Nurs. Rep., Volume 14, Issue 3 (September 2024) – 77 articles

Background: A chronic disease occurring in a person’s life is a stressor, disrupting every aspect of their life. Objectives: This study aims to assess the relationship between functioning in chronic illness and quality of life with the prevalence of symptoms of depression and anxiety in patients with high cardiovascular risk. Material and methods: This study included 200 patients (aged 18–80 years) under the care of a primary care physician, diagnosed with hypertension and/or hypercholesterolemia, and/or diabetes between 6 and 24 months before the enrollment. The presented analysis assessed the symptoms of anxiety and depression using the Hospital Anxiety and Depression Scale (HADS); and the quality of life of patients with cardiovascular disease using the Heart Quality of Life (HeartQoL) questionnaire and functioning in chronic illness using the Functioning in Chronic Illness Scale (FCIS). Results: The HADS scores amounted to 4.34 ± 3.414 points for the HADS-Anxiety subscale and 3.20 ± 2.979 points for the HADS-Depression subscale. The score indicative of functioning in chronic illness assessed with the FCIS was 98.32 ± 13.89 points. The independent predictors of HADS-anxiety were HeartQoL Emotional and FCIS Global, while HeartQoL Global and FCIS Global were the independent predictors for HADS-depression. Better functioning in chronic illness (FCIS Global) was associated with less frequent symptoms of anxiety and depression based on the HADS: HADS-Anxiety (R Spearmann = −0.3969; p < 0.0001) and HADS-Depression (R Spearmann = −0.5884; p < 0.0001). Higher HeartQoL scores, both globally, as well as in emotional and physical dimensions, were associated with a lower severity of anxiety and depression assessed with the HADS: HADS-Anxiety (R Spearmann = −0.2909; p = 0.0001) and HADS-Depression (R Spearmann = −0.2583; p = 0.0002). Conclusions: The quality of life and functioning in chronic illness are connected with symptoms of depression and anxiety. When assessing the severity of the depression symptoms in relation to the individual aspects of functioning in chronic illness, the areas requiring supportive-educational intervention can be identified. The assessment of both functioning in a chronic disease and the severity of the depression symptoms should be included in a standard nursing diagnosis and further supportive and educational intervention. Full article

Background: Over the past two decades, intervention strategies to improve the use of the elimination of mother-to-child transmission (EMTCT) services have been implemented for several reasons. The reasons include elimination of HIV infections during pregnancy, delivery, breastfeeding, prevention of HIV, prevention of unintended pregnancies, and safer conception. Poor utilization of EMTCT services has been proven to put the child at risk of acquiring HIV, which could have been avoided. Objective: This study aims to explore and describe interventions to promote the elimination of mother-to-child transmission services among pregnant and nursing mothers in Africa. Method: A scoping literature review technique was undertaken on research papers published in English that focused on EMTCT, barriers, interventions, and methods to address challenges to EMTCT utilization. These were screened independently and coded. Results: The analysis comprised 14 out of approximately 9029 literature sources. Intervention strategies to improve EMTCT service utilization, according to the findings, include accessibility and affordability, healthcare worker training, integrating the elimination of mother-to-child transmission into maternal and child health services, community-based interventions, family-centred approaches, and the use of technology. Conclusions: Interventions that increase women’s use of EMTCT services will contribute to the aim of HIV-free generation by reducing new HIV infections in children and saving lives. Full article

Background: Amidst current misinformation, media literacy is an essential competency for nursing professionals. This study aimed to analyze the level of media health literacy among Spanish undergraduate nursing students, stratifying the results by gender, region, and other associated factors. Methods: A cross-sectional study was conducted at five Spanish universities (N = 416) using the Spanish version of the Media Health Literacy (MeHLit-SV) Questionnaire. Results: Students presented an average media health literacy score of 48.73 points. The media health literacy level was significantly higher among students from universities in the central and northeastern regions of Spain (ANOVA Test, p = 0.0002), those who had previously studied in a city (ANOVA Test, p = 0.001), those who combined their studies with employment (ANOVA Test, p = 0.001), and those residing in communities with fewer than 500 inhabitants (ANOVA Test, p = 0.001). No differences were found based on gender. Conclusions: The media health literacy level of the students was deficient and varied according to socio-economic and socio-educational factors. Understanding the literacy level of future nurses and promoting the inclusion of this competency in their education will enable them to become leaders in improving the population’s health self-care. Full article

Introduction: Caring for the dying can generate anxiety and emotional distress, particularly in nursing students, and perceived competence could play a crucial role in enabling nurses to perform their duties with greater confidence. Unfortunately, few studies describe the relationship between students’ nursing attitudes and perceived self-efficacy in palliative care (PC). To overcome this gap, this survey aimed to assess the attitudes towards dying patients and the perceived competence of nursing students in palliative care at different universities in the south of Italy. Methods: A cross-sectional study was conducted from September 2022 to March 2023 involving nursing students from the three major Sicilian universities (Italy). The study included a survey investigating socio-demographic characteristics, palliative care training, knowledge about pain management, and previous experience with dying. Moreover, the Professional Competence of the Core Curriculum in Palliative Care Nursing (CCPCN) questionnaire and the Frommelt Attitudes Toward Care of the Dying—B Italian version (FATCOD-B-I) assessed competencies and emotional attitudes. Results: A total of 1913 nursing students were recruited, of which 71.3% were females, and 53.9% were in the age range of 18 to 21 years. In the multivariable analysis, practical PC training was a substantial factor in enhancing competencies (Adj-OR 2.78 [95% CI = 2.12–3.65]). Male students had higher competence odds (Adj-OR 1.38 [95% CI = 1.14–1.66]), and perceived knowledge strongly correlated with self-assessed competence. Advancement in academic years also positively influenced competence self-assessment (Adj-OR 1.98 [95% CI = 1.75–2.24]). Regarding emotional attitudes, a per-quartile increase in competence score was found to improve the attitude score (Adj-OR 1.24 [95% CI = 1.13–1.35]). Conclusions: Nursing students gain valuable experience during clinical experience. PC training and perceived knowledge of PC significantly increase nurses’ competencies, and the latter seem to be strongly associated with attitudes. Thus, introducing palliative care education into nurses’ core curricula could be a way to reduce anxiety and emotional distress in young students. Full article

Dementia increases dependence in older adults and decreases their quality of life and that of their family members. These family members often take on the responsibility of caregiving and suffer from burden and health deterioration due to facing various stressors. The aim is to verify the effectiveness of existing interventions aimed at relieving the burden and stress of informal caregivers of older people with dementia. A scoping review was conducted by consulting the Web of Science, Scopus, ProQuest, and PubMed databases, following the guidelines of the PRISMA 2020 Statement. The review protocol has been registered in PROSPERO under number CRD42024558609. Twenty-six articles met the inclusion criteria and were reviewed, studying the type of intervention design, the sample size of caregivers and their main characteristics, the duration and follow-up, and the variables investigated with their respective measurement instruments. The analysis of the different studies showed that the most developed types of interventions are psychoeducational and cognitive-behavioral therapies, both individual and group. These interventions were mainly effective in reducing the burden and depressive symptoms of caregivers. It is considered advisable to implement more randomized controlled trials for further research, because as the number of caregivers increases, so does the need for affordable and effective interventions. Full article

Background/Objectives: Poisonings among children are a major cause of morbidity and mortality worldwide and present a significant challenge for emergency medical services (EMS). The aim of this study was to analyze the types of substances causing poisonings and the intention of poisonings in children, providing detailed information on the most common causes of poisonings in different age groups. Methods: A retrospective study was conducted analyzing medical records of pediatric patients under the care of emergency medical services (EMS) in Wroclaw, Poland, between 2015 and 2017. The study included all patients under 18 years old diagnosed with poisoning. Data collected included age, sex, cause of poisoning, location of the incident, neurological status (GCS), and the type of healthcare facility. Results: The study included 484 patients, with a mean age of 13 years. The largest age group was 16–18 years (44%), and the majority were female (58%). The most common causes of poisonings were alcohol (29.3%), medications (26%), and intoxicants (24.8%). Over half of the incidents occurred at home (52.5%). Intentional poisonings constituted 75% of cases, particularly involving alcohol (38.6%), intoxicants (32%), and medications (26.7%). Accidental poisonings were mainly due to household chemicals (28.7%) and carbon monoxide (27%). The differences in causes and locations of poisonings were statistically significant (p < 0.001). Conclusions: Our study showed that the most common causes of poisonings among children were alcohol, medications, and intoxicants. Poisonings most frequently occurred at home, especially with medications, while outside the home, alcohol and intoxicants were predominant. This study was not registered. Full article

The implementation and sustainability of evidence-based practice (EBP) is a complex process. Best practice guidelines (BPGs) can facilitate the translation of knowledge from theory into practice, but they require working groups to adapt recommendations and encourage adherence to them. The aim of this study was to identify facilitators and barriers of BPGs in the Registered Nurses’ Association of Ontario^®, within the framework of Best Practice Spotlight Organisations^® (BPSOs^®), in a hospital setting. Methods: This study was conducted using the modified Delphi method (two rounds) with a cohort of BPSO^® Best Practice Champions. The facilitators and barriers included in the first round were identified through a bibliographic search. The degree of concordance was determined in the second round using the highest mean resulting values. Results: A total of 44 nurses responded, with a mean age of 42.57 ± 8.563. The facilitators included the following: work environment; working in a hospital that encourages research; and dedicating time to EBP (p < 0.001). The barriers included the following: excessive workload; professional mobility (p < 0.001); and lack of time (p = 0.002). Implications for practice: As such, it is necessary to approach human resource management by implementing new policies that guarantee systemic sustainability. The BPSO^® programme is an excellent framework for promoting the translation of theoretical knowledge into practice and effecting institutional change. Full article

Background: Games are a promising strategy for rehabilitating older adults. The effect of games on promoting healthy lifestyles and preventing frailty remains uncertain. This article aims to describe the process of development and validation of the game “Bem-me-quer para a saúde”^® to promote the acquisition of healthy lifestyles and prevent frailty in over 65-year-olds. Methods: This study comprised three distinct phases, spanning from December 2023 to June 2024. The first phase comprised a thorough review of the scientific literature on the frailty and lifestyles of older adults, a second phase of game design, and a third phase of content and semantic validation conducted by specialized nurses and older adults. Results: After revising literature, this study utilized an e-Delphi with a panel of 14 specialist nurses who underwent two rounds of evaluation. The “Bem-me-quer para a saúde”^® game includes a puzzle board with 54 pieces and 30 educational cards. In the final phase, we evaluated the game on a cohort of 50 older adults, highlighting its reflective, interactive, and educational aspects. Conclusions: The game presented sufficient evidence of content validity and relevance to clinical practice. We should conduct additional research to evaluate its impact on lifestyle modification and frailty prevention. Full article

Objective: The aim of this study was to evaluate the effectiveness of an interactive program designed to reduce nursing students’ perceived stress and improve self-efficacy and readiness to professionally address incivility during clinical practice. Background: Incivility in clinical settings adversely impacts learners, educators, institutions, and healthcare systems, undermining safety and the teaching–learning process. Despite its increasing global prevalence, effective interventions remain largely unexplored. Methods: Our mixed-methods study, conducted from March to April 2024, involved senior baccalaureate pre-licensure nursing students (N = 35) from a California State University. The three-week, one-hour-per-week, interactive clinical incivility management program was developed through an extensive literature review. Pre- and post-intervention differences were assessed using a 10 min self-administered online survey that included the Uncivil Behavior in Clinical Nursing Education (UBCNE; 12 items), Perceived Stress Scale (PSS; 10 items), General Self-Efficacy Scale (GSE; 10 items), and a sample characteristics questionnaire (11 items). A one-hour face-to-face focus group (n = 11) then provided qualitative data on personal experiences of clinical incivility. Quantitative data were analyzed using SPSS version 27, while qualitative data were analyzed using Colaizzi’s method. Results: Clinical incivility prevalence was 71.4% (n = 25 out of 35). No statistically significant differences were found in UBCNE, PSS, and GSE scores between pre- and post-intervention. However, professional responses to clinical incivility significantly improved after the intervention (t = −12.907, p < 0.001). Four themes emerged from the qualitative data: (a) uncivil behaviors or language from nurses, (b) emotional discouragement and low self-confidence, (c) resource and personnel shortages at clinical sites for education, and (d) the necessity for interventions to manage clinical incivility. Conclusions: Nursing schools and clinical agencies should collaborate to establish monitoring systems, enhance communication, and implement evidence-based policies and interactive interventions to prevent and manage clinical incivility experienced by nursing students from clinical sites. Full article

The most frequently performed invasive procedures in hospitals and healthcare centers are needle-related procedures, such as intravenous cannulation and phlebotomy, and they are identified as the major sources of pain, fear, and anxiety in children and adolescents. The objective of this systematic review was to evaluate the effectiveness of VR as a distraction measure to reduce pain, fear, and anxiety in children and adolescents undergoing needle-related invasive procedures. For this purpose, the CINAHL, Scopus, WOS, and Cochrane Library scientific databases were used. The protocol review was registered in PROSPERO (ID:42024563245), and inclusion and exclusion criteria were applied. Twenty-one studies were included in the systematic review, involving a total of 2663 participants. Significant differences favored the use of virtual reality for the control of pain intensity (WBFSpatients p = 0.001; MD = −1.83; 95% CI −2.93 to −0.72; WBFSparents p = 0.0002; MD = −2.61; 95% CI −4.00 to −1.23; WBFSnurses p = 0.0001; MD = −2.71; 95% CI −2.82 to −2.60; VAS/NRS p = 0.001, MD = −0.71; 95% CI −1.13 to −0.28), anxiety (CAMpatient p = 0.02, MD = −2.92; 95% CI −5.45 to −0.38; CAMparents p = 0.01, MD = −3.87; 95% CI −6.99 to −0.75) and fear (CFSpatients p = 0.0005, MD = −1.27; 95% CI −1.99 to −0.56; CFSparents p = 0.0005, MD = −1.33; 95% CI −2.08 to −0.58; and CFSnurses p = 0.04, MD = −1.13; 95% CI −2.24 to −0.03). However, high heterogeneity was noted. The use of virtual reality as a distraction appears to be a valuable strategy for reducing pain, fear, and anxiety during needle-related procedures, although further studies with higher methodological rigor, based on a standardized protocol, are needed. Full article

Background: The belief in the evil eye is defined as the power to cause harm through ‘negative energy’ obtained through a glance. The practice of “medicine of the evil eye or sa mexina de s’ogu” by the “feminas e ominis de mexina” (healers) is so deeply rooted in the Sardinian culture that it influences health practices. Transcultural nursing, conceptualised by Madeleine Leininger, emphasises the importance of providing health care that takes into account patients’ cultural beliefs, practices and values. This study aims to explore, from the perspective of Madeleine Leininger’s transcultural nursing theory, the perception of the “feminas e ominis de mexina” practising “sa mexina de s’ogu”, in order to promote and raise awareness among health professionals of the importance of patients’ beliefs and cultures. Methods: A qualitative phenomenological study was conducted. Data were collected using semi-structured face-to-face interviews. The interviews were transcribed, read thoroughly, and analysed. Results: Fourteen healers were interviewed. Six main themes were extracted: (1) figure of the healer in its social context; (2) dynamics and methodology related to rituals; (3) effects of the Evil Eye; (4) ritual demand; (5) effectiveness of the ritual; and (6) comparison between the ancient and modern world. Conclusions: These findings suggest that healers act as central pillars in the connection between traditional medicine and religious practices. In response to the results obtained, it is essential to train healthcare personnel in transcultural nursing in order to provide care that is respectful and in harmony with the individual’s beliefs, promoting their comfort and well-being, and their health outcomes. Full article

Adequate coordination between healthcare levels has been proven to improve clinical indicators, care costs, and user satisfaction. This is more relevant to complex or vulnerable patients, who often require increased care. This study aims to evaluate the differences between hospital discharge follow-up indicators, including number of general practitioners’ (GPs) and community nurses’ (CNs) consultations, presentiality of consultations, type of first post-discharge consultation, and time between hospital discharge and first consultation. Vulnerable and non-vulnerable patients were compared. A longitudinal retrospective study was carried out in the north of Tenerife on the post-discharge care of patients discharged from the Canary Islands University Hospital (Spanish acronym HUC) between 1 January 2018 and 31 December 2022. The results obtained show deficiencies in the care provided to patients by primary care (PC) after being discharged from the hospital, including delayed first visits, low presentiality of those visits that were less frequent even with increased patient complexity, scarce first home visits to functionally impaired patients and delays in such visits, and a lack of priority visits to patients with increased follow-up needs. Addressing these deficiencies could help those most in need of care to receive PC, thus reducing inequalities and granting equal access to healthcare services in Spain. Full article

Background: Palliative care provides holistic support, addressing physical, psychological, social, emotional, and spiritual dimensions of suffering, known as “total pain”, to improve patients’ quality of life. Patients often rely on healthcare professionals, particularly nurses, for support. This study aimed to develop and validate questionnaires assessing nurses’ perceptions of psychological, social, and spiritual issues in palliative care and their effectiveness in managing them. Methods: Two self-rated questionnaires were created: the Psychological, Social, and Spiritual Problems of Palliative Patients’ Questionnaire and the Effectiveness in Coping with the Psychological, Social, and Spiritual Challenges of Palliative Care Patients. The study surveyed 237 nurses caring for palliative patients in Split Dalmatian County, Croatia. Results: The questionnaires demonstrated high reliability with Cronbach’s α values of 0.98 and 0.99. Factor analysis revealed four factors for the first questionnaire and three for the second. Nurses primarily perceived patients as experiencing fear and emotional/spiritual suffering, with the greatest difficulty coping with the fear of the disease outcomes. Nurses acknowledged the need for improvement in addressing patient challenges, highlighting gaps in the Croatian system. Conclusions: Ongoing efforts are crucial to prioritize palliative care globally, with nursing professionals playing a vital role in symptom management. Full article

Grief is a natural and self-limited adaptation process to a new reality that emerges after a significant loss (whether real or perceived), with a broad variety of manifestations that exert an impact on a grieving person’s health. The study aim was to synthesize the evidence available about the interventions carried out by Primary Health Care nurses, by means of an individual approach to reduce maladaptive grief or maladaptive grief risk. A scoping review was conducted (November and December 2023) through searches in Medline, Cinahl, Web of Science, ProQuest and Scopus using MeSH terms combined with Booleans. Primary research of any design in adult people undergoing grief situations and receiving professional assistance by nurses in the primary, home and community care contexts published after 2009 in English, Spanish or Portuguese languages were included. Excluded publications were those conducted in in-hospital clinical settings and which did not correspond to research designs or the gray literature. The screening process was carried out by two reviewers using the appropriate JBI critical appraisal tools for each design and discrepancies were resolved by a third reviewer. A total of n = 10 studies were included (n = 4 qualitative, n = 2 RCTs, n = 1 quasi-experimental, n = 2 cross-sectional observational, and n = 2 mixed methods). The qualitative studies identified topics and subtopics of professionals’ and families’ experiences of grief. The observational studies analyzed symptoms and factors associated with the grieving process. Interventions consisted of cognitive–behavioral therapies delivered by psychological specialists who assessed the severity of grief in a range of cultural contexts using different instruments. The evidence retrieved from the studies that address the reduction in maladaptive grief or maladaptive grief risk is not conclusive. There is a need to increase both the number and the methodological quality of studies assessing the effectiveness of Nursing care in Primary Health Care for individuals experiencing maladaptive grief or maladaptive grief risk. Further research should focus on experimental studies, developing specific interventions conducted by nurses to address individual’s grief and prevent maladaptive grief. Full article

Comprehending the significance of legacy in end-of-life (EoL) situations helps palliative care professionals enhance person-centered outcomes for those with a life-threatening illness and their families. Our purpose was to conduct a concept analysis of legacy in EoL care. By employing Walker and Avant’s approach, we identified the concept’s defining characteristics. Subsequently, we established the antecedents, consequences, and empirical referents. After conducting a thorough review of titles and abstracts, a total of 30 publications were analyzed. These articles were sourced from three databases (CINAHL, Medline via PubMed, and Scopus) from 2002 to 2023. Our analysis identified several core attributes of legacy: (a) leave behind something of value that transcends death; (b) determine how people want to be remembered; (c) build and bestow across generations; (d) integrate advance care planning through EoL conversations and shared decision-making; and (e) develop strategies of dignity-conserving care. The consequences are related to improvements in spiritual and subjective well-being; coping with inevitable EoL existential issues; decreases in EoL suffering; engendering self-awareness, hope, gratitude, and peace; achieving and maintaining dignity; creating good memories; promoting mutually constructive and transformative relationships; and fostering the adjustment of bereaved people. Nevertheless, further effort is required to implement the key attributes of legacy that form the basis for creating legacy-oriented interventions near the EoL. Full article

The healthcare environment faced by nurses is complex, with high workloads and situations of high comorbidity. The integration of nurses into the work environment is a cause for concern, and improvements are sought for their incorporation into the workforce. The benefits of mentoring programs are described not only for nurses but also for patients with safer practices and benefits for the institution due to the increased commitment of its professionals. A methodological article that illustrates the complete process to design and implement a tutoring program for new nurses in an emergency department is presented. The competency profile required for the figure of tutor was developed, including the steps followed for the development of the program and the structure and phases of which it is composed, as well as the validation of the evaluation instruments of the process. A strength was the participation of experts during the in-depth analysis of the competency profile, as well as in the adaptation of the evaluation items, which endorses the pertinence, relevance, usefulness, and clarity of the content of this program. The transparency in this methodology makes it possible to follow the steps for its reproduction and applicability in other hospitals. Full article

Background: Collaborative Online International Learning (COIL) involves international online activities that allow the support of transversal competencies in diverse and multicultural environments without moving from home. This paper presents the learning experiences and satisfaction of undergraduate nursing students at the University of Girona (Spain) from a COIL activity involving clinical simulation in collaboration with the University of Coventry (United Kingdom). Methods: Qualitative study of content analysis. Twelve students from each of the two universities participated in the data collection process using reflective diaries. Results: The data analysis highlighted five topics related to the COIL activity involving clinical simulation: (a) initial attitudes towards the COIL activity; (b) main learning through the COIL activity; (c) positive aspects of the COIL activity; (d) weaknesses of the COIL activity and proposals for improvement; and (e) overall evaluation of the COIL activity. Conclusions: The main learning outcomes referred to by students were the relationships between transversal competencies and the skills for life, language skills, cultural skills, and more specific skills related to clinical standards. The students were most satisfied with the teaching activities and specified positive aspects and weaknesses that will add value to future versions of the activities. Full article

Our study aims to estimate the prevalence of depressive symptomatology among older adults and to assess their association with loneliness and quality of life according to institutionalisation status in a Portuguese sample. Background: The World Health Organisation estimates that by 2050, the world’s population over 60 will number two billion people, which poses complex challenges in terms of maintaining the mental health of older adults. The COVID-19 pandemic has increased the prevalence of depressive symptoms in this population, but the post-pandemic phase has not yet been studied much. Methods: A cross-sectional survey was carried out in 2023 among institutionalised and non-institutionalised older adults (total n = 525; institutionalised = 458; non-institutionalised = 67) who were selected by convenience sampling. The Patient Health Questionnaire (PHQ-9) was used to assess the presence of depressive symptoms, the WHOQOL-BREF to assess perceived quality of life and the Loneliness Scale (UCLA) to assess negative feelings of loneliness. Unconditional logistic regression models were fitted to compute crude adjusted odds ratios (ORs) and the respective 95% confidence intervals (95%CIs) for the association between sociodemographic, clinical and psychosocial characteristics and depressive symptomatology, according to institutionalisation status. The final model was adjusted for sex, age, QoL and feelings of loneliness. Results: Of the 525 participants, 74.6% of the non-institutionalised participants had no or minimal depressive symptoms, while 55.4% of the institutionalised participants fell into this category. Mild to moderately severe depressive symptoms were present in 25.4% of the non-institutionalised participants. 26.9% of the institutionalised participants had mild symptoms, 11.8% had moderate symptoms, 3.9% had moderately severe symptoms, and 2.0% had severe depressive symptoms. Overall, a higher quality of life was associated with lower levels of depressive symptoms. Participants describing feelings of loneliness were more likely also to present depressive symptoms (OR = 78.10; 95%CI 2.90–2106.08 and OR = 3.53; 95%CI 1.72–6.91 for non-institutionalised and institutionalised older adults, respectively), independently of institutionalisation status. Conclusions: The prevalence of depressive symptoms is high in older adults, which means that it has not decreased after the increase seen due to the COVID-19 pandemic. A lower perception of quality of life and the presence of negative feelings of loneliness are associated with the presence of depressive symptoms. These conclusions suggest that plans should be developed to intervene in the dimensions of depressive symptoms, perceived quality of life and negative feelings of loneliness. Full article

The evaluation of the competencies corresponding to the different professional profiles of future nursing graduates is fundamental to their training. In this regard, students’ self-evaluation must be part of their training. This study aimed to develop and psychometrically test the Perceived Self-Efficacy in Nursing Competencies (PSENC) Scale. This study was conducted in two phases: selecting and adjusting items and assessing the instrument’s psychometric properties. A sample of 1416 students completed the scale online. Exploratory factor and confirmatory factor analyses were conducted. Inferential analysis was carried out. The exploratory factor analysis of the PSENC scale with 20 items resulted in five factors (76.3% of variance). All factors showed Cronbach’s alpha coefficients > 0.70. The confirmatory factor analysis measurement model showed satisfactory and adequate goodness-of-fit indices. The developed scale showed the psychometric adequacy and usefulness to the self-assessment of nursing students regarding their self-efficacy expectations in competencies during their clinical practicum. This study was not registered. Full article

In recent years, there has been an increase in the practice of chemsex, which is becoming an increasingly serious public health problem. The complex interaction between chemsex and mental health underscores the need to understand the psychological, social, and environmental factors that influence this practice. Methods: A qualitative descriptive phenomenological study was conducted in the community of Madrid, Spain to explore the depth of the chemsex phenomenon through a thematic analysis. Between April and June 2024, interviews were conducted with 15 MSM (gay, bisexual, and other men who have sex with men) who participate in these practices, using purposive and snowball sampling. Results: three main themes were identified, namely, (T1) contextualization of the practice, (T2) factors associated with chemsex, and (T3) strategies and interventions for risk and harm reduction. Conclusion: Chemsex is a phenomenon that combines sexual practices with substance use in complex social environments, presenting significant risks to physical, mental, and sexual health. It is necessary to implement public health interventions to mitigate these risks. Full article

Background: Heart failure significantly impacts healthcare systems and society, affecting quality of life (QoL) due to its symptoms and continuous care needs. Nurses are crucial in managing heart failure, supporting both patients and caregivers who face physical, emotional, social, and spiritual challenges. The Family Caregiver Quality of Life (FAMQOL) scale evaluates caregivers’ QoL across all dimensions. This study aims to translate and culturally adapt the FAMQOL from English to Italian, enhancing its utility in nursing research and practice to better identify and support caregiver well-being. Methods: Following EORTC guidelines (2017), the FAMQOL underwent linguistic validation and cultural adaptation. This included independent forward translations from English to Italian, back translations, and reconciliation discussions to produce a testable translation. A pilot test with 15 caregivers assessed the questionnaire’s acceptability and comprehensibility. Results: Linguistic adjustments ensured the questionnaire’s understandability in Italian. Interviews confirmed its acceptability and comprehensibility, with minor modifications enhancing clarity. Conclusions: The translation process successfully adapted the FAMQOL for Italian caregivers. This tool is essential for nursing research and practice, providing a culturally relevant assessment of the burden of care. It allows targeted interventions to support health workers, intercepting the QoL of caregivers early and, consequently, the well-being of patients with heart failure. Full article

Background: Postpartum depression is a public health problem that affects a considerable percentage of women. Despite the proliferation of related apps, there are limited data available on the best apps to prevent postpartum depression. We identified which apps available in Spanish could be recommended by midwives based on their content, quality, and behaviour change techniques, as a complementary tool for preventing postpartum depression in women. Methods: A systematic search was performed to identify apps available on iOS App Store and Google Play, which were used to replicate how patients’ access “postpartum depression prevention” apps. Apps’ quality, behaviour change potential, and contents were assessed. Results: A total of 1408 apps were identified, of which 7 were retrieved for assessment (0.5%). The mean objective and subject quality were 3.1 (SD = 1.01) and 2.7 (SD = 1.27), respectively. A total of 24 topics were identified. The mean ABACUS score was 6.6 (SD = 3.64), and the mean number of topics addressed by the apps was 9.9 (SD = 5.90). Conclusion: The results of the present study suggest that a specific free app is not available in Spanish for the prevention of postpartum depression, and only a small percentage of free apps should be recommended based on their quality, BCTs, and contents. The systematic review protocol was not registered. Full article

Background: The use of complementary therapies in the general population is increasing, so it is necessary to understand the training that health professionals receive in this type of therapy in their training plans, as they are often the primary source of information for patients. Our aim was to investigate Spanish universities that offer subjects on complementary therapies in their nursing degree programs. Methods: This study is an observational, descriptive, cross-sectional study. For this purpose, we used a document published on the website of the Ministry of Universities as the working document. Additionally, a literature search was conducted up to September 2023 in the PubMed database, along with reverse searches. Results: Out of a total of 62 universities, only 16 (29%) offer a subject related to this type of therapy, 27.5% (11) are public universities and 22.7% (5) are private universities, most of them being optional subjects. Conclusions: The training content on complementary care in nursing degree programs in Spanish universities is scarce, highlighting the potential benefit of expanding and promoting it, in line with the recommendations of the World Health Organization. Full article

Background: The number of people who access social networking sites continues to increase at an exponential rate. The use of technology is an essential skill for nursing professionals and its development represents a challenge in improving health education, promotion and care. The objective of this systematic review is to analyse the use of social networking sites by healthcare professionals as an intervention tool for evidence-based public health education. Methods: The protocol of this umbrella review was registered in the International Prospective Register of Systematic Reviews (CRD42023407249). Searches were carried out in MEDLINE (PubMed), Web of Science, CINAHL, PsycINFO (EBSCOhost), and Cochrane Library of Systematic Reviews, in February 2023. A narrative synthesis of the results was conducted. Results: 1896 articles were found, of which 15 reviews fulfilled the inclusion criteria. Social networks broadened the profession; they were YouTube, X (formerly Twitter), Facebook, and Instagram. The target population was mainly young professionals, and they came across different topic areas that addressed health education. Conclusions: It is important to have information backed by scientific evidence to make health decisions. Health professionals active on social networking sites have a unique opportunity to educate the public about health by sharing scientific evidence in an accessible and clear way, which helps to combat misinformation. Full article

Understanding and addressing dehumanization in healthcare is crucial due to its profound impact on patient care, ethical implications on patient dignity and autonomy, and its potential to affect the psychological well-being of healthcare professionals. The primary aim of this study was to establish reliable and valid instruments measuring two different types of dehumanization, namely animalistic dehumanization (i.e., stripping one of their uniquely human characteristics) and mechanistic dehumanization (i.e., stripping one of their human nature characteristics) among healthcare professionals. In this cross-sectional validation study among healthcare professionals, we tested measures of both animalistic and mechanistic dehumanization, focusing on the dehumanization of patients (hetero-dehumanization) and oneself (self-dehumanization), respectively. All measures were developed and validated based on a concept analysis, a literature review, and an appraisal of pre-existing scales. The research was conducted among 400 nurses and medical doctors employed in Greek public hospitals. Coefficient validity ratio results showed that 100% of items were acceptable for both measures. The newly established and validated hetero-dehumanization scale encompassed two factors (factor 1: animalistic dehumanization, factor 2: mechanistic dehumanization; Cronbach’s alpha was equal to 0.86 for each measure). The self-dehumanization scale was a mono-factorial measure of mechanistic dehumanization (Cronbach’s alpha = 0.97). Two validated measures of (self- and hetero-) animalistic and mechanistic dehumanization measures were developed for the assessment of dehumanization among health professionals, which will form the basis for future research in this important scientific field. Full article

Background: Chemsex has been defined as the deliberate use of drugs for prolonged sexual intercourse between gay and bisexual men and other men who have sex with men (MSM). Drugs associated with chemsex can trigger mental health problems such as anxiety, depression, risk of psychosis and suicidal ideation, social isolation, stigmatization, and even loss of impulse control and lack of coping strategies. Currently, the increase in illicit drugs in a sexual context is considered an outbreak of a public health emergency. Objective: The aim of this study is the construction and validation of the Chem-Sex Inventory (CSI), a new scale to assess the mental health risk of chemsex behaviors. Methods: A cross-sectional design was conducted to study 563 participants. Data were collected through an online questionnaire between January and April 2023, and the construct validity of the CSI was assessed through exploratory and confirmatory factor analysis. Results: The sample was, on average, 36 years old (SD: ±9.2). The majority of gender identity was cisgender (97.7%). A factor structure was found that can be summarized in four dimensions: emotional instability, risk of psychosis, altered body perception, and risk of suicide. The confirmatory factor analysis (CFA) presents adequate reliability values, with a Cronbach’s alpha above 0.87 for all dimensions and a McDonald’s omega above 0.88 with a good fit of the 42 items. Conclusions: Our study has shown that the Chem-Sex Inventory (CSI) scale has factorial validity and could be used in clinical practice and research to measure the behavioral contribution of the chemsex phenomenon in MSM. Full article

The aim of the study is to assess the psychometric properties of the Portuguese version of the 18-items Dysfunctional Attitudes Scale (Form B) in a Portuguese sample of people aged 60 and over. Background: The 18-item Dysfunctional Attitudes Scale (Form B) is an instrument for assessing dysfunctional attitudes and can be useful as a predictor of depression for both initial episodes and relapses Methods: This was a one-stage cross-sectional survey of Portuguese-speaking people aged 60 years and over, able to read and write, functionally autonomous, and living in the community in their usual residences. The instrument was evaluated for its psychometric properties. Convergent validity with the Beck Depression Inventory-II was assessed. Results: The Portuguese version of the 18-item Dysfunctional Attitudes Scale (Form B) was structured into three factors, which explained a total of 58.95% of the total variance of the instrument. The exploratory factor analysis resulted in a modified model in which three factors were obtained with an eigenvalue greater than one (Kaiser’s criterion). Three factors were obtained instead of two as in the original study. It showed an internal consistency (Cronbach’s alpha = 0.770) and an interclass correlation coefficient ranging from 0.166 to 0.449, and the overall convergent validity with the Beck Depression Inventory-II was considered good; Conclusions: The Portuguese version of the Dysfunctional Attitudes Scale (DAS-18B) of people aged 60 and over demonstrated good psychometric properties. Full article

Background. Nurses’ perceptions of health are essential to decision making and communicating with clients. However, little is known about their own perceptions of this phenomenon. This study focuses on health-related beliefs among young nurses enrolled in a master’s-level nursing program using a modified photovoice methodology. Methods. The study population was 87 nurses undergoing a master’s degree in nursing at Jagiellonian University Medical College in Krakow, Poland, participating in an obligatory health psychology course. For the modified photovoice activity, the participants took three photos related to their perceptions of (1) health, (2) health protective factors, and (3) health risk factors. The data interpretation involved a thematic analysis of these photos and captions; a narrative analysis to distinguish between documentary and symbolic photos; and a descriptive analysis of the photo production. Results. Eighty-seven students completed the photography assignment. The mean age was 22.1 years (SD = 1.1). Most photos (91%) documented real-life health behaviours. Some photos (9%) used everyday objects such as sunflowers to create symbols related to health. A photo series showed a model of the human brain in different environments and activities. Conclusions. Student participation in the photovoice activity appeared to strengthen observation and interpretation skills, which are essential to client care. Students used this opportunity to reflect on their own lives and environments and show their perceptions of health, health protective factors, and health risks. The activity planted seeds for changes in students’ health perceptions and critical thinking. Future research could explore whether participation in a modified photovoice activity as experiential learning in a required health psychology course contributes to changes in master’s-level nursing students’ personal health behaviours and client care. Full article

Patients with substance use disorders may view healthcare professionals as capable of supporting them through their suffering and experience. Although numerous studies have focused on the roles, approaches, and attitudes of healthcare professionals, there is a lack of information on the nursing perspective. This study aims to explore the experiences and nursing approaches towards patients with psychoactive substance dependence admitted to an Italian acute hospital ward. A qualitative phenomenological study was conducted. Data were collected using semi-structured face-to-face interviews. The interviews were transcribed, read thoroughly, and analysed. Fifteen nurses were interviewed. Six main themes were extracted: (1) origin context, (2) participants’ personal thoughts, (3) type of approach provided, (4) school education received on the topic, (5) effectiveness of rehabilitative therapy, and (6) methods that can improve nursing care. The findings suggest that most respondents experience stigma and discrimination when providing care to these patients. In response to the results obtained, models have been suggested, such as Jean Watson’s Human Caring Theory, which shows how practising a holistic approach based on empathy and active listening can improve the relationship between nurses and patients. Furthermore, to eliminate stereotypes, it would be appropriate to act on the university education of nurses. This study was not registered. Full article