María Ruzafa-Martínez

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

BackgroundNursing 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.MethodsThe 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.ResultsThe 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.ConclusionsEBP-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.

Effectiveness of a Brief, Basic Evidence‐Based Practice Course for Clinical Nurses

BACKGROUND Barriers to the implementation of evidence-based practice (EBP) by nursing professionals include a lack of knowledge, inadequate skills in searching for and appraising evidence, and consulting research articles. However, few studies have addressed the effectiveness of educational interventions to improve their competence. AIMS To evaluate the effectiveness of a brief basic online and face-to-face educational intervention to promote EBP attitudes, knowledge and skills, and practice in clinical care nurses. METHODS This study was quasi-experimental, pretest-posttest design with a comparison group. The sample included registered nurses enrolled in the free continuing education courses offered in 2013 by the Nursing Council of Jaén (Spain). The study included 109 participants (54 in the intervention group and 55 in the comparison group). The intervention was a brief, basic EBP course with online and face-to-face learning. The comparison group received an educational intervention with different content. The evidence-based practice questionnaire (EBPQ) was used to evaluate EBP attitude, knowledge and skills, and practice before the intervention, and at 21 and 60 days following the intervention. Two-way mixed analysis of variance was conducted. RESULTS There was a significant difference between intervention and comparison groups in the knowledge and skills dimension. The difference between groups was not significant in the EBP practice dimension. Both groups had high scores in the attitude dimension that did not change after the intervention. LINKING EVIDENCE TO ACTION A brief basic educational intervention on EBP with online and face-to-face learning can produce improvements in the knowledge and skills of clinical nurses.

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.

Competencias en investigación: propuesta de la Unidad de coordinación y desarrollo de la Investigación en Enfermería (Investén-isciii)

Resumen Objetivo Establecer y priorizar las competencias en investigacion que deben tener los profesionales de enfermeria en los diferentes niveles academicos (grado, master y doctorado), en la practica asistencial (nivel basico, medio y avanzado) y en la formacion especializada. Metodo Estudio observacional, descriptivo y transversal; desarrollado durante el ano 2006. Tras establecer las competencias genericas y especificas para cada uno de los 7 ambitos mencionados, se enviaron por correo electronico a un grupo de expertos, para que valorasen cada una de las competencias del 1 al 5 (1 = nada importante, 5 = muy importante). Resultados Se recibieron valoraciones de 34 (74%) de los 46 expertos a los que se enviaron las competencias para que las priorizasen. De las competencias genericas, las mejor puntuadas, con una mediana de 5 puntos, han sido “compromiso etico” y “capacidad para trabajar en equipo”. Y acerca de las especificas, “conciencia de la necesidad de fundamentar la practica enfermera en los resultados obtenidos de la investigacion cientifica”, “capacidad para leer criticamente documentacion cientifica” y “capacidad para fundamentar la practica enfermera en los resultados obtenidos de la investigacion cientifica y en la mejor evidencia disponible”. Para el doctorado y nivel avanzado de practica clinica, la mayoria, tanto genericas como especificas, obtuvieron medianas de 5. Conclusiones Las competencias mejor puntuadas han sido las relativas a estimular la actitud critica, etica y de analisis de la informacion en la formacion enfermera de los 3 niveles. Sin embargo, se valora menos el manejo del ingles y la habilidad en el terreno de las relaciones interpersonales.

Expectativas y experiencias de uso de las mujeres gitanas mayores ante los servicios sanitarios de atención primaria

OBJECTIVE To know the expectations and user experiences of older Roma women with health services in primary care (PC). DESIGN Phenomenological qualitative study. Using focus groups (4-9 women/group) and semistructured interviews. Audio recorded from March to November 2011. LOCATION Performed in Úbeda and Linares (Spain). PARTICIPANTS AND SETTING Roma women over 50years. A purposive sample stratified by age and area of residence was carried out. Woman were recruited through community leaders. METHOD Process of qualitative content analysis: coding, triangulation, obtain and verify results. Supported whit the software Nvivo 8. RESULTS Three focus groups and four interviews were conducted, including 23 women. The expectations for the PC are focus exclusively on their physician, being invisible other professionals. They look for a relationship with their physician based on trust. In their user experience with the PC coexist three types of user: who goes to their appointments, demands attention only in acute disease and does not attend appointments and reviews. There are socio-cultural factors related to accessibility. CONCLUSIONS Older Roma women set their expectations and experiences with health service in PC around the binomial disease/physician. Expect attention based on trust and a high instrumentalization. A speech with signs of change directed towards a more active and demanding participation in PC services is observed.Resumen Objetivo Conocer las expectativas y las experiencias de uso de las mujeres gitanas mayores ante los servicios sanitarios de atención primaria (AP). Diseño Estudio cualitativo fenomenológico. Uso de grupos focales (4-9 mujeres/grupo) y entrevistas semiestructuradas. Registradas en audio. Realizadas entre marzo y noviembre de 2011. Emplazamiento Estudio realizado en Úbeda y Linares (España). Participantes y contexto Mujeres gitanas de más de 50 años. Muestreo intencional con criterio de segmentación de edad y zona de residencia. Captación a través de líderes comunitarias. Método Proceso de análisis cualitativo de contenido: codificación, triangulación, obtención y verificación de resultados. Apoyado con el software Nvivo 8. Resultados Se realizaron 3 grupos focales y 4 entrevistas, incluyéndose 23 mujeres. Las expectativas ante la AP se dirigen exclusivamente a su médico, siendo invisibles otros profesionales. Quieren una relación con su médico basada en la confianza. En sus experiencias de uso de la AP conviven 3 tipos de uso: acuden a sus citas, demandan atención solo ante patología aguda y no acuden a citas y revisiones. Existen elementos socioculturales relacionados con la accesibilidad. Conclusiones Las mujeres gitanas mayores plantean sus expectativas y experiencias en los servicios de AP alrededor del binomio enfermedad/médico. Esperan una atención basada en la confianza y con una alta instrumentalización. Se observa un discurso con signos de cambio dirigidos hacia una participación más activa y reivindicativa en los servicios de AP.

Efectividad de la vacuna de la varicela en el contexto de brotes escolares en una zona semiurbana

OBJECTIVE To estimate the effectiveness of the varicella vaccine in school outbreaks during the academic year 2009-2010. MATERIAL AND METHOD Retrospective cohort study in public day-care centers and/or schools in an area in the region of Murcia. Spain. The participants were all children of 1 to 12 years who were in the same classroom where there was an outbreak of varicella. The main measurements were the sociodemographic, clinical and vaccination data, as well as variables related to varicella disease obtained through a questionnaire self-completed by parents, and from the computerized regional immunization registry (VACUSAN). RESULTS A total of 51 varicella outbreaks were detected, with a median of 3 cases per outbreak at both educational levels. The overall vaccination coverage was 10.7% (95% CI 8.63 to 13.18), always being higher in Spanish schoolchildren versus foreign (OR: 21.21, 95% CI: 2.92 to 153.92, P<.001). Discrepancies were found between the vaccine questionnaire data and vaccination program (kappa=0.50, 95% CI: 0.43 to 0.58, P<.001). According to VACUSAN, the overall attack rate was 59.7 (95% CI: 55.82 to 63.43) in unvaccinated and 6.5 (95% CI: 2.54 to 15.45) in vaccinated children. An overall effectiveness of 89.1% (95% CI: 74.55 to 95.35) and 100% was obtained for 1 and 2 doses of vaccine, respectively. CONCLUSIONS There is a high effectiveness of varicella vaccine, emphasizing that the administration of two doses of vaccine produces an adequate and optimal protection against varicella disease. A discrepancy was found between the information provided by parents and official records. Finally, there was a lower vaccination coverage in the immigrant community.

Oleanolic acid induces migration in Mv1Lu and MDA-MB-231 epithelial cells involving EGF receptor and MAP kinases activation

During wound healing, skin function is restored by the action of several cell types that undergo differentiation, migration, proliferation and/or apoptosis. These dynamics are tightly regulated by the evolution of the extra cellular matrix (ECM) contents along the process. Pharmacologically active flavonoids have shown to exhibit useful physiological properties interesting in pathological states. Among them, oleanolic acid (OA), a pentacyclic triterpene, shows promising properties over wound healing, as increased cell migration in vitro and improved wound resolution in vivo. In this paper, we pursued to disclose the molecular mechanisms underlying those effects, by using an in vitro scratch assay in two epithelial cell lines of different linage: non-malignant mink lung epithelial cells, Mv1Lu; and human breast cancer cells, MDA-MB-231. In every case, we observed that OA clearly enhanced cell migration for in vitro scratch closure. This correlated with the stimulation of molecular pathways related to mitogen-activated protein (MAP) kinases, as ERK1,2 and Jun N-terminal kinase (JNK) 1,2 activation and c-Jun phosphorylation. Moreover, MDA-MB-231 cells treated with OA displayed an altered gene expression profile affecting transcription factor genes (c-JUN) as well as proteins involved in migration and ECM dynamics (PAI1), in line with the development of an epithelial to mesenchymal transition (EMT) status. Strikingly, upon OA treatment, we observed changes in the epidermal growth factor receptor (EGFR) subcellular localization, while interfering with its signalling completely prevented migration effects. This data provides a physiological framework supporting the notion that lipophilic plant extracts used in traditional medicine, might modulate wound healing processes in vivo through its OA contents. The molecular implications of these observations are discussed.

Competencia en práctica basada en la evidencia en estudiantes del Grado en Enfermería

AIM Evidence-based practice (EBP) learning has become a key issue for nurses. An EPB subject was included in the 4(th) year in the new syllabus of the Nursing Degree at University of Murcia (UM). To know the competence level in EBP of undergraduate nursing students at UM and compare the results between all four years. METHOD Observational descriptive study with a cross-sectional approach. STUDY POPULATION undergraduate nursing students from all four years at Nursing Degree at the Faculty of Social and Healthcare Science at UM in the year 2013-14. EBP evaluation of competence of the nursing students consisted of attitude, skills and knowledge on EBP. A validated questionnaire, the EBP-COQ, was used. The scale range is 1 point «lowest level» to 5 points «higher level».The SPSS 21.0 program has been used to carry out descriptive and bivariate analyses. RESULTS 144 students were included, 76.4% was female, and the median age was 23 years, 84.7% attended more than 75% class hours. The mean differences in the questionnaire between first and fourth years were 0.58 points in attitude, 0.60 in skills, 1.6 in knowledge and 0.83 in global competence in EBP. Significant differences in mean scores between the fourth and the remaining years in the global competence in EBP were observed, as well as in the three dimensions (p <0.05). CONCLUSION The undergraduate-nursing students studied here have acquired an appropriate competence level in EBP, with a gradual increase by year. The biggest increase was in the fourth year students.

Diseño y validación de un cuestionario sobre conocimientos y hábitos en higiene corporal infantil (HICORIN

OBJECTIVE To develop and validate a questionnaire on the integral assessment of the habits and knowledge in personal hygiene in children between 7 to 12 years old in the educational, social and health environment. DESIGN Cross-sectional study for the validation of a questionnaire. LOCATION One primary and secondary school and one childrens home in the Region of Murcia, Spain. PARTICIPANTS A total of 86 children were included (80 from a primary and secondary school; 6 from a childrens home), as well as 7 experts. MAIN MEASUREMENTS Content validation by experts; qualitative assessment; identify difficulties related to some questions, item response analysis, and test-retest reliability. RESULTS After the literature search, 20 tools that included items related to child body hygiene were obtained. The researchers selected 34 items and drafted 48 additional ones. After content validity by the experts, the questionnaire (HICORIN®) was reduced to 63 items, and consisted of 7 dimensions of child personal hygiene (skin, hair, hands, oral, feet, ears, and intimate hygiene). After with the children some terms were adapted to improve their understanding. Only two items had non-response rates that exceeded 10%. The test-retest showed that 84.1% of the items had between very good and moderate reliability. CONCLUSIONS HICORIN® is a reliable and valid instrument that integrally assesses the habits and knowledge in personal hygiene in children between 7-12 years old. It is applicable in educative and social and health environments and in children from different socioeconomic levels.

Social support and subjective burden in caregivers of adults and older adults: A meta-analysis

Background Despite the generally accepted belief that social support improves caregiver adjustment in general and subjective burden in particular, the literature shows mixed findings, and a recent review concluded that the predictive strength of caregiver social support in determining caregiver burden is less evident, due to the conceptual diversity of this determinant. Objective The purpose of this review is to analyse the relationship of perceived and received social support with subjective burden among informal caregivers of an adult or older adult. Methods A systematic search was carried out up to September 2017 in the following databases: MEDLINE (PubMed), CINAHL, EMBASE, PsycINFO), Scopus and ISI Proceedings, and a meta-analysis was performed with the results of the selected and included studies. Results Fifty-six studies were included in the meta-analysis, which provided 46 independent comparisons for perceived support and 16 for received support. Most of these studies were cross-sectional. There was a moderate, negative association of perceived social support on subjective burden (r = -0.36; CI 95% = -0.40, -0.32) and a very small, negative association of received support on subjective burden (r = -0.05; CI 95% = -0.095, -0.001). Conclusions 1) perceived and received support are not redundant constructs, 2) the relationships between social support and subjective burden depend on whether the social support is measured as perceived or received, 3) the relationship of perceived social support with subjective burden has a bigger effect size than that of received social support, the relation between received support and subjective burden being clinically irrelevant, 4) perceived social support may be a good predictor of subjective burden. Implications of key findings Our findings broadly support interventions promoting social support in caregivers to prevent or alleviate subjective burden, and specifically, to intervene on the promotion of perceived social support more than on the promotion of received social support when preventing or alleviating burden.