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Simulation inFamily and Community Nursing: Description of Anxiety Levels and Their Relationship With the Sense of Coherence, Satisfaction, and Self-Confidence in University Students
(WILEY, 2025-09-06) da-Silva-Domingues, Henrique; Moreno-Cámara, Sara; Palomino, Pedro Ángel
A Systematic Review and Meta‑analysis of Gamified Affective Sexual Health Interventions in Schools
(Springer, 2025-04-01) Sierra‑Yagüe, Alba; Zafra‑Agea, José Antonio; Aguilar‑Quesada, Ana; González‑Cano‑Caballero, María; del‑Pino, Rafael; Lima, Marta
Abstract Introduction Adolescent sexual education targets risk reduction in STIs, pregnancies, and gender inequality. Inadequacies in traditional methods drive exploration of innovative approaches. This systematic review aims to synthesise, compare, and evaluate gamified affective sexual health interventions for adolescents within the school. Methods A systematic literature review was conducted across five databases from March 2022, with an update in December 2023, including PubMed, Scopus, PsycINFO, WOS, and EMBASE. Experimental studies of gamified interventions in schoolbased affective sexual health for adolescents aged 10–19 years were included. Methodological quality was assessed using the Quality Assessment Tool for Quantitative Studies by the Effective Public Health Practice Project. The selected articles were conducted primarily in the USA, encompassing 13 randomised controlled trials, two quasi-experimental studies, and one clinical trial. A subsequent meta-analysis was conducted using the random-effects model to calculate combined effect sizes and 95% confidence intervals (CI). Results Interventions yielded positive short and long-term impacts, improving attitudes, knowledge, and behaviours, and delaying sexual initiation. Studies revealed a statistically significant effect in follow-ups of less than six months, with 81% of outcomes showing positive impacts on delaying the initiation of any sexual activity and 50% on contraceptive use, knowledge, and improved attitudes. In follow-ups exceeding six months, a consistently positive and significant effect was maintained, ranging between 19% and 62.5%, for the delay in sexual initiation, contraceptive use, knowledge, and attitudes. The results from the meta-analysis indicate that gamified interventions are effective in delaying sexual initiation among adolescents, achieving an 15% reduction in the probability of initiating sexual relationships. Conclusions To enhance affective sexual health, a recommended methodological framework standardizes the design of universal interventions, enabling comprehensive effectiveness analysis. Emphasizing the encouragement of early initiation of interventions, adopting technological advances to enhance traditional education and address contemporary challenges in adolescent sexual health is highlighted. Policy Implications Sex education is essential to prevent risky behaviours, unwanted pregnancies, and STIs. This requires effective educational programmes that improve knowledge, skills, attitudes, and behaviours in a standardised way that is accessible to all adolescents.
Relationship Between Perceived and Received Social Support in Family Caregivers: A Systematic Review with Meta-Analysis
(MDPI, 2024-11-12) Gutiérrez-Sánchez, Belén
Antecedentes: El cuidado de las personas dependientes es eminentemente familiar y, en muchas ocasiones, existe un alto nivel de dedicación a dicho cuidado familiar. El cuidado constante y continuado conlleva una serie de consecuencias psicológicas negativas. El apoyo social se ha relacionado con una mejor salud mental en cuidadores familiares. Encontramos resultados heterogéneos en cuanto a la relación entre los tipos de apoyo social recibido y el nivel de apoyo percibido. Además, hasta donde sabemos, ninguna revisión analiza esta relación entre cuidadores familiares. Objetivos : Por tanto, nos proponemos sintetizar sistemáticamente las relaciones entre el apoyo social percibido y recibido en cuidadores informales. Metodología : Hemos realizado una revisión sistemática cuantitativa con metaanálisis, registrada en PROSPERO (id: CRD42023470047); la búsqueda sistemática se realizó en las siguientes bases de datos: PubMed, CINAHL, PsycINFO y Scopus, hasta noviembre de 2023. Tras la selección y revisión de los resultados, se obtuvieron doce estudios, dos de los cuales fueron eliminados por un alto riesgo de sesgo de clasificación. Resultados : En cuanto a los resultados, se encontró una asociación estadísticamente positiva de tamaño medio (r = 0,43). Los resultados fueron consistentes, precisos y robustos. La prueba Trim and Fill mostró una variación del 7%. El análisis de subgrupos no indicó diferencias en el grupo de edad de las personas atendidas (adultos o niños), sesgo de selección y sesgo de confusión. Conclusiones : En conclusiones, el apoyo social percibido se relaciona con un mayor apoyo social recibido por los cuidadores familiares.
Effectiveness of Internet-Based or Mobile App Interventions for Family Caregivers of Older Adults with Dementia: A Systematic Review
(MDPI, 2024-07-27) de-Moraes-Ribeiro, Fabiane Elizabetha; Moreno-Cámara, Sara; da-Silva-Domingues, Henrique; Palomino-Moral, Pedro Ángel; del-Pino-Casado, Rafael
Introduction: Global aging presents socioeconomic and health challenges. Dementia, a growing concern, affects millions of older adults, intensifying the burden on family caregivers. E-health interventions offer hope through technological solutions, although current research is limited. This study evaluated the effectiveness of internet-based or mobile app interventions for family caregivers of older adults with dementia. Methodology: A systematic review with a narrative synthesis was conducted using databases (PubMed, CINAHL, Scopus, LILACS, and PsycInfo) and the bibliographies of retrieved articles, with no restrictions on time or language. Results: The search yielded 2092 results, of which 22 studies met the inclusion criteria, encompassing a total of 2761 family caregivers. Twenty-one different outcomes were evaluated and classified into three main types of interventions: psychoeducational, psychotherapeutic, and multicomponent. Conclusions: The study highlights the importance of internet-based and mobile app interventions in supporting family caregivers of older adults with dementia. These interventions positively affect many aspects of caregiver well-being, suggesting their utility in addressing this group’s emotional, social, and self-care needs.
Validation of the Paykel Suicide Scale and the Plutchik Suicide Risk Scale in Spanish Women during the Perinatal Period
(WILEY, 2024-07-23) Martínez-Galiano, Juan Miguel; Martínez-Vázquez, Sergio; Peinado-Molina, Rocio Adriana; Hernández-Martínez, Antonio
Introducción . No se dispone de instrumentos específicos para detectar el riesgo de suicidio en mujeres durante el periodo perinatal. El suicidio en mujeres perinatales está poco estudiado a pesar de ser una de las principales causas de mortalidad materna. Su prevalencia ha aumentado un 100% en Estados Unidos en una década. Además, tiene consecuencias para la madre y el recién nacido. Objetivo . Validar la Escala de Suicidio de Paykel y la Escala de Riesgo de Suicidio de Plutchik en mujeres españolas durante el periodo perinatal. Material y Métodos . Estudio transversal con mujeres españolas embarazadas o que habían dado a luz hace menos de 18 meses. Se recogió información sobre variables sociodemográficas, variables obstétricas y del recién nacido. Se utilizó un cuestionario que incluía ambas escalas de suicidio y la Escala de Depresión Postnatal de Edimburgo (EDPS). Se realizó un análisis factorial exploratorio (AFE), validación convergente y de criterio, así como análisis de consistencia interna. Resultados . En total participaron 237 mujeres. El AFE determinó que en la Escala de Riesgo de Suicidio de Plutchik 4 componentes explicaron el 54.8% de la varianza, mientras que en la Escala de Paykel, un solo componente explicó el 53.0% de la varianza. En la validez convergente, el riesgo de suicidio o ideación suicida se relacionó en la Escala de Riesgo de Suicidio de Plutchik y la Escala de Suicidio de Paykel, respectivamente, con las variables: percepción de bajo apoyo social, riesgo de violencia de pareja, nivel de ansiedad, antecedente de patología mental y haber vivido un evento estresante en el último año, entre otras ( p < 0.05). El área bajo la curva de características operativas del receptor para las puntuaciones de la Escala de Riesgo de Suicidio de Plutchik fue de 0.88 (IC 95%: 0.82–0.93), y para la Escala de Paykel, fue de 0.90 (IC 95%: 0.85–0.95). El valor del alfa de Cronbach ( α ) se situó para la Escala de Riesgo Suicida de Plutchik en 0,806 y para la Escala de Suicidio de Paykel en 0,766. Conclusión . Ambas escalas presentaron características psicométricas adecuadas para ser utilizadas como instrumento de cribado del riesgo suicida en mujeres españolas en el periodo perinatal.
Lifestyles of university students: analyzing the role of social support and family dynamics
(BMC PUBLIC HEALTH, 2024-12-18) da Silva-Domingues, Henrique; Palomino, Pedro Ángel; Gutiérrez-Sánchez, Belén; Moreno-Cámara, Sara; Almeida Macedo Loureiro, Helena Maria; del Pino, Rafael
Background Youth is a critical stage for developing healthy lifestyles, as the habits and behaviors formed during this period can persist into adulthood. Understanding the relationship between family factors and the lifestyles of university students can contribute to creating strategies to improve this important health determinant. This research aimed to analyze the relationship between social support, family dynamics, and lifestyles in young university students. Design: A cross-sectional descriptive study. Methods A probability sample of 530 young university students was analyzed. The main measurements included social support, family dynamics, and lifestyles. Descriptive analysis of quantitative and qualitative variables was performed. Pearson correlation coefficient was used for bivariate analysis, and Student’s t-test was used to analyze differences between male and female participants. Additionally, multivariate analysis was conducted using multiple linear regression. Results For the total sample, a positive and moderate association was found between family dynamics (r = 0.28) and social support (r = 0.32) with the lifestyles of young individuals. Conclusions Our results indicated that social support and family dynamics are possible protective factors that have a positive effect on the lifestyles of university students. The findings of this study highlight the importance of family and familial support in adopting healthy lifestyles among university students.
Development and validation of the Pressure Injury Prevention Barriers questionnaire in hospital nurses in Spain
(BMJ, 2020-12-30) López-Franco, María Dolores; Parra-Anguita, Laura; Comino-Sanz, Inés; Pancorbo-Hidalgo, Pedro Luis
Objective: To develop and validate a new questionnaire to measure the nurses’ perceptions of the barriers towards the prevention of pressure injuries (PIs) at hospitals. Design: Validation study with mixed methods. Setting: Four university hospitals in southern Spain. Participants: The questionnaire was developed based on a literature review. A panel of 14 wound care experts rated the content validity. A sample of 438 nurses (registered nurses and assistant nurses) participated in the survey. Main outcome measures: The psychometric properties of the Pressure Injury Prevention Barriers (PIPB) questionnaire evaluated were: content validity, internal consistency reliability and construct validity. Results: The final version of the questionnaire has 25 items grouped into four factors (management and organisation, motivation and priority, knowledge, and staff and collaboration). The confirmatory factor analysis showed good fit and error indices for the model (Comparative Fit Index=0.92, root mean square error of approximation=0.074). Cronbach’s alpha was 0.90 (overall), and 0.89 (factor 1), 0.75 (factor 2), 0.72 (factor 3) and 0.45 (factor 4). Construct validity was good, demonstrated by the expected association with the scores on patient safety culture and on considering PIs as an adverse effect of hospital stay, but not with attitude score. Conclusion: The PIPB questionnaire is an instrument useful for measuring nurses’ perceptions of the barriers to PIs prevention. The initial evidence shows that the questionnaire has good content validity, internal consistency and adequate construct validity. Relevance and comprehensiveness need to be assessed in further studies. It can be used both in research and in the evaluation of clinical settings to implementation of PIs preventive programmes in hospitals.
Undergraduate nursing students' knowledge of Alzheimer's disease and related dementias care
(ELSEVIER, 2022-03) Parra-Anguita, Laura; López-Franco, María Dolores; Del Pino-Casado, Rafael; García-Fernández, Francisco Pedro; Pancorbo-Hidalgo, Pedro Luis
Background: The increase in the number of people with Alzheimer's disease and Related Dementias (ADRD) will results in an increased need for nurses with up-to-date knowledge of ADRD and who are well-educated in ADRD care. Therefore, it is important to be sure that this topic is covered in the undergraduate nursing curriculum. Purpose: To assess undergraduate nursing students' knowledge of Alzheimer's disease and related dementias care. Method: Cross-sectional study carried out among nursing students at two universities in southern Spain. The University of Jaen (UJA)-Alzheimer's Care scale was used to measure their knowledge. Results: The mean age of the students was 21.39 years, and 83.2% of the 678 students were women. For students, the UJA Alzheimer's Care scale has a good fit and reliability of 0.99 for the items and 0.74 for the persons, according to the Rasch model. The mean knowledge score of nursing students was 15.33 (SD 3.69) out of 23; (95%CI: 15.06–15.61). The value of the latent variable (theta) was 1.16 (SD 1.21); (95%CI: 1.06–1.25). The factors positively associated with students' knowledge were the number of years in the program, experience in caring for a patient with ADRD during their placements, and the education on ADRD received in the nursing program as self-rated by the students. Conclusion: The UJA-Alzheimer's Care scale is a useful tool for measuring knowledge of ADRD care among nursing students in Spain and other Spanish-speaking countries. Nursing students at the two universities reached moderate scores in the knowledge of ADRD care. More years in the nursing program, practical experience in clinical placements, and higher self-rated level of education on ADRD received during the program were associated with higher scores on knowledge.
Effects of climate change in the elderly’s health: a scoping review protocol.
(BMJ, 2022) Montoro-Ramírez, Eva María; Parra-Anguita, Laura; Álvarez-Nieto, Carmen; Parra-Anguita, Gema; López-Medina, Isabel María
Introduction Climate change is a global problem that affects human health, especially the most vulnerable groups, including the elderly. However, no scope review includes the perspective of institutions specialised in climate change and health and whose reports are the basis for policies orientated on the environmental health. Therefore, this study aims to identify these effects on older people health. The results will allow health professionals to have valuable information enabling them to provide quality care in meeting the demand that this situation is producing. Methods and analysis A scoping review of the relevant literature will be performed from 2008 to 2021. The Joanna Briggs Institute guidelines and the PRISMA- Scoping Review Extension checklist will be used. A peer- reviewed search will be conducted using the electronic databases Medline, Scopus, Cumulative Index to Nursing and Allied Health Literature, Cochrane, PsycINFO and Cuiden Plus between October and December 2021. Original quantitative studies and reports from official agencies on the effects of climate change on the elderly health in any health and geographical context will be included. Literature selection will be made by two reviewers. The table format used for data extraction will be reviewed by the review team and tested by two reviewers. Ethics and dissemination This study does not require approval by an ethics committee to be conducted. This article will result in the mapping of the direct and indirect effects of climate change on the health of the elderly. The results will be published in scientific journals to be accessible to health professionals in the creation of care plans for the elderly at climate risk.
Efectividad de las intervenciones educativas para la prevención del embarazo en la adolescencia.
(Elsevier, 2019-09) Sanz-Martos, Sebastián; López-Medina, Isabel María; Álvarez-García, Cristina; Álvarez-Nieto, Carmen
Objetivo: Evaluar la efectividad de las intervenciones educativas dirigidas a prevenir el embarazo en la adolescencia. Diseño: Revisión sistemática. Fuentes de datos: Se consultaron las bases de datos PubMed, CINAHL, Scopus, Cuiden Plus, LILACS e IME para buscar estudios sobre intervenciones educativas para la prevención del embarazo en la adolescencia. Selección de estudios: Se seleccionaron un total de 24 investigaciones primarias, donde se evaluaba el efecto de un programa educativo para la prevención del embarazo en la adolescencia. La calidad de los estudios seleccionados se evaluó usando la escala CASPe. Resultados: Los programas educativos que midieron una modificación de la tasa de embarazo en la adolescencia muestran resultados poco concluyentes, ya que 2 investigaciones obtienen una reducción y otros 2 no hallan cambios significativos. Sin embargo, los programas educativos se muestran efectivos para aumentar el nivel de conocimiento sobre sexualidad y métodos anticonceptivos, y para modificar las actitudes sobre el riesgo de embarazo en la adolescencia o las actitudes hacia el uso de los métodos anticonceptivos. No se encuentran diferencias estadísticamente significativas entre los estudios que muestran un resultado positivo y los estudios con resultado negativo (p > 0,05) para ninguno de los resultados analizados en la revisión. Conclusión: No existe una modalidad de intervención que sea la más efectiva para la prevención de un embarazo en la adolescencia. Se necesita un mayor número de investigaciones con un abordaje longitudinal que valoren no solo resultados intermedios, sino una modificación en la tasa de embarazo.
AMEE Consensus Statement: Planetary health and education for sustainable healthcare
(Taylor & Francis, 2021) Shaw, Emily; Walpole, Sarah; McLean, Michelle; Álvarez-Nieto, Carmen; Barna, Stefi; Bazin, Kate; Behrens, Georgia; Chase, Hannah; Duane, Brett; El Omrani, Omnia; Elf, Marie; Faerron, Carlos A.; Falceto, Enrique; Gibbs, Trevor J.; Groome, Jonny; Hackett, Finola; Harden, Jeni; Hothersallr, Eleanor J.; Houriane, Maca; Huss, Norma May; Ikiugu, Moses; Joury, Easter; Leedham-Green, Kathleen; MacKenzie-Shalders, Kristen; Madden, Diana Lynne; McKimm, Judy; Schwerdtle, Patricia Nayna; Parkes, Margot W; Peters, Sarah; Redvers, Nicole; Sheffield, Perry; Singleton, Judith; Tun, SanYouMay; Woollard, Robert
The purpose of this Consensus Statement is to provide a global, collaborative, representative and inclusive vision for educating an interprofessional healthcare workforce that can deliver sustainable healthcare and promote planetary health. It is intended to inform national and global accreditation standards, planning and action at the institutional level as well as highlight the role of individuals in transforming health professions education. Many countries have agreed to ‘rapid, far-reaching and unprecedented changes’ to reduce greenhouse gas emissions by 45% within 10 years and achieve carbon neutrality by 2050, including in healthcare. Currently, however, health professions graduates are not prepared for their roles in achieving these changes. Thus, to reduce emissions and meet the 2030 Sustainable Development Goals (SDGs), health professions education must equip undergraduates, and those already qualified, with the knowledge, skills, values, competence and confidence they need to sustainably promote the health, human rights and well-being of current and future generations, while protecting the health of the planet. The current imperative for action on environmental issues such as climate change requires health professionals to mobilize politically as they have before, becoming strong advocates for major environmental, social and economic change. A truly ethical relationship with people and the planet that we inhabit so precariously, and to guarantee a future for the generations which follow, demands nothing less of all health professionals. This Consensus Statement outlines the changes required in health professions education, approaches to achieve these changes and a timeline for action linked to the internationally agreed SDGs. It represents the collective vision of health professionals, educators and students from various health professions, geographic locations and cultures. ‘Consensus’ implies broad agreement amongst all individuals engaged in discussion on a specific issue, which in this instance, is agreement by all signatories of this Statement developed under the auspices of the Association for Medical Education in Europe (AMEE). To ensure a shared understanding and to accurately convey information, we outline key terms in a glossary which accompanies this Consensus Statement (Supplementary Appendix 1). We acknowledge, however, that terms evolve and that different terms resonate variably depending on factors such as setting and audience. We define education for sustainable healthcare as the process of equipping current and future health professionals with the knowledge, values, confidence and capacity to provide environmentally sustainable services through health professions education. We define a health professional as a person who has gained a professional qualification for work in the health system, whether in healthcare delivery, public health or a management or supporting role and education as ‘the system comprising structures, curricula, faculty and activities contributing to a learning process’. This Statement is relevant to the full continuum of training – from undergraduate to postgraduate and continuing professional development.
Nursing students' attitudes towards climate change and sustainability: A cross-sectional multisite study
(Elsevier, 2022-01) Álvarez-Nieto, Carmen; Richardson, Janet; Navarro-Perán, María Ángeles; Tutticci, Naomi; Huss, Norma May; Elf, Marie; Anåker, Anna; Aronsson, Jennie; Baid, Heather; López-Medina, Isabel María
Background: Education is a social tipping intervention necessary for stabilising the earth's climate by 2050. Integrating sustainable healthcare into healthcare professions curricula is a key action to raise awareness. Objectives: This study aimed to: i) investigate nursing students' attitudes towards and awareness of climate change and sustainability issues and its inclusion in nurse education, ii) explore differences across a range of countries, and iii) compare attitudes in 2019 with those of a similar sample in 2014. Design: A cross-sectional multicentre study. Data were collected through the Sustainability Attitudes in Nursing Survey (SANS_2) questionnaire. Settings: Seven different universities and schools of nursing in five countries (UK, Spain, Germany, Sweden, and Australia). Participants: A convenience sample of first-year undergraduate nursing students. Methods: The SANS_2 questionnaire was self-administered by nursing students at the seven participating universities at the start of their undergraduate degree, between September 2019 and February 2020. Results: Participants from all seven universities (N = 846) consistently showed awareness and held positive attitudes towards the inclusion of climate change and sustainability issues in the nursing curriculum (M = 5.472; SD: 1.05; min-max 1-6). The relevance of climate change and sustainability to nursing were the highest scored items. Esslingen-Tübingen students scored the highest in the 'inclusion of climate change and sustainability in the nursing curricula'. Students at all universities applied the principles of sustainability to a significant extent at home. Nursing students' attitudes towards climate change and sustainability showed significantly higher values in 2019 (Universities of Plymouth, Brighton, Esslingen-Tübingen, Jaen, Murcia, Dalarna, and Queensland) than in 2014 (universities of Plymouth, Jaen, Esslingen, and Switzerland). Conclusions: Nursing students have increasingly positive attitudes towards the inclusion of sustainability and climate change in their nursing curriculum. They also recognise the importance of education regarding sustainability and the impact of climate change on health, supporting formal preparation for environmental literacy. It is time to act on this positive trend in nursing students' attitudes by integrating these competencies into nursing curricula.
Student nurses' knowledge and skills of children's environmental health: Instrument development and psychometric analysis using item response theory
(Elsevier, 2018-10) Álvarez-García, Cristina; Álvarez-Nieto, Carmen; Pancorbo, Pedro Luis; Sanz-Martos, Sebastián; López-Medina, Isabel María
Background: Climate change has an important impact on health, particularly in children. Therefore, the inclusion of environmental issues in the undergraduate nursing curriculum is essential. Knowledge and skills in environmental sustainability can be measured through questionnaires. Objectives: The aim of this study was to develop and validate the Children's Environmental Health Knowledge Questionnaire (ChEHK-Q) and the Children's Environmental Health Skills Questionnaire (ChEHS-Q) to measure knowledge and skills, respectively, about children's environmental health in nursing students. Design: This was an observational, cross-sectional study undertaken in four phases: (1) Development of the questionnaire and item wording, (2) content validation by an expert panel, (3) pilot test and (4) psychometric evaluation. Settings: A Faculty of Health Sciences in Spain. Participants: 308 nursing students enrolled in the first, third and fourth years of study. Methods: The development and validation of the children's environmental health questionnaires was carried out based on the item response theory. Results: The 26-item ChEHK-Q shows good fit and reliability of 0.98 for items and 0.70 for people based on the Rasch Model. The 12-item ChEHS-Q also shows good fit and reliability of 0.87 for items and 0.76 for people based on Andrich's rating scale model. The temporal stability measured using the intraclass correlation coefficient was 0.86 in the ChEHK-Q and 0.73 in the ChEHS-Q. Both questionnaires present enough evidence for construct validity; they work well to distinguish between nursing students with low or high knowledge of or skills in children's environmental health. Conclusions: The Children's Environmental Health Knowledge Questionnaire and the Children's Environmental Health Skills Questionnaire are useful tools for measuring knowledge and skills, respectively, among nursing students. This validation study obtained good psychometric properties concerning validity and reliability.
Sustainability education in nursing degree for climate-smart healthcare: a quasi-experimental study
(Emerald Publishing Limited, 2024-07-26) Álvarez-Nieto, Carmen; Parra-Anguita, Laura; Álvarez-García, Cristina; Montoro-Ramírez, Eva María; López-Franco, María Dolores; Sanz-Martos, Sebastián; López-Medina, Isabel María
Purpose– In light of the world’s accelerating march towards a sustainable future, the education for sustainable healthcare must be sufficiently acknowledged in health professions curricula. Early integration of these competences into nursing degree programme emphasizes its importance and applicability. This paper aims to investigate the effectiveness of an educational sustainability intervention in higher education to change nursing students’ attitudes towards sustainability and climate change, and environmentalawareness. Design/methodology/approach– A quasi-experimental study was performed with repeated measures between September 2019 and May 2023. Undergraduate students were introduced to sustainability and climate change in the context of healthcare using scenario-based learning and augmented reality over the courses in nursing degree. Participants’ attitudes and awareness were collected by online questionnaires. Findings– The educational intervention showed effectiveness in significantly improving attitudes towards climate change and sustainability, and the environmental awareness for changing their clinical practice (p < 0.01). However, students struggled to apply sustainability and address unsustainable practices in healthcare settings. Originality/value– This study shows an effective model of curricular sustainability that can be implemented in other universities and health disciplines. The findings highlighting the importance of sustainability education in nursing and its potential to drive positive change in healthcare practice and society at large. Embedding key topics aligned with sustainable development goals in the curriculum prepares nursing or health workforce to address planetary health and implement sustainable practices that provide climate-smart care.
Coping and anxiety symptoms in family carers of dependent older people: Mediation and moderation effects of subjective caregiver burden
(Wiley, 2024-01-05) López-Martínez, Catalina; Orgeta, Vasiliki; Frías-Osuna, Antonio; Del-Pino-Casado, Rafael
Introduction: Coping responses influence anxiety symptoms experienced by informal carers. However, only a few studies have investigated the longitudinal association between coping responses and anxiety symptoms in family carers. We also currently have limited knowledge on the mediating or moderating influence of subjective caregiver burden on this relationship over time. The aim of the present study was to investigate the longitudinal relationship between coping and anxiety symptoms in family carers of dependent older people, and examine the mediating or moderating role of subjective caregiver burden over time.Design: Prospective longitudinal study.Methods: We recruited and enrolled participants from a probability sample of 132 family carers of older dependent relatives. We measured coping strategies, anxiety symptoms, subjective caregiver burden, and several covariates (sex and intensity of care) at baseline and at 1-year follow-up. We used generalized estimating equations with multiple imputations to examine associations over time.Results: Considering both direct and indirect effects through subjective burden, anxiety symptoms were positively associated with proactive coping (B = 0.13), planning(B = 0.15), self-distraction (B = 0.24), denial (B = 1.15), venting (B = 0.94) and self-blame(B = 0.90), and negatively associated with positive reframing (B = −0.83) and acceptance (B = −0.75). Subjective caregiver burden moderated the relationship between anxiety symptoms and planning, and the use of denial as a form of coping.Conclusions: Our results show that subjective caregiver burden is an important moderator and mediator of the longitudinal association between coping responses and anxiety symptoms in carers.Clinical Relevance: Proactive coping and planning when subjective burden is low, self-distraction, denial, venting, and self-blame significantly increase levels of anxiety and caregiver burden in carers over time. Acceptance and positive reframing however as coping responses are associated with lower levels of anxiety and caregiver burden long-term. Our findings highlight the need for a multi-dimensional approach in future caregiving interventions.
Evaluating Satisfaction and Self-Confidence among Nursing Students in Clinical Simulation Learning
(MDPI, 2024-04-25) Moreno-Cámara, Sara; da-Silva-Domingues, Henrique; Parra-Anguita, Laura; Gutiérrez-Sánchez, Belén
Background: Clinical simulation is effective in nursing student education, fostering autonomous learning and critical skill development in safe environments. This method is adaptable to dynamic educational approaches and integrates technology. Satisfaction and self-confidence are key elements in its evaluation. The general objective of this research was to describe the levels of satisfaction and self-confidence among undergraduate nursing students regarding the use of clinical simulation in the field of family and community nursing. Methods: A cross-sectional descriptive study was conducted at the University of Jaén, Spain, during the 2023/2024 academic year. Data on sociodemographic aspects, satisfaction, and self-confidence were collected using a validated instrument. The statistical analysis included central measures, dispersion, and frequencies, with confidence intervals. Results: The study involved 96 students in scenario 1 (family assessment) and 97 in scenario 2 (family intervention), with the majority being women. In scenario 1, the mean satisfaction score was 4.38 out of 5, and self-confidence was scored 4.44 out of 5. Prior preparation time correlated significantly with higher levels of satisfaction and self-confidence. In scenario 2, the mean scores were slightly higher but not statistically significant. Conclusions: Our study demonstrated high levels of satisfaction and self-confidence among nursing students following clinical simulations. Prior preparation was associated with better outcomes, and the quality of the simulation positively impacted the results.
Dry care versus chlorhexidine cord care for prevention of omphalitis. Systematic review with meta-analysis
(2019) López-Medina, María Dolores; Linares-Abad, Manuel; López-Araque, Ana Belén; López-Medina, Isabel M
Objective: to compare the effect of dry care and the application of chlorhexidine to the umbilical cord of newborns at risk of developing omphalitis. Method: systematic review with meta-analysis. Clinical trials comparing dry care with the application of clorexidine to evaluate omphalitis were selected. Methodological quality was evaluated using the Consolidated Standards of Reporting Trials. Results: the joint analysis of the studies shows a significant decrease in the risk of omphalitis in the chlorhexidine group compared to the dry care group (RR=0.58, CI: 0.53-0.64). However, in the analysis by subgroups, chlorhexidine umbilical cord care did not reduce the risk of omphalitis in hospital births (RR=0.82, CI: 0.64-1.05), in countries with a low infant mortality rate (RR=0.8, CI: 0.5-1.28), or at chlorhexidine concentrations below 4% (RR=0.55, CI: 0.31-1). Chlorhexidine acted as a protective factor at a concentration of 4% (RR=0.58, CI: 0.53-0.64), when applied in cases of home births (RR=0.57, CI: 0.51-0.62), in countries with a high infant mortality rate (RR=0.57, CI: 0.52-0.63). Conclusion: dry cord care is effective in countries with low infant mortality rate and in hospital births. However, 4% chlorhexidine for umbilical cord care protects against omphalitis in home births, in countries with a high infant mortality rate.
Knowledge, skills and attitudes related to evidence-based practice among undergraduate nursing students: A survey at three universities in Colombia, Chile and Spain
(2019) Sánchez-García, Inmaculada; Ureña-Molina, Pilar; López-Medina, Isabel M; Pancorbo-Hidalgo, Pedro L
Teaching nursing students about the model of evidence-based practice is a challenge for university faculty. The aim of this study was to measure knowledge, skills and attitudes related to evidence-based practice among undergraduate nursing students, as well as associated factors. The study involved a cross-sectional design using a survey of all students enrolled in a Bachelor of Nursing programme (1st to 4th year) in three nursing faculties of universities in Chile, Colombia and Spain. The Spanish version of the Evidence-Based Competence Questionnaire was used to measure knowledge, skills, attitudes and overall competency. In total, 875 students completed the questionnaire. The overall score of competency in evidence-based practice was similar in all three universities (range 1–5) (3.63 in Chile, 3.58 in Colombia and 3.68 in Spain). The score of self-rated attitudes was strongly correlated with the overall competency measured. More hours of training in research methods and reading nursing journals articles in the last month were the factors associated with higher scores in evidence-based practice competency. The undergraduate nursing students at the three universities surveyed obtained a high score in overall competency in evidence-based practice. No differences were found among them, despite the different approaches used in educational programmes.
Competencies On Environmental Health And Pedagogical Approaches In The Nursing Curriculum: A Systematic Review Of The Literature
(2019) López-Medina, Isabel María; Álvarez-Nieto, Carmen; Grose, Jane; Elsbernd, Astrid; Huss, Norma May; Huynen, Maud; Richardson, Janet
It has been suggested that climate change is the biggest threat to public health for the 21st Century; increased demand on health services will impact on already overstretched resources and systems will need to be able to respond. However limited attention is given to climate change and sustainability in nursing education; there is no clear guidance on curricula content for nurses or recommendations regarding the skills and competencies that will be required. Literature published in Dutch, English, German, and Spanish was searched and 32 papers met the inclusion criteria for the review. Results suggests that holistic/systems thinking is relevant to healthcare so bringing a ‘sustainability lens’ to nursing curricula could be seen as being consistent with wider determinants of health. The literature review has identified the educational approaches necessary to provide a broad based curriculum and a cross-disciplinary approach. The findings suggest that topics such as the use of resources, food, health promotion, globalism, disease management, and the environmental impact of delivering healthcare, if embedded in nursing education could support the nursing profession's response for this new and important aspect of healthcare.
Undergraduate Nursing Students' Attitudes, Knowledge and Skills of Children´s Environmental Health. Journal of Nursing Education.
(2019) Álvarez-García, Cristina; Álvarez-Nieto, Carmen; Sanz-Martos, Sebastián; Puente, Daniel; López-Leiva, Inmaculada; Gutiérrez-Puertas, Lorena; Cantón, Vanesa; Porcel, Ana María; Lavedán, Ana; Sarabia, Raquel; López-Medina, Isabel María
BACKGROUND:Nurses are in a privileged position to detect environmental risks among children. The objective was to determine attitudes, knowledge, and skills related to children's environmental health in undergraduate nursing students. METHOD:A cross-sectional study was designed in eight universities (n = 2,462) from September 2017 to June 2018. Descriptive values and multivariate analysis of variance were calculated using three questionnaires. RESULTS:Of the total 2,462 students in the sample, 2,155 had a good attitude regarding addressing children's environmental health problems, 501 had good knowledge, and 1,162 had good skills. Students who had attended a session on sustainability more than 3 months prior had a better attitude (9.93%), knowledge (11.16%), and skills (3.82%). Second course students and men had better environmental competency (p < .001). CONCLUSION:Undergraduate nursing students have good attitudes; however, they lack knowledge and skills. There is a need to include children's environmental health in nursing curricula. [J Nurs Educ. 2019;58(7):401–408.]

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