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We aim to study the the reliability and factorial structure of the Postpartum Bonding Questionnaire (PBQ)administered through two different formats, offline (paper-and-pencil) and online. We also compared clinical, obstetrical, reproductive, and psychopathological variables related to poor mother infant bonding (MIB). A cross-sectional study was conducted on 1,269 mothers. The offline group included 812 women who attended a 40-day postpartum clinical appointment. The online group consisted of 457 women recruited during admission for delivery who volunteered to carry out the online protocol 40 days postpartum. All the participants individually completed the PBQ, the Edinburg Postnatal Depression Scale (EPDS) and other clinical and sociodemographic variables. The 4-factor solution proposed in the PBQ and its Spanish validation showed good model fit for both samples. Online participants reported higher levels of stress, depressive symptoms, and poor bonding, specifically on PBQ scores and the Rejection and Anger subscales. No differences were found in both samples regarding the type of statistical associations between PBQ and sociodemographic, reproductive, obstetric and psychological outcomes. Online assessment may be an appropriate option for detecting possible alterations in MIB due to the reduction of desirability bias, the increased perception of anonymity, and being a more cost-effective method. [ABSTRACT FROM AUTHOR]

Aim: To examine the influence of health care provider's communication skills on the quality of care perceived by Emergency Department patients. Background: Communication between patients and health care providers in the context of Emergency Department is challenging and can potentially have a negative impact on the quality of care perceived by patients. Design Cross‐sectional descriptive study conducted in the Emergency Department at the University Clinical Hospital Virgen de la Arrixaca of Murcia, Spain. Method: Data were collected from 6 to 9 June 2016. Different instruments were used to evaluate the perception of patients on the communication skills and quality of care at the Emergency Department. Results: The sample was composed of 200 patients, with an average age of 44.1 (SD = 18.3), of which 106 (53%) were men. The multiple linear regression analysis showed the association between communication skills (respect, problem solving, and nonverbal communication) and age with the quality of care perceived by the patients. Conclusions: We found that the communication skills of the health care providers were explanatory variables of the quality of care perceived in an Emergency Department. SUMMARY STATEMENT: What is already known about this topic? The needs of patients and families seeking emergency care differ from those of other care settings.Patient‐health care provider communication in an Emergency Department are a true challenge.Effective communication between emergency professionals and patients/family has been described as a fundamental component of health care. What this paper adds? Health care provider communication skills are explanatory for the quality perceived by Emergency Department patients.Respect, problem solving, and nonverbal aspects are explanatory for the quality of care in an Emergency Department. The implications of this paper: Humanized care, in which patients feel listened to and respected, and which is concerned about their health problems, could increase the quality of care perceived in the Emergency Department.Health care providers in Emergency Departments should be encouraged to increase their level of communication skills. [ABSTRACT FROM AUTHOR]

Accessible summary: What is known on the subject?: AHDs in mental health are fundamental tools in advance care planning processes. It is an important method for involving mental healthcare users in clinical decisions and in providing effective healthcare based around user preferences.AHDs can be applied in situations in which the person may forfeit their legal capacity, according to the Convention on the Rights of Persons with Disabilities.However, the use of AHDs as described above is not yet a reality in Spain. What the paper adds to existing knowledge?: The present study surveys the knowledge and attitudes of mental healthcare providers towards AHDs in clinical practice.Although providers had a moderate–low level of knowledge about AHDs, they presented positive attitudes towards them. What are the implications for practice?: The use of AHDs in mental healthcare practice poses challenges to the Spanish mental healthcare system. Acquiring up‐to‐date data on the knowledge and attitudes of providers towards AHDs allows organizations to address aspects of their service that require reinforcement. This data could also be used by other countries just starting to use AHDs, as an initial step towards supporting the implementation of a multistage intervention process.More in‐depth training for providers would help improve their competence to implement or honour the statements set out in AHDs, the related legal and ethical issues, and liability issues related to their implementation.The Spanish mental healthcare system requires structural changes so that providers can embrace new ways of relating to users and to organize partnerships and a continuity of care centred on user preferences. Introduction: Advance healthcare directives (AHDs) in mental health offer important information regarding service users' preferences. However, whether AHDs are truly understood by providers is questionable. Aim: To survey the knowledge and attitudes of mental health professionals towards AHDs and examine any associations with sociodemographic and occupational variables. Method: We cross‐sectionally surveyed the knowledge and attitudes of 113 mental health professionals by using two validated questionnaires. Results: Participants showed very positive attitudes and high levels of knowledge about the conceptual definition and application of AHDs in clinical practice but their knowledge of the legalities, procedure and registration of AHDs was poor. Working in a community, having a career specializing in mental health or having personally signed an AHD was associated with enhanced knowledge about them. Moreover, female sex or employment as an auxiliary nursing‐care technician was associated with stronger positive attitudes. Discussion: Legal and structural changes will be needed to implement AHDs in Spain and to promote competence among healthcare providers in order to include AHDs in everyday practice. Implications for practice: The Spanish mental healthcare system requires legal and structural changes and must improve healthcare providers' competence in AHDs before they are implemented. [ABSTRACT FROM AUTHOR]

The hardy personality or hardiness concept is defined in scientific papers as a personal resource to lessen the negative effects of stressful events on health and to protect it from job strain. Although it is common to find studies on the assessment of this concept in different occupational samples, research in police officers is scarce (even though officers are exposed to stressful events on a daily basis). Moreover, the lack of methodological rigor in the assessment of hardiness promotes the accomplishment of studies that establish the proper use of assessment instruments. The objective of this article is to determine the psychometric characteristics of the Occupational Hardiness Questionnaire (OHQ) n a sample of Spanish police officers. This is a cross-sectional study with 212 officers from Madrid, Spain. Descriptive analysis, correlations, confirmatory factor analysis, and regression analysis were performed. The results showed appropriate validity and reliability, with values for Cronbach's alpha ranging between .81 and .87. As a main conclusion, it can be said that the instrument can be recommended for the assessment of personality hardiness; in addition, its proper application in police officers is confirmed. [ABSTRACT FROM AUTHOR]

Aims To report a systematic review of the psychometric properties of self-report instruments to identify the symptoms of anxiety in pregnancy to help clinicians and researchers select the most suitable instrument. Background Excessive anxiety in pregnancy is associated with adverse birth outcomes, developmental and behavioural problems in infants and postnatal depression. Despite recommendations for routine psychological assessment in pregnancy, the optimal methods to identify anxiety in pregnancy have not been confirmed. Design Psychometric systematic review. Data sources A systematic literature search of the multiple databases (1990-September 2014). Review methods Identification of self-report instruments to measure anxiety in pregnancy using COSMIN guidelines to assess studies reporting a psychometric evaluation of validity and reliability. Results Thirty-two studies were included. Studies took place in the UK, Australia, Belgium, Canada, Germany, Italy, Scandinavia, Spain and the Netherlands. Seventeen different instruments were identified. Measures of validity were reported in 19 papers and reliability in 16. The overall quality of the papers was rated as fair to excellent using the COSMIN checklist. Only one paper scored excellent in more than one category. Conclusion Many instruments have been adapted for use in different populations to those for which they were designed. The State Trait Anxiety Inventory, Edinburgh Postnatal Depression Scale and the Hospital Anxiety and Depression Scale have been tested more frequently than other instruments, yet require further assessment to confirm their value for use in pregnancy. [ABSTRACT FROM AUTHOR]

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

Purpose: This paper aims to estimate the comorbidity of mental disorders and chronic physical conditions and to describe the impact of these conditions on health-related quality of life (HRQoL) in a sample of older primary care (PC) attendees by gender.Methods: Cross-sectional survey, conducted in 77 PC centres in Catalonia (Spain) on 1192 patients over 65 years old. Using face-to-face interviews, we assessed HRQoL (SF-12), mental disorders (SCID and MINI structured clinical interviews), chronic physical conditions (checklist), and disability (Sheehan disability scale). We used multivariate quantile regressions to model which factors were associated with the physical component summary-short form 12 and mental component summary-short form 12.Result: The most frequent comorbidity in both men and women was mood disorder with chronic pain and arthrosis. Mental disorders mainly affected 'mental' QoL, while physical disorders affected 'physical' QoL. Mental disorders had a greater impact on HRQoL than chronic physical conditions, with mood and adjustment disorders being the most disabling conditions. There were some gender differences in the impact of mental and chronic physical conditions on HRQoL. Anxiety disorders and pain had an impact on HRQoL but only in women. Respiratory diseases had an effect on the MCS in women, but only affected the PCS in men.Conclusions: Mood and adjustment disorders had the greatest impact on HRQoL. The impact profile of mental and chronic physical conditions differs between genders. Our results reinforce the need for screening for mental disorders (mainly depression) in older patients in PC. [ABSTRACT FROM AUTHOR]

Background As future health educators, nursing and physiotherapy students will play an essential role in the prevention of smoking. Aim To determine the prevalence of smoking among students and to analyse their knowledge of and attitudes towards smoking. Method This was a descriptive cross-sectional study using an anonymous questionnaire and conducted in a Spanish Faculty of Health Sciences in 2013. Findings 247 nursing and physiotherapy students (82.33%) participated in the study. The global prevalence of smoking (18.2%) was lower compare with the general population group of the same age. We have observed statistical significance in relation to previous studies. Nursing and physiotherapy students showed a low nicotine dependence. We found a lack of knowledge about the harmful effects of cigarette consumption on health. Statistically significant results were also found in relation to degree courses (p < 0.01) as regards students' opinions about their knowledge of strategies and methods to help patients stop smoking. Conclusion Most students started smoking before commencing their university studies; consequently, interventions should focus on cessation programmes. An analysis of university curricula leading to the award of a degree in the health sciences could serve to identify educational deficiencies in order to implement the necessary modifications. Implications for nursing and health policy This paper presents an update in tobacco use characteristics amongst nursing and physiotherapy students. Those results have showed a need to improve the curricula in order to develop specific programmes to improve knowledge, attitudes and beliefs. Measures to prevent smoking must be taken at school. [ABSTRACT FROM AUTHOR]

Background: Variation in prescription of antibiotics in primary care can indicate poor clinical practice that contributes to the increase of resistant strains. General Practitioners (GPs), as a professional group, are expected to have a fairly homogeneous prescribing style. In this paper, we describe variation in prescribing style within and across groups of GPs from six countries. Methods: Cross-sectional study with the inclusion of 457 GPs and 6394 sore throat patients. We describe variation in prescribing antibiotics for sore throat patients across six countries and assess whether variation in “prescribing style” - understood as a subjective tendency to prescribe - has an important effect on variation in prescription of antibiotics by using the concept of prescribing style as a latent variable in a multivariable model. We report variation as a Median Odds Ratio (MOR) which is the transformation of the random effect variance onto an odds ratio; Thus, MOR = 1 means similar odds or strict homogeneity between GPs' prescribing style, while a MOR higher than 1 denotes heterogeneity in prescribing style. Results: In all countries some GPs always prescribed antibiotics to all their patients, while other GPs never did. After adjusting for patient and GP characteristics, prescribing style in the group of GPs from Russia was about three times more heterogeneous than the prescribing style in the group of GPs from Denmark - Median Odds Ratio (6.8, 95% CI 3.1;8.8) and (2.6, 95% CI 2.2;4.4) respectively. Conclusion: Prescribing style is an important source of variation in prescription of antibiotics within and across countries, even after adjusting for patient and GP characteristics. Interventions aimed at influencing the prescribing style of GPs must encompass context-specific actions at the policy-making level alongside GP-targeted interventions to enable GPs to react more objectively to the external demands that are in place when making the decision of prescribing antibiotics or not. [ABSTRACT FROM AUTHOR]

Aim: To provide initial data regarding country‐specific evidence of workplace violence towards nurses working within the health sector in five European countries. Methods: This is a descriptive and cross‐sectional pilot study, conducted in June 2016. The sample consisted of 260 nurses working in selected health care settings in five participating countries (Poland, Czech Republic, Slovakia, Turkey, and Spain). The questionnaire used was adapted from the International Labour Office/International Council of Nurses/World Health Organisation/Public Services International Workplace Violence in the Health Sector Country Case Study—Questionnaire. Results: A large number of participants confirmed that they had been physically attacked or verbally abused in the workplace in the last 12 months. In most cases, the physical and verbal abuse was inflicted by patients and to a lesser degree by relatives of patients, staff members, or managers/supervisors. In the majority of cases, no action was taken to investigate the causes of the incidents. In most cases, participants believed there was no point in reporting the incidents. However, the reasons for not reporting or discussing incidents of workplace violence varied depending on the country. Conclusion: Workplace violence towards nurses is a serious problem internationally, and violence prevention strategies need to be implemented. SUMMARY STATEMENT: What is already known about this topic? The nursing profession is at high risk of workplace violence. However, the problem seems to be severely underreported.What this paper adds? A better understanding of the problem in the social and cultural context, together with data fill information gaps regarding workplace violence in selected European countries.The implications of this paper: On the basis of the data obtained, prevention programmes and recommendations can be established and implemented in nurses' daily lives. Evaluation can also be conducted of the effectiveness of existing programmes and standards. [ABSTRACT FROM AUTHOR]