Cultural adaptation and validation of the caring behaviors assessment tool into Spanish

BACKGROUND

The aim of the research was to translate, culturally adapt and validate the Caring Behaviors Assessment (CBA) tool in Spain, ensuring its appropriateness in the Spanish cultural context.

METHODS

Three-phase cross-cultural adaptation and validation study. Phase 1 involved the transculturation process, which included translation of the CBA tool from English to Spanish, back-translation, and refinement of the translated tool based on pilot testing and linguistic and cultural adjustments. Phase 2 involved training research assistants to ensure standardized administration of the instrument. Phase 3 involved administering the transculturally-adapted tool to a non-probabilistic sample of 402 adults who had been hospitalized within the previous 6 months. Statistical analyses were conducted to assess the consistency of the item-scale, demographic differences, validity of the tool, and the importance of various caring behaviors within the Spanish cultural context. R statistical software version 4.3.3 and psych package version 2.4.1 were used for statistical analyses.

RESULTS

The overall internal consistency of the CBA tool was high, indicating its reliability for assessing caring behaviors. The subscales within the instrument also demonstrated high internal consistency. Descriptive analysis revealed that Spanish participants prioritized technical and cognitive aspects of care over emotional and existential dimensions.

CONCLUSIONS

The new version of the tool proved to be valid, reliable and culturally situated, which will facilitate the provision of objective and reliable data on patients beliefs about what is essential in terms of care behaviors in Spain.

Describing Non-Binary People's Encounters with the Healthcare System: A Qualitative Study in Catalonia (Spain)

Non-binary people face numerous stressors in their daily lives, including personal, interpersonal, and environmental. These stressors gain strength when such individuals access healthcare services, and discrimination and cisgenderism become the main barrier to obtaining gender-affirming healthcare. This study aimed to describe the experiences of non-binary people regarding the care and medical attention received in Catalonia (Spain). A qualitative phenomenological study was conducted with 21 non-binary people recruited using snowball sampling in 2022. Data were gathered through open-ended interviews and analyzed using thematic analysis. Two main themes were identified, which were further classified into two categories each: Theme 1-This is me composed of the categories, "My Name and My Pronouns" and "One's Chosen Gender," and Theme 2-I do not exist for the health system consisting of "Uneducated Health System in Sexual Health" and "Feeling Like an Outsider for Being Non-Binary." Non-binary people face multiple stressors when accessing the healthcare services that makes them feel invisible, vulnerable, and marginalized. Further widespread implementation of person-centered care is essential to promote the relationship between non-binary people and the healthcare system. In addition, further sexual health training is required for all health professionals.

Non-pharmacological management for chemotherapy-induced nausea and vomiting in patients with cancer: a scoping review†

Objective

This review aimed to map and summarize published studies that tested non-pharmacological management for chemotherapy-induced nausea and vomiting (CINV).

Methods

We searched for eligible studies in 5 electronic databases and screened the retrieved studies using the inclusion and exclusion criteria. Data were then collated according to the types of interventions, measurement tool, and outcomes.

Results

The search yielded 2343 records, of which 11 were included. Four categories of non-pharmacological CINV management were made; manipulative and body-based therapy (n = 5 studies); mind–body therapy (n = 3 studies); biologically based practice (n = 1 study), and energy therapy (n = 2 studies). Seven different scales were used to measure CINV. Nine studies reported improvement in CINV.

Conclusions

This scoping review demonstrates the breadth of non-pharmacological management to address CINV. Various types of CINV scales were used to measure CINV severity. The management and scale can be utilized to improve nursing care, particularly in cancer care.

Nurses' Experiences of Care at Crisis Resolution Home Treatment Teams: A case study research

WHAT IS KNOWN ON THE SUBJECT?: There are many international studies on CRHTTs; however, there has been little research on nurses' experiences of working with CRHTTs. Earlier studies focused on the nurses' gatekeeping role but did not explore nurses' perception of care as a construct. WHAT DOES THE PAPER ADD TO EXISTING KNOWLEDGE?: This study provides information based on mental health nurses' experiences. It explains the home environment, the therapeutic relationship and the process of mental health nursing care during a crisis. Also, the study explains nurses' satisfaction with care provided at patients' home. Unlike other studies, this study focused on nurses' experiences while providing care, rather than on nurses' general responsibilities and the services they provide. This study is the first of its kind in Spain with such a focus. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Acknowledging nurses' experiences and their perspectives about the care they provide could help shift mental health nursing paradigms from those based on biomedical models to newer perspectives found in recovery models. Furthermore, this knowledge could improve the quality of care in mental health settings due to its potential to guide nursing practices. Raising mental health care providers' awareness of mental health nurses' personal and professional care constructs would help implement support systems to meet the professional's needs. Meeting the needs of nurses related to the care they provide is likely to impact patient care positively.

ABSTRACT

INTRODUCTION: Crisis resolution home treatment teams (CRHTTs) provide short-term, intensive home treatment to people experiencing mental health crises. There is limited research on nurses' experiences with CRHTTs. While earlier studies mainly focussed on mental health nurses' gatekeeping responsibilities, more investigation is needed in this field.

AIM

To explore nurses' perceptions and constructions about care in CRHTT services.

METHOD

A qualitative case study was employed. Ten semi-structured interviews were performed to nursing staff working in CRHTT services.

RESULTS

Three main categories emerged from the data analysis: nurses' perspectives of the care provided, nursing setting of care at home and nursing care plan at home.

DISCUSSIONS

Findings revealed that nurses experienced greater satisfaction providing care in the home settings, and therefore, it positively impacted the quality of care and reduced patient's stigma. This study also relates the value of developing care plans centred on patients' environments increasing Mental Health Nursing (MHN) work satisfaction.

IMPLICATIONS FOR PRACTICE

Knowledge of the intrinsic experiences of care provided by nurses in CRHTTs may help facilitate the development of the nursing role in CRHTT by improving understanding of care in mental health settings.

Nursing students first experience on high fidelity simulation: A phenomenological research study

AIM/OBJECTIVE

This study aimed to explore the perceptions of nursing students towards their first experience with high-fidelity simulation (HFS) in a Spanish university.

BACKGROUND

Simulation experiences are becoming more popular in nursing education, allowing students to practice clinical skills before encountering actual patients.

METHODS

A phenomenological approach was used. Sixteen in-depth, semi-structured, qualitative one-on-one interviews were conducted among second-year undergraduate nursing students who had completed a scheduled HFS training program. The interview transcripts were analyzed using Colaizzi's phenomenological method.

RESULTS

Four themes were identified: "Learning through simulation"; "Acting like a nurse instead of being a student"; "Facilitators and barriers of learning"; and "Transition from simulation to reality."

CONCLUSION

This study provides support for including high-fidelity simulation programs in the nursing curricula to enhance student preparedness for clinical placements.

Student's satisfaction and intercultural competence development from a short study abroad programs: A multiple cross-sectional study

Nurses should be culturally competent to care appropriately to all patient groups. Whilst there are many opportunities to obtain clinical experiences, there are less curriculum-based opportunities to develop cultural competencies. This multiple cross-sectional study aimed to explore the development of intercultural awareness, knowledge, and competence in two different nursing students' groups (2016 and 2017 program edition) during a one-week study abroad program hosted by a European network of 14 higher education institutions. A questionnaire was designed specifically for the study and reliability established. Factor analysis confirmed three dimensions: perceived benefits, satisfaction, and acquisition of learning outcomes. Fifty-eight students (71.6%) completed the questionnaire for the April 2016 group, and 60 (88.2%) from the April 2017 group. There were minimal differences in responses between the two groups which suggested perceived benefits were retained one year later. Ratings were high for perceived satisfaction, perceived benefits; and the learning outcomes with regard to cultural competencies. Overall, the one-week program was considered a success and students would recommend it to others. This study concludes that a short, one-week study abroad program enabled nursing students to develop individually as well as develop cultural competencies in healthcare.

Early Patient Experiences of Primary Above-the-Knee Amputation From Vascular Etiologies: A Phenomenological Study

The aim of this study was to explore the different meanings of the experience of lower-limb amputation due to vascular causes in the time period from the fifth to twelfth week post-amputation. A phenomenological study involving semi-structured interviews was carried out. Data collection took place in a Public Hospital in Spain and included a convenience sample of 20 patients who had undergone amputation. The study highlighted patients' fears related to mobility, pain, dependence, and autonomy. Moreover, patients experience of the rehabilitation process and resources for adaptation were described as well as all the changes related to the social environment. The figure of a nurse was considered essential after amputation by the patients. This study provides a deep understanding of their experiences at the immediate time after amputation considering patients demographical associations and the etiology of the vascular pathology. This could be the starting point to understand patients' immediate needs upon discharge.

Nurses' perceptions of patient safety culture: a mixed-methods study

BACKGROUND

There are relatively few qualitative studies concerning patient safety culture.

METHODS

We aimed to explore patient safety culture as perceived by the nursing staff in two public hospitals in Catalonia, Spain. A mixed-methods design was employed using a questionnaire, in-depth interviews, and non-participant observations.

RESULTS

Sixty-two percent of the nursing staff rated patient safety as "Acceptable" but was not higher because of work pressure and lack of resources as perceived by staff. "Teamwork within units" had the highest rate of positive responses, and "Staffing" had the lowest rate. Emergency units showed more negative results than the other two units.

CONCLUSIONS

Safety incidents are not always reported due to fear of punishment, reflecting a lack of positive safety culture. It is necessary to design and implement strategies that promote a positive culture to avoid punitive responses and apply and evaluate these changes.

Treating mental health crises at home: Patient satisfaction with home nursing care

WHAT IS KNOWN ON THE SUBJECT?: Most studies have focused on whether hospital admissions have been reduced by the introduction of crisis services, rather than focusing on how these services are employed. Research has also shown that home assistance decreases costs and increases the level of patient satisfaction, thereby being more efficient in terms of the cost/effectiveness ratio than is traditional hospital care. Patient satisfaction with nursing care has long been identified as a key element of quality of care; however, satisfaction with nursing care among patients and families receiving crisis resolution at home has not been studied yet. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: There is limited research on patient satisfaction with CRHTTs. This study provides new insights and data including that on relationships between patient satisfaction and the teams' attention to person-centred mental health care. The difference between this study and other studies on patient satisfaction with crisis resolution home treatment teams is that this study focused on patients' and families' satisfaction with the nursing care provided by crisis resolution home treatment teams rather than with the general service provided. This study is the first of its kind with such a focus. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: This research has both academic and clinical implications. Patients' and their families' satisfaction with nursing care is an integral aspect for evaluating mental health services, and this is especially important regarding services provided by crisis resolution home treatment teams because such teams are currently being introduced in countries such as Spain. Closely examining patients and families' satisfaction with nursing care can also foster improvements in current practices. Nurses in crisis teams might need to focus on equalizing power relations, which the data gathered in this study suggests is most important to patient satisfaction. ABSTRACT: Introduction Crisis resolution home treatment teams (CRHTT) provide short-term, intensive home treatment to people experiencing mental health crises. Patient satisfaction has long been identified as a key element of quality of care; however, satisfaction with nursing care as part of this service has not been studied yet. Aim To assess patients' and their families' satisfaction with the nursing care provided through a home care program offered by a hospital in Catalonia which administers person-centred care. Method A mixed methods research design was conducted. A cross-sectional study including quantitative survey data and qualitative interview data with a phenomenological focus was conducted. Results Twenty interviews were conducted. Patients and relatives reported high satisfaction that seems to be related to the person-centred nature of the care. Discussion The findings provide new insights, including how home treatment tends to equalize power relations between nurses and patients/the patient's family members, and how nurses increase sensitivity when focusing on service users' needs and priorities, leading to high patient and family satisfaction. Implications for practice This research has both academic and clinical implications. It highlights what mental health patients and their families value most about home care and interactions with nurses, and also drives improvements in current practices.

Mapping nursing practices in rehabilitation units in Spain and the United Kingdom: A multiple case study

Because of the crisis in the health sector with few employment opportunities, many Spanish nurses are looking for professional development abroad. No studies have mapped nursing practices across Europe. The aim of this research was to provide a comprehensive approach to understand nursing practices and features of the context in Spain and the United Kingdom within the rehabilitation unit and to discuss those practices from a patient safety point of view. Multiple case study design with thematic analysis was applied in this study. The methods for data collection were in-depth interviews, nonparticipant observations, and document analysis. Results were classified into six categories: resources, techniques and nursing procedures, patients' personal care, health education, documentation task, and attitudes and communication skills. This study concludes that differences exist between nursing practices despite both countries having similar nursing competences. In addition, the UK unit has a positive safety culture, recognizes that mistakes happen, and applies more barriers to avoid them. The study provides valuable information to help the decision-making process for Spanish nurses considering working in the UK.

Patient safety culture in Hungarian hospitals

PURPOSE

The Hospital Survey on Patient Safety Culture (HSOPSC) is a rigorously designed tool for measuring inpatient safety culture. The purpose of this paper is to develop a cross-cultural HSOPSC for Hungary and determine its strengths and weaknesses.

DESIGN/METHODOLOGY/APPROACH

The original US version was translated and adapted using existing guidelines. Healthcare workers (n=371) including nurses, physicians and other healthcare staff from six Hungarian hospitals participated. Answers were analyzed using exploratory factor analyses and reliability tests.

FINDINGS

Positive responses in all dimensions were lower in Hungary than in the USA. Half the participants considered their work area "acceptable" regarding patient safety. Healthcare staff worked in "crisis mode," trying to accomplish too much and too quickly. The authors note that a "blame culture" does not facilitate patient safety improvements in Hungary.

PRACTICAL IMPLICATIONS

The results provide valuable information for promoting a more positive patient safety culture in Hungary and for evaluating future strategies to improve patient safety.

ORIGINALITY/VALUE

Introducing a validated scale to measure patient safety culture in Hungary improves healthcare quality.