers from first and second cycles (Bachelors degree and Masters degree, respectively) and a lower prevalence in those having very satisfactory social relationships. Significant differences were found in relation to consumption of tranquilizer drugs and Bach flower remedies. PMHQ scores were lower among teachers with a GHQ-12 score >2. Participants presented a good level of positive mental health. Preventive policies should be applied with the aim of reducing psychological ill-being among professors and potentiating positive mental health. [Journal of Psychosocial Nursing and Mental Health Services, 55(7), 38-48.].

Critical thinking: A comparative analysis between nurse managers and registered nurses

AIM To analyse the levels of critical thinking among nurse managers and registered nurses and to explore the association between these levels and socio-demographic and occupational factors. BACKGROUND Critical thinking is an essential skill in advanced clinical nursing. However, few studies to date have explored critical thinking levels in nurse managers or compared them with those recorded in registered nurses. METHODS A randomized sample of 44 nurse managers and 295 registered nurses from a tertiary hospital in Barcelona participated in this study. The Nursing Critical Thinking in Clinical Practice Questionnaire was used to measure the level of critical thinking. The data were analysed using multivariate analysis by logistic regression. RESULTS Levels of critical thinking were higher in nurse managers than in registered nurses. Age, work shift schedule and educational level were associated with a higher level of critical thinking in nurse managers and were predictor factors. CONCLUSIONS This study identified age, work shift schedule and educational level as factors that impact on the acquisition of critical thinking skills among nurse managers. IMPLICATIONS FOR NURSING MANAGEMENT This study provides substantive evidence of the levels of critical thinking among nurse managers. When introducing strategies to enhance these skills, the associated occupational factors should be taken into account.

Psychometric properties of instruments measuring quality and satisfaction in mental health: A systematic review

AIM To identify the methodological quality of each study and analyse the psychometric properties of instruments measuring quality and satisfaction with care from the perspective of mental health patients and professionals. BACKGROUND In recent years, interest in rigorously assessing quality of care in mental health and nursing has increased. Health professionals and researchers should select the most adequate instrument based on knowledge of its measurement properties. REVIEW DESIGN A psychometric review was conducted of the instruments from the perspectives of both patients and professionals according to the COnsensus-based Standards for the selection of health Measurement INstruments panel (COSMIN). DATA SOURCES Articles published from January 2005 - September 2016 were identified in a search of MEDLINE, CINAHL, and SCOPUS. We included studies in English, Spanish, and Portuguese. REVIEW METHODS Inclusion criteria were applied to all articles validated and reviewed by a second independent reviewer. The analysis included the use of the COSMIN checklist and the Terwee quality criteria. RESULTS In the 34 studies selected, a total of 22 instruments which measure quality and satisfaction with care provided, according to patients and/or professionals, were identified. Most are instruments with sound, contemporary theoretical foundations. They vary to the extent to which they have been used in empirical studies and with respect to evaluation of their validity and reliability, although five instruments stand out as yielding good-excellent values in quality criteria. CONCLUSION The present psychometric review found that five of the instruments met valid psychometric criteria. In light of the current economic situation, future reviews should include analysis of the usefulness of instruments based on cost-effectiveness, acceptability, and educational impact.